bupivacaine + meloxicam

Zynrelef (bupivacaine and meloxicam) is an extended-release, fixed-dose combination of the amide local anesthetic bupivacaine and the nonsteroidal anti-inflammatory drug (NSAID) meloxicam. Developed by Heron Therapeutics, it is specifically formulated for needle-free instillation into the surgical site to provide analgesia for up to 72 hours post-surgery. The mechanism of action is synergistic: bupivacaine blocks voltage-gated sodium channels to prevent the generation and conduction of nerve impulses, while meloxicam inhibits cyclooxygenase-2 (COX-2) to reduce prostaglandin synthesis and local inflammation. This reduction in inflammation helps maintain a higher local pH, which enhances the efficacy of bupivacaine. The Allegheny Singer Research Institute has conducted prospective cohort studies evaluating its use in robot-assisted total knee arthroplasty (RATKA) to assess its impact on postoperative pain and opioid consumption.

Brand names

Zynrelef

Other names

bupivacaine/meloxicam extended-releaseHTX-011HTX011HTX 011