bupivacaine and meloxicam

N01BB59

Forms & Strengths

Injectable suspension: bupivacaine 5 mg/mL and meloxicam 0.6 mg/mL in a 20 mL single-dose vial

Adult Dosing

Postoperative administration: 20 mL (100 mg bupivacaine / 12 mg meloxicam) administered via instillation into the surgical site as directed for targeted postsurgical analgesia

Pediatric Dosing

Safety and efficacy in pediatric patients below the age of 18 have not been established

Indications

Initiation of postsurgical analgesia for up to 72 hours following specific surgical procedures (e.g., bunionectomy, total knee arthroplasty)

Mechanism of Action

Bupivacaine: Local anesthetic of the amide class that blocks nerve impulse propagation by inhibiting sodium ion influx through voltage-gated sodium channels in neuronal membranes
Meloxicam: Preferential COX-2 inhibitor nonsteroidal anti-inflammatory drug (NSAID) that reduces prostaglandin synthesis, providing localized and systemic anti-inflammatory and analgesic effects

Contraindications

Known hypersensitivity to local anesthetics of the amide type, meloxicam, or other NSAIDs
History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
Use in obstetric paracervical block anesthesia
Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery

Adverse Reactions

Drug Interactions

Concomitant use with other local anesthetics or structurally related amide-type local anesthetics increases the risk of systemic toxicity
Co-administration with systemic NSAIDs or corticosteroids increases the risk of gastrointestinal ulceration or bleeding
May attenuate the antihypertensive effects of ACE inhibitors, angiotensin receptor blockers, and diuretics
May increase plasma lithium and methotrexate levels when used concurrently with systemic NSAIDs

Curated Content: Needs Vetting Before Put to Clinical Use