Bupivacaine Hydrochloride and Tisagenlecleucel Intravenous

• 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: tisagenlecleucel
• Dosage Forms: n.a.
• Other Brand Names: Kymriah

Tisagenlecleucel injection is used to treat B-cell acute lymphoblastic leukemia (ALL) that has come back a second or later time or after other medicines did not work well in patients up to 25 years of age. Leukemia is a type of cancer where the body makes abnormal white blood cells.

Tisagenlecleucel injection is also used to treat diffuse large B-cell lymphoma (DLBCL) that has come back a second or later time or after at least 2 other medicines did not work well. Lymphoma is a type of cancer where the body makes abnormal white blood cells.

Tisagenlecleucel injection is an antineoplastic (cancer) medicine that is made from your own white blood cells. These cells are reprogrammed to contain a chimeric antigen receptor (CAR) to identify the cancer cells from the normal cells and kill them. Before you begin treatment, talk to your doctor about the benefits of tisagenlecleucel as well as the possible risks of receiving it.

Tisagenlecleucel is available only under a restricted distribution program called Kymriah® REMS (Risk Evaluation and Mitigation Strategy) Program.