What Is Exparel? Uses, Dosage, and What You Need to Know in 2026

Exparel is a prescription injectable medication used to control pain after surgery. Unlike standard local anesthetics that wear off in a few hours, Exparel is specially formulated to provide pain relief for up to 72 hours from a single injection — without opioids. It's made by Pacira BioSciences and has been FDA-approved since 2011.

This guide covers everything you need to know about Exparel: what it is, how it works, who it's approved for, typical dosing, and what to expect if your surgeon uses it.

What Is Exparel?

Exparel's full generic name is bupivacaine liposome injectable suspension. The active drug is bupivacaine, a well-established local anesthetic that has been used in medicine since the 1960s. What makes Exparel unique is its delivery system: the bupivacaine is encapsulated inside tiny fat-based particles called multivesicular liposomes, using Pacira's proprietary DepoFoam technology.

These liposomal particles are shaped like a honeycomb, with multiple internal compartments that each contain small amounts of bupivacaine. After the drug is injected, the particles slowly break down and release bupivacaine gradually — providing sustained analgesia rather than a burst-and-fade effect.

What Is Exparel Approved to Treat?

The FDA has approved Exparel for the following uses:

• Single-dose wound infiltration — for postoperative local analgesia in patients 6 years and older (approved October 2011; pediatric extension approved 2021)
• Interscalene brachial plexus nerve block — for postoperative regional analgesia in adults after shoulder surgery (approved April 2018)
• Sciatic nerve block in the popliteal fossa — for postoperative analgesia in adults (approved 2023)
• Adductor canal block — for postoperative analgesia in adults (approved 2023)

Common Surgical Uses

Exparel is used across a wide range of procedures where postoperative pain is a significant concern and where reducing opioid use is a priority:

• Total knee replacement (TKA)
• Total hip replacement (THA)
• Shoulder arthroplasty and rotator cuff repair
• Colectomy and colorectal procedures
• Hernia repair (inguinal and ventral)
• Breast augmentation and reconstruction
• Thoracic surgeries (VATS, sternotomy)
• Hemorrhoidectomy and bunionectomy

Exparel Dosage and Administration

Exparel is available as a 13.3 mg/mL (1.3%) injectable suspension:

• Standard adult dose: Up to 266 mg (one 20 mL vial) — this is the maximum single dose
• Pediatric dose (6+ years): Lower doses based on body weight and procedure
• Frequency: Single dose only — do not repeat within 72 hours
• Route: Infiltration (injected into soft tissue at surgical site) or perineural (injected near a nerve for nerve blocks). Never IV, intrathecal (spinal), or intra-articular (into a joint).

The dose can be diluted with normal saline to increase the volume for wider wound coverage, but it must not be diluted with water or other hypotonic solutions (which destroy the liposomes).

Who Should NOT Receive Exparel?

Exparel is contraindicated in:

• Obstetrical paracervical block anesthesia (pregnant women in labor)
• Children under 6 years for infiltration (safety not established)
• Patients with known hypersensitivity to bupivacaine or amide-type local anesthetics

Caution is warranted in patients with liver disease, kidney disease, and the elderly (higher risk of systemic toxicity).

Is Exparel a Controlled Substance?

No. Exparel is not a controlled substance and is not scheduled by the DEA. It does not carry addiction potential. This is one of its key advantages in surgical pain management — it provides extended pain relief without the risks of opioid dependence.

How to Get Access to Exparel

Talk to your surgeon at your preoperative appointment. If they don't use it routinely, ask why and whether it would be appropriate for your procedure. For help locating other prescriptions that may be part of your post-surgical care, medfinder is a paid service that calls pharmacies near you to check which ones have your medications in stock and texts you the results.

Want more detail on the science? See: How Does Exparel Work? Mechanism of Action Explained in Plain English.

And: Exparel Side Effects: What to Expect and When to Call Your Doctor.