Pearl of daily medication: bupivacaine and meloxicam (Zynrelef)
Zynrelef is indicated in adults for soft tissue or periarticular instillation to provide post-surgical analgesia for up to 72 hours after total foot and ankle arthroplasty, open abdominal small to medium height and lower limbs.
Pearl of the day medication: Bupivacaine and meloxicam (Zynrelef)
Indication: Zynrelef contains bupivacaine, an amide-type local anesthetic, and meloxicam, a nonsteroidal anti-inflammatory drug (NSAID). It is indicated in adults for soft tissue or periarticular instillation to produce post-surgical analgesia for up to 72 hours following surgical procedures for total foot and ankle arthroplasty, open abdomen of small medium height and lower limbs.
- Dosage: The recommended dose of Zynrelef is up to a maximum dose of 400 mg/12 mg (14 mL).
- Dosage forms: Zynrelef extended-release solution is available in 4 strengths in single-dose glass vials: 400 mg bupivacaine and 12 mg meloxicam; 300 mg of bupivacaine and 9 mg of meloxicam; 200 mg of bupivacaine and 6 mg of meloxicam; 60 mg of bupivacaine and 1.8 mg of meloxicam.
- Adverse events: The most common adverse effects (incidence ≥ 10%) are constipation, vomiting and headache.
- Action mechanism: Local anesthetics block the generation and conduction of nerve impulses presumably by increasing the threshold for electrical excitation in the nerve, slowing the propagation of nerve impulses and reducing the rate of rise of the action potential. Meloxicam is a potent inhibitor of prostaglandin synthesis in vitro. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in pain induction in animal models.