Black Box = Zenrelef



















As a pharmacist, we are programmed to go with an alternative compound if a similar has a black box.


Which similar product are you referring? Zynrelef is the ONLY FDA labeled extended release local anesthetic. It is also the ONLY dual acting synergistic combination anesthetic and the ONLY product to prove superior to standard of care bupivacaine for pain control and opioid reduction.

Good point, as a pharmacist you always have to evaluate risk benefits of similar products however Zynrelef has no true comparator at this point. If you really want to compare them take a look at the Pk of the anesthetic itself and determine which has more consistent and reliable release kinetics. (Zynrelef > Exparel) Then take a look at the block box warning and review the literature and ADR reporting networks for any of these events linked to Zynrelef. The black box is a class effect and attached to the label out of necessity as is all other listed side effects for the individual ingredients. (Zynrelef safer than exparel, and more effective.) Seems to be consensus in the literature.