Bupivacaine Hydrochloride and Voltaren Gel

• 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: diclofenac topical
• Dosage Forms: gel
• Other Brand Names: Pennsaid, Solaraze, Voltaren Topical, DST Plus Pak, Diclozor, Voltaren, Flector Patch, Klofensaid II, Vopac MDS, Xrylix, Flector, Licart

Voltaren Gel contains diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Diclofenac works by reducing substances in the body that cause pain and inflammation.

Voltaren Gel is used to treat joint pain caused by osteoarthritis in the hands, wrists, elbows, knees, ankles, or feet.

Voltaren Gel may not be effective in treating arthritis pain elsewhere in the body.