ZYNRELEF

Bupivacaine 29.25mg/1mL, Meloxicam 0.88mg/1mL, Solution for injection, Extended Release

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: Do not drink take Grapefruit juice or grapefruit-containing foods and Meloxicam together without talking to your health care professional. Side effects from Meloxicam may get worse if you take these together. Contact your health care provider immediately if you experience upset stomach, heartburn, nausea, vomiting, ulcers, or any unusual bleeding. Signs of bleeding may include bloody or black, tarry stools; red or dark-brown urine; spitting up blood or brown material that looks like coffee grounds; red spots on the skin; unusual bruising or bleeding from the eye, gums, or nose.

· Notes for Professionals: Consider a meloxicam dose reduction and monitor for adverse reactions if coadministration with grapefruit juice is necessary. Concurrent use may increase meloxicam exposure. Concurrent use may increase meloxicam exposure. Meloxicam is a CYP2C9 substrate and grapefruit juice is a moderate CYP2C9 inhibitor.

Bupivacaine 29.25mg/1mL, Meloxicam 0.88mg/1mL, Solution for injection, Extended Release

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication increases the risk of stomach bleeding. Contact your care team right away if you experience bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds.

· Notes for Professionals: Advise patients to avoid alcohol and alcohol-containing products while taking NSAIDs. Concomitant ingestion of alcohol with NSAIDs increases the risk of developing gastric irritation and GI mucosal bleeding. Alcohol is a mucosal irritant and NSAIDs decrease platelet aggregation. Routine ingestion of alcohol and NSAIDs can cause significant GI bleeding, which may or may not be overt. Even occasional concomitant use of NSAIDs and alcohol should be avoided. Chronic alcohol ingestion is often associated with hypoprothrombinemia and this condition increases the risk of bleeding.

Bupivacaine 29.25mg/1mL, Meloxicam 0.88mg/1mL, Solution for injection, Extended Release

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. Smoking while taking this medication increases the risk for stomach bleeding. Contact your care team right away if you experience bloody or black, tar-like stools, or vomiting blood or brown material that looks like coffee grounds.

· Notes for Professionals: Advise patients to avoid smoking tobacco while taking nonsteroidal anti-inflammatory drugs (NSAIDs). Concomitant use of NSAIDs with tobacco smoking may enhance the risk of gastrointestinal side effects, including peptic ulcer and GI bleeding. Patients using tobacco and NSAIDs concurrently should be monitored closely for GI adverse reactions.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>