Exparel (bupivacaine liposome) is a prescription drug used to help reduce pain after surgery. Exparel can cause side effects that range from mild to serious. Examples include nausea and constipation.

Specifically, Exparel is approved for the following uses:

  • as a localized analgesia (pain relief for a small area of your body) for people ages 6 years and older
  • as a nerve block in certain bodily locations in adults

The active ingredient in Exparel is bupivacaine liposome. The drug comes as a liquid solution that’s given as an injection by healthcare professionals.

Keep reading to learn about common, mild, and serious side effects that Exparel can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during Exparel treatment. Examples of the drug’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Exparel. These include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop Exparel treatment unless your doctor recommends it.

Exparel may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.

Serious side effects have been reported with Exparel. These include:

If you develop serious side effects from Exparel, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Exparel, visit MedWatch.

Allergic reaction

For some people, Exparel can cause an allergic reaction, but it’s not clear how often this side effect occurred in the drug’s studies.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Exparel treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Exparel, they may have you switch to a different treatment.

Get answers to some frequently asked questions about Exparel’s side effects.

What’s the Exparel wristband used for?

Your doctor may have you wear an Exparel wristband as a reminder to your healthcare team that you’ve received this injection. The wristband has the date and time you received your dose and is used to help prevent you from receiving more Exparel than your doctor prescribed.

It also helps prevent you from receiving other drugs that may interact with Exparel. Taking other medications that are similar to or interact with Exparel can increase your risk of serious side effects, such as methemoglobinemia.

Talk with your doctor if you have additional questions about the Exparel wristband.

How long does it take before Exparel starts wearing off?

Exparel can help reduce pain during the first few days following surgery. Its effects may last up to 5 days as seen in studies. How long Exparel stays in your system can vary from person to person. Other factors that can affect how long it takes Exparel to wear off include the dose you received and the type of surgery you had.

If you have additional questions about Exparel and what to expect, talk with your doctor.

Learn more about some of the side effects Exparel may cause.

Nausea and vomiting

Nausea and vomiting were common side effects reported in studies of Exparel.

Nausea and vomiting can be due to multiple causes, such as combining Exparel with other medications to reduce pain. Alcohol can also increase the risk of these side effects, since alcohol can cause nausea and vomiting as well.

What might help

To help reduce the risk of nausea and vomiting, try eating smaller, more frequent meals. Eating light, plain foods, such as bread and crackers may also help. If your symptoms are ongoing or bothersome, talk with your doctor right away.

Methemoglobinemia

There is a risk of methemoglobinemia with Exparel use. This condition was reported in people receiving treatments similar to Exparel in studies.

Methemoglobinemia is a blood disorder in which not enough oxygen is delivered to your cells. This may cause symptoms such as:

  • skin color changes, including pale, blue, or gray skin
  • blood color changes, including brown blood
  • headache
  • dizziness
  • confusion
  • shortness of breath

Some factors that can increase your risk of methemoglobinemia when taking this drug include having glucose-6-phosphate dehydrogenase deficiency (G6PD), heart problems, or lung problems.

What might help

Talk with your doctor right away if you experience any of the symptoms listed above. Note that symptoms of methemoglobinemia may be delayed at times. Left untreated, this condition could lead to coma and death.

Keeping track of side effects

During Exparel treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Sharing notes with your doctor will help them learn more about how Exparel affects you. They can then use this information to adjust your treatment plan if needed.

Exparel can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Exparel is a good treatment option for you.

Talk with your doctor about your health history before receiving an Exparel injection. Be sure to tell them if any of the following factors apply to you:

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.