Long-acting Bupivacaine/Local Anesthetics Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Other local anesthetics can have additive effects on the nervous system and heart. Some may also increase the risk of a condition called methemoglobinemia. Some local anesthetics can change how bupivacaine liposomal works when administered with it.

What might happen:

You may develop problems with your nervous system or heart and/or develop methemoglobinemia.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Seek medical help right away if you have any very serious side effects, including: dizziness, drowsiness, slow/shallow breathing, mental/mood changes (such as confusion, nervousness), shaking, seizures, vision changes (such as double/blurred vision), ringing in the ears, fainting, pale/bluish/gray skin, unusual tiredness, shortness of breath, or fast/slow/irregular heartbeat.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Exparel (bupivacaine liposomal) US prescribing information. Pacira Pharmaceuticals, Inc. March 26, 2021.
  • 2.Zynrelef (bupivacaine and meloxicam) US prescribing information. Heron Therapeutics, Inc. December, 2021.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.