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Non-Opioid Alternative Helps Seniors Avoid Opioids After Surgery

While healthcare providers have various ways to treat pain after surgery, they don’t always provide adequate pain relief. Among seniors in particular, uncontrolled pain can lead to poor outcomes. Opioids, which are often used to manage pain, can contribute to poor outcomes as well by potentially causing nausea, vomiting, constipation, delirium, and falls.1

“Many of my older patients don’t want opioids because of their potential risks,” said Alan Rechter, M.D., a Houston-based orthopaedic surgeon at Orthopaedic Associates LLP. “Medications often affect people more strongly as they age, putting patients 65 and older at an even higher risk of experiencing severe side effects from opioids, such as delirium, urinary retention, excessive drowsiness, and slow and ineffective breathing.”

In 2018, a greater proportion of seniors (25 percent) filled at least one opioid prescription compared to any other age group.2 Yet opioids also pose a risk of addiction, and recent data from the Centers for Disease Control and Prevention (CDC) shows drug overdose deaths at an all-time high, causing many patients to remain wary of such prescriptions.3

ZYNRELEF® (bupivacaine and meloxicam) is a new non-opioid option approved by the U.S. FDA for use in adults to reduce pain for up to three days after foot and ankle, small-to-medium open abdominal, and lower extremity total joint arthroplasty surgical procedures. It has been shown to significantly reduce or eliminate opioid use in many patients following surgery. In those aged 65 years and older, a recent analysis showed that 58 percent of bunion removal and 87 percent of hernia repair patients receiving ZYNRELEF required no opioids to manage their postoperative pain through three days.1

“I received ZYNRELEF after my double hernia repair and was pleasantly surprised by the lack of pain following my surgery,” said Robert Cooper, 70 years old, who saw Timothy Beard, M.D., a general surgeon at Summit Medical. “I was pleased to be able to avoid opioids following surgery and only needed ibuprofen to help manage the pain. I felt little pain during my recovery and was able to resume my daily activities more quickly than I expected.”

“Some of my patients used to tell me that they were in miserable pain for the first few days after knee replacement surgery, but now that we’re using ZYNRELEF, I haven’t been hearing that from them,” Dr. Rechter added. “ZYNRELEF was also recently approved for additional procedures, and I’m excited to provide a similar level of pain relief and comfort to my patients receiving total hip replacements. I encourage anyone who might be facing surgery to talk to their doctor or visit to learn more.”

Important Safety Information for Patients

ZYNRELEF contains an NSAID (non-steroidal anti-inflammatory drug), a type of medicine which:

  • Can increase the risk of a heart attack or stroke that can lead to death.This riskincreases with higher doses and longer use of an NSAID.

  • Cannot be used during heart bypass surgery.

  • Can increase the risk of gastrointestinal bleeding, ulcers, and tears.

ZYNRELEF should also not be used:

  • if you are allergic to any component of ZYNRELEF, similar local anesthetics, aspirin or other NSAIDs (such as ibuprofen or naproxen), or have had an asthma attack, hives, or other allergic reaction after taking any of these medicines.

  • as a paracervical block, during childbirth.

The most common side effects of ZYNRELEF are constipation, vomiting, and headache.

The medicines in ZYNRELEF (a local anesthetic and an NSAID) may affect the nervous and cardiovascular system; may cause liver or kidney problems; may reduce the effects of some blood pressure medicines; should be avoided if you have severe heart failure; may cause adverse effects on cartilage; may cause a rare blood disorder, or life-threatening skin or allergic reactions; may harm your unborn baby if received at 20 weeks of pregnancy or later; and may cause low red blood cells (anemia).

Tell your healthcare provider about all your medical conditions and about all the medicines you take including prescription or over-the-counter medicines, vitamins, or herbal supplements to discuss if ZYNRELEF is right for you.

Talk to your healthcare provider for medical advice about side effectsReport side effects tHeron at 1-844-437-6611 or to FDA at 1-800-FDA-1088 or

The information provided here is not comprehensivePlease see full Prescribing Information, including Boxed Warning.



1- Yip, T., Hu, J., Hawn, P. S., Yamamoto, A., & Oderda, G. (2021). HTX-011 effectively reduces postoperative pain intensity and opioid use in the elderly. Pain management, 10.2217/pmt-2021-0043. Advance online publication.

2- Centers for Disease Control and Prevention. (2019). 2019 Annual Surveillance Report of Drug-Related Risks and Outcomes. National Center for Injury Prevention and Control.

3- Ahmad, F.B., Rossen, L.M., Sutton, P. (2021). Provisional drug overdose death counts. National Center for Health Statistics.