Amide Local Anesthetic

Cyclooxygenase Inhibitors

Nonsteroidal Anti-inflammatory Drug

Arthritis, Rheumatoid

Osteoarthritis

Pain, Postoperative

<section class="Section" data-sectioncode="34089-3"><a name="S11"></a><a name="section-10"></a><p></p><h1>11 DESCRIPTION</h1><p class="First">ZYNRELEF (bupivacaine and meloxicam) extended-release solution, for soft tissue or periarticular instillation use, contains bupivacaine, an amide local anesthetic, and meloxicam, a nonsteroidal anti-inflammatory drug (NSAID).</p><div class="Section" data-sectioncode="42229-5"><a name="section-10.1"></a><p></p><p class="First"><span class="Underline">Bupivacaine</span></p><p>Bupivacaine is a white to off-white crystalline powder, crystals, or granules. The chemical name for bupivacaine is (±)-1-butyl-<span class="Italics">N</span>-(2,6-dimethylphenyl)piperidine-2-carboxamide, and its empirical formula is C<span class="Sub">18</span>H<span class="Sub">28</span>N<span class="Sub">2</span>O. The molecular weight of bupivacaine is 288.4. Bupivacaine is sparingly soluble in water and freely soluble in alcohol. Bupivacaine has a log P<span class="Sub">ow</span> of 1.82 and a pKa of 8.1. Bupivacaine has the following structural formula:</p><div class="Figure"><img alt="Chemical Structure" src="zynrelef-02.jpg"/></div></div><div class="Section" data-sectioncode="42229-5"><a name="section-10.2"></a><p></p><p class="First"><span class="Underline">Meloxicam</span></p><p>Meloxicam is a pale yellow solid, practically insoluble in water, with higher solubility observed in strong acids and bases. It is very slightly soluble in methanol. Meloxicam has an apparent partition coefficient (log P)<span class="Sub">app</span> = 0.1 in <span class="Italics">n</span>-octanol/buffer pH 7.4. Meloxicam has pKa values of 1.1 and 4.2. Meloxicam is chemically designated as 4-hydroxy-2-methyl-<span class="Italics">N</span>-(5-methyl-2-thiazolyl)-2<span class="Italics">H</span>-1,2-benzothiazine-3-carboxamide-1,1-dioxide. The molecular weight is 351.4. Its empirical formula is C<span class="Sub">14</span>H<span class="Sub">13</span>N<span class="Sub">3</span>O<span class="Sub">4</span>S<span class="Sub">2</span> and it has the following structural formula:</p><div class="Figure"><img alt="Chemical Structure" src="zynrelef-03.jpg"/></div><p>ZYNRELEF is a sterile, clear, pale yellow to yellow, viscous liquid provided in single-dose vials (10 mL or 20 mL) for instillation into the surgical site. Each mL of the solution contains active ingredients bupivacaine 29.25 mg and meloxicam 0.88 mg; and inactive ingredients tri(ethylene glycol) poly(orthoester) (730 mg), triacetin (293 mg), dimethyl sulfoxide (117 mg), and maleic acid (0.59 mg).</p></div></section>

ZYNRELEF

bupivacaine

7 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection [Zynrelef]

14 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection [Zynrelef]

10.5 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection [Zynrelef]

bupivacaine / meloxicam

2.3 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection [Zynrelef]

14 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection

10.5 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection

2.3 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection

7 ML bupivacaine 29.3 MG/ML / meloxicam 0.88 MG/ML Injection

Zynrelef

meloxicam

Psoriasis (PsO)

Psoriatic Arthritis (PsA)

Ankylosing Spondylitis (AS)

Nonradiographic Axial Spondyloarthritis

Taltz

Juvenile Idiopathic Arthritis

Hidradenitis Suppurativa (HS)

Cosentyx

Siliq

Tremfya

Crohn's Disease (CD)

Ulcerative Colitis (UC)

Stelara

Skyrizi

Ilumya

Migraine

Cluster Headache

Migraine Prevention

Emgality

Qulipta

Acute Migraine

Ubrelvy

Nurtec ODT

Vyepti

Aimovig

Ajovy

Breast Cancer: HR+ (HER2-)

Verzenio

Ibrance

Kisqali

Atopic Dermatitis (Eczema)

Cibinqo

Eucrisa

Asthma (injectable)

Asthma OCS Dependent

Nasal Polyposis

Eosinophilic Esophagitis (EoE)

Prurigo Nodularis

Dupixent

Opzelura

Adbry

NSCLC ALK+ OR ROS1+ Disease

Lorbrena

Alecensa

Alunbrig

NSCLC cMET Mutation

Xalkori

Rheumatoid Arthritis (RA)

Xeljanz

Uveitis

Graft Versus Host Disease (GVHD)

Orencia

COVID-19 Treatment

Alopecia Areata

Olumiant

Multiple Sclerosis (MS)

Secondary Progressive Multiple Sclerosis

Zeposia

Rinvoq

Entyvio

Report Adverse Event 

Prescribing Information 

Pharmacy List 

Reimbursement & Billing Guide 

How to Order Zynrelef

Reimbursement Information 

Coverage Authorization Request 

Coverage Authorization Appeals 

Letter of Medical Necessity 

Insurance Verification & Enrollment Form 

Enroll in Patient Savings Program 

Other HCP Resources 

Specialties: Anesthesiology

Specialties: General Surgery

Specialties: Orthopedic Surgery 

Instructions For Use: Postsurgical Analgesia 

Patient Brochure 