Bupivacaine Hydrochloride and Human papillomavirus (HPV) vaccine, 9-valent

• Generic Name: bupivacaine
• Dosage Forms: n.a.
• Other Brand Names: Marcaine HCl, Marcaine Spinal, Sensorcaine, Sensorcaine-MPF, Sensorcaine-MPF Spinal, Bupivacaine Fisiopharma, Bupivacaine Spinal, Marcaine, Marcaine Preservative Free, P-Care M, ReadySharp Bupivacaine

Local or regional anesthesia or analgesia in surgical, obstetrical, dental, diagnostic, and therapeutic procedures.

Available as conventional bupivacaine hydrochloride preparations with or without epinephrine or as a liposomal injection containing bupivacaine in an aqueous suspension of multivesicular liposomes (Exparel).

Conventional preparations are used for local infiltration and nerve block techniques including peripheral, sympathetic, epidural (including caudal), retrobulbar, and dental block. Do not use 0.75% concentration for obstetrical anesthesia. (See Boxed Warning.) A hyperbaric solution containing 0.75% bupivacaine hydrochloride in 8.25% dextrose is used for spinal anesthesia.

Liposomal bupivacaine (Exparel) is used for local infiltration or interscalene brachial plexus nerve block to provide postsurgical analgesia; safety and efficacy not established for other nerve blocks. Because of possible differences in physiochemical and functional properties, do not use liposomal bupivacaine interchangeably with other bupivacaine-containing preparations.

Local anesthetics should be used as a component of multimodal analgesia (i.e., simultaneous use of a combination of analgesic drugs and techniques that target different mechanisms) in the management of postoperative pain.

Studies comparing relative efficacy of liposomal bupivacaine and conventional bupivacaine hydrochloride for postsurgical analgesia have shown variable results.

Do not use for obstetric paracervical block.

• Generic Name: human papillomavirus vaccine
• Dosage Forms: n.a.
• Other Brand Names: Gardasil 9, Cervarix

Human papillomavirus (HPV) can cause genital warts, cancer of the cervix, anal cancer, and various cancers of the vulva or vagina.

HPV 9-valent vaccine is used in girls and young women ages 9 through 45 to prevent cervical/vaginal/anal cancers or genital warts caused by certain types of HPV.

HPV 9-valent vaccine is also used in boys and young men ages 9 through 45 to prevent anal cancer or genital warts caused by certain types of HPV.

You may receive this vaccine even if you have already had genital warts, or had a positive HPV test or abnormal pap smear in the past. However, this vaccine will not treat active genital warts or HPV-related cancers, and it will not cure HPV infection.

HPV 9-valent vaccine prevents diseases caused only by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. It will not prevent diseases caused by other types of HPV.

The Centers for Disease Control and Prevention (CDC) recommends HPV vaccine for all boys and girls ages 11 or 12 years old. The vaccine is also recommended in teenage boys and girls who have not already received the vaccine or have not completed all booster shots.

Like any vaccine, the HPV 9-valent vaccine may not provide protection from disease in every person.

HPV 9-valent vaccine may also be used for other purposes not listed in this medication guide.