This information is intended for US healthcare professionals.

ANJESO Is the IV Form of Meloxicam

For a Non-Opioid Option in Multimodal Analgesia, Go With ANJESO

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Up to 24 hours pain relief 1,*

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Demonstrated safety and tolerability1

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COX-2 preferential IV NSAID1-3,†

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Once-daily IV push1

Dosing and Administration1

  • ANJESO is dosed once daily, delivered as an IV push over 15 seconds
  • No dose adjustments are necessary in patients >65 years of age with mild renal impairment or mild to moderate hepatic impairment
  • ANJESO can be administered preoperatively, intraoperatively, or postoperatively

How Supplied1

  • Supplied ready to use as a 30 mg/1 mL single-dose vial
  • No reconstitution or refrigeration is required

*When initiating ANJESO, monitor patient pain response. If patient experiences inadequate analgesia during the 24-hour dosing interval, consider adding a short-acting, non-NSAID, immediate-release analgesic.1

The mechanism of action of ANJESO, like other NSAIDs, is not completely understood, but involves inhibition of both COX-1 and COX-2 pathways. COX-2 activity is based on in vitro data, not clinical trial data.1

COX-1, cyclooxygenase 1; COX-2, cyclooxygenase 2; IV, intravenous; NSAID, nonsteroidal anti-inflammatory drug.

May not reflect actual size.

ANJESO Was Studied in More Than 1500 Patients Across a Broad Range of Surgical Procedures1-3

Select a procedure to view study details

ERAS, Enhanced Recovery After Surgery; FDA, Food and Drug Administration; LOCF, last observation carried forward; PCA, patient-controlled analgesia; PGA, Patient Global Assessment; PO, orally; SPI, summed pain intensity; SPID, summed pain intensity difference.

Bunionectomy (N=201)<sup>4</sup>
Postoperative Administration in an Efficacy and Safety Study

Bunionectomy (N=201)4

Study design

A phase 3, double-blind, randomized controlled study of ANJESO 30 mg vs placebo (1:1 ratio).

After the popliteal block removal (by 3:00 AM), patients reporting a pain score of ≥4 were randomized and given study drug (by 12:00 PM).

Dosing

Two doses of ANJESO were administered postoperatively once every 24 hours, with an optional third dose prior to discharge.

Other analgesia

Oxycodone 5 mg, up to every 2 hours as requested for uncontrolled pain.

Primary endpoint

Pain reduction was evaluated by the SPID from baseline over 48 hours (ie, SPID-48) using a 2-hour windowed LOCF.

Secondary endpoints

  • SPID-6, SPID-12, SPID-24, and SPID-24-48
  • Time to perceptible and meaningful pain relief
  • Proportion of patients with pain reduction from baseline of ≥30% and ≥50% within 6 and 24 hours
  • PGA of pain control at 24 hours and 48 hours
  • Time to first rescue dose and number of rescue doses
View Clinical Data
Head, Neck, and Spine (n=14)<sup>5</sup>
Postoperative Administration in a Safety Study

Head, Neck, and Spine (n=14)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Shoulder (n=16)<sup>5</sup>
Postoperative Administration in a Safety Study

Shoulder (n=16)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Gastrointestinal (n=39)<sup>5</sup>
Postoperative Administration in a Safety Study

Gastrointestinal (n=39)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Abdominoplasty (N=219)<sup>6</sup>
Postoperative Administration in an Efficacy and Safety Study

Abdominoplasty (N=219)6

Study design

A phase 3, double-blind, randomized, placebo-controlled study of ANJESO 30 mg vs placebo (1:1 ratio). Patients were randomized within 3 hours of surgery and given study drug or placebo once pain level of ≥4 was reported.

Dosing

ANJESO was administered postoperatively once every 24 hours. Patients received a minimum of 2 doses, and a majority received an optional third dose prior to discharge at 48 hours.

Other analgesia

Oxycodone 5 mg was provided every 2 hours as needed for uncontrolled pain.

Primary endpoint

Pain reduction was evaluated by the SPID from baseline over 24 hours (ie, SPID-24) using a 2-hour windowed LOCF.

Secondary endpoints

  • SPID-6, SPID-12, SPID-48, and SPID-24-48
  • Time to perceptible and meaningful pain relief
  • Proportion of patients with improvement ≥30% and ≥50% within 6 hours
  • PGA of pain control at 24 hours and 48 hours
  • Time to first dose of rescue and number of times rescue was used
View Clinical Data
Colorectal (N=55)<sup>2</sup><span><sup>‡</sup>Not evaluated by the FDA for approval.</span>
Preoperative Administration in an Efficacy and Safety Study

Colorectal (N=55)2Not evaluated by the FDA for approval.

Study design

A phase 3b, multicenter, randomized, double-blind, placebo-controlled trial in which ANJESO 30 mg or placebo was added to an ERAS protocol with multimodal analgesia (1:1 ratio).

Dosing

ANJESO was administered preoperatively, 30 minutes prior to surgery, then once every 24 hours until discharge or until IV analgesia was no longer clinically appropriate, per investigator and institutional standards.

Other analgesia

  • Preoperative:
    • Gabapentin PO
    • Acetaminophen PO or IV
  • Perioperative: IV opioids
  • Postoperative:
    • Morphine IV PCA and/or IV bolus, then converted to oxycodone as needed
    • Acetaminophen PO every 8 hours (discontinued 24 hours after the last study drug dose)

Primary endpoint

Safety and tolerability of ANJESO 30 mg.

Select secondary endpoints

  • Opioid consumption
  • Pain assessments
  • Impact on healthcare resource utilization and functional endpoints, including length of stay, hospital costs, and bowel function recovery
View Clinical Data
Total Hip Replacement (n=68)<sup>5</sup>
Postoperative Administration in a Safety Study

Total Hip Replacement (n=68)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Gynecologic (n=89)<sup>5</sup>
Postoperative Administration in a Safety Study

Gynecologic (n=89)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Hernia Repair (n=132)<sup>5,7</sup>
Postoperative Administration in a Safety Study

Hernia Repair (n=132)5,7

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Total Knee Arthroplasty (N=181)<sup>3,7</sup> <span><sup>‡</sup>Not evaluated by the FDA for approval.</span>
Preoperative Administration in an Efficacy and Safety Study

Total Knee Arthroplasty (N=181)3,7 Not evaluated by the FDA for approval.

Study design

A phase 3b, multicenter, randomized, double-blind, placebo-controlled trial in which ANJESO 30 mg or placebo was used with multimodal analgesia (1:1 ratio).

Dosing

ANJESO was administered preoperatively, just prior to incision, then every 24 hours until discharge or until IV analgesia was no longer clinically appropriate, per investigator and institutional standards.

Other analgesia

  • Preoperative:
    • Gabapentin PO
    • Acetaminophen PO
  • Perioperative:
    • Spinal anesthesia
    • Bupivacaine
  • Postoperative:
    • Morphine IV bolus, then converted to oxycodone PO as needed
    • Acetaminophen PO every 8 hours (discontinued 24 hours after the last dose)
    • Aspirin for venous thromboembolism prophylaxis per investigator

Primary endpoint

Total use of opioid analgesia from end of surgery through 24 hours.

Select secondary endpoints

  • SPI time periods:
    • Hour 0 to 24
    • Hour 24 to 48
    • Hour 48 to 72
    • Hour 0 to end of treatment
  • Safety and tolerability of ANJESO preoperative dosing
  • Impact on healthcare resource utilization, including total hospital costs, time to discharge, and postdischarge healthcare resource utilization (discharges to skilled nursing facilities, ER visits, readmissions, and phone calls due to pain)
View Clinical Data
Total Knee Arthroplasty (n=156)<sup>5</sup>
Postoperative Administration in a Safety Study

Total Knee Arthroplasty (n=156)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Complex Foot/Ankle (n=72)<sup>5</sup>
Postoperative Administration in a Safety Study

Complex Foot/Ankle (n=72)5

Study design

A phase 3, multicenter, randomized, double-blind, placebo-controlled study of ANJESO 30 mg vs placebo (3:1 ratio). Randomization was stratified by patients >65 years of age with mild renal failure vs others, and by surgery type.

Dosing

ANJESO was administered postoperatively once every 24 hours for up to 7 doses.

Other analgesia

  • Institutional postoperative analgesia standard of care, except for other NSAIDs
  • Opioid analgesia to treat uncontrolled pain at investigator discretion

Primary objective

Safety and tolerability of ANJESO 30 mg vs placebo, including number of patients with adverse events up to 28 days.

Guidelines Recommend NSAIDs as Part of Multimodal Analgesic Regimen


Paper

“[W]henever possible, anesthesiologists should use multimodal pain management therapy…unless contraindicated, patients should receive an around-the-clock regimen of COXIBs, NSAIDs, or acetaminophen.”

Practice Guidelines for Acute Pain Management in the Perioperative Setting (2012)8

Clinical practice guidelines recommend including NSAIDs as part of a multimodal approach to pain management.8-14

  • American College of Surgeons
  • American Society of PeriAnesthesia Nurses
  • American Society for Pain Management Nursing
  • American Geriatrics Society
  • American Pain Society
  • Enhanced Recovery After Surgery Society
  • American Society of Anesthesiologists
  • American Society of Regional Anesthesia and Pain Medicine

ANJESO Pharmacokinetic Profile Supports Use in the Surgical Setting


Pharmacokinetics of once-daily ANJESO and oral meloxicam1,7


  • IV ANJESO 30 mg reaches peak plasma concentration in approximately 7 minutes vs 6.5 hours for oral meloxicam 15 mg1,7
  • ANJESO plasma concentrations exceed those of oral meloxicam throughout the first 24 hours1,7
  • No first-pass effect with IV agents15

ANJESO pharmacokinetics: AUCinf (ng•hr/mL), 107,508.7 (34,443.0); Cmax (ng/mL), 5642.9 (1009.0); Ke (l/hr), 0.03 (0.02); t1/2 (h), 23.3 (9.36).1,7

AUCinf, area under the curve; Cmax, maximum serum concentration; Ke, elimination rate constant; t1/2, elimination half-life.

§In adults, the maximum recommended daily oral dose of meloxicam is 15 mg.16

Time to onset of pain relief with ANJESO:

  • Because of delayed onset of analgesia, ANJESO alone is not recommended for use when rapid onset of analgesia is required1
  • The majority of patients in the clinical trials reached meaningful pain relief within 2-3 hours1,7,||
  • 57.3% of patients first perceived pain relief within 30 minutes7,||

||Onset of action may be delayed in some patients.1

INDICATION

ANJESO is indicated for use in adults for the management of moderate-to-severe pain, alone or in combination with non-NSAID analgesics.

Limitation of Use: Because of delayed onset of analgesia, ANJESO alone is not recommended for use when rapid onset of analgesia is required.

IMPORTANT SAFETY INFORMATION

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Risk

  • Non-steroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use.
  • ANJESO is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Risk

  • NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

CONTRAINDICATIONS

ANJESO is contraindicated in patients with:

  • Known hypersensitivity (eg, anaphylactic reactions and serious skin reactions) to meloxicam or any components of the drug product.
  • History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.
  • In the setting of coronary artery bypass graft (CABG) surgery.
  • Moderate to severe renal insufficiency patients who are at risk for renal failure due to volume depletion.

WARNINGS AND PRECAUTIONS

Hepatotoxicity: Elevations of ALT or AST have been reported in patients with NSAIDs. In addition, rare, sometimes fatal, cases of severe hepatic injury including fulminant hepatitis, liver necrosis, and hepatic failure have been reported. Inform patients of warning signs and symptoms of hepatotoxicity. Discontinue ANJESO immediately if abnormal liver tests persist or worsen or if clinical signs and symptoms of liver disease develop.

Hypertension: NSAIDs including ANJESO can lead to new onset of hypertension or worsening of preexisting hypertension, which may contribute to the increased incidence of cardiovascular (CV) events. Patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. Monitor blood pressure.

Heart Failure and Edema: NSAID use increased the risk of myocardial infarction (MI), hospitalization for heart failure, and death. Avoid use of ANJESO in patients with severe heart failure unless benefits are expected to outweigh risk of worsening heart failure. If ANJESO is used in patients with severe heart failure, monitor patients for signs of worsening heart failure.

Post MI Patients: Avoid the use of ANJESO in patients with recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. If ANJESO is used in these patients, monitor for signs of cardiac ischemia.

Renal Toxicity: Long-term administration of NSAIDs has resulted in renal papillary necrosis, renal insufficiency, acute renal failure, and other renal injury. ANJESO is not recommended in patients with moderate to severe renal insufficiency and is contraindicated in patients with moderate to severe renal insufficiency who are at risk for renal failure due to volume depletion. Correct volume status in dehydrated or hypovolemic patients prior to initiating ANJESO. Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia. Avoid use of ANJESO in patients with advanced renal disease unless benefits are expected to outweigh risk of worsening renal function. If ANJESO is used in patients with advanced renal disease, monitor patients for signs of worsening renal function.

Anaphylactic Reactions: Meloxicam has been associated with anaphylactic reactions in patients with and without known hypersensitivity to meloxicam and in patients with aspirin-sensitive asthma. Seek emergency help if an anaphylactic reaction occurs.

Exacerbation of Asthma Related to Aspirin Sensitivity: ANJESO is contraindicated in patients with aspirin-sensitive asthma. Monitor patients with preexisting asthma (without aspirin sensitivity).

Serious Skin Reactions: NSAIDs, including ANJESO, can cause serious skin reactions, including exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal and can occur without warning. Discontinue ANJESO at first appearance of skin rash or other signs of hypersensitivity.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Inform patients to stop taking ANJESO immediately if they develop any type of rash or fever and to contact their healthcare provider as soon as possible.

Hematologic Toxicity: Anemia has occurred in NSAID-treated patients. Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia. NSAIDs, including ANJESO, may increase the risk of bleeding events. Monitor patients for signs of bleeding.

Fetal Toxicity: Limit use of NSAIDs, including ANJESO, between about 20 to 30 weeks in pregnancy due to the risk of oligohydramnios/fetal renal dysfunction. Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy due to the risks of oligohydramnios/fetal renal dysfunction and premature closure of the fetal ductus arteriosus.

DRUG INTERACTIONS

Drugs That Interfere With Hemostasis (eg, warfarin, aspirin, SSRIs/SNRIs): Monitor patients for bleeding who are concomitantly taking ANJESO with drugs that interfere with hemostasis. Concomitant use of ANJESO and analgesic doses of aspirin is not generally recommended.

ACE Inhibitors, Angiotensin Receptor Blockers (ARB), or Beta-Blockers: Concomitant use with ANJESO may diminish the antihypertensive effect of these drugs. Monitor blood pressure.

ACE Inhibitors and ARBs: Concomitant use with ANJESO in elderly, volume depleted, or those with renal impairment may result in deterioration of renal function. In such high risk patients, monitor for signs of worsening renal function.

Diuretics: NSAIDs can reduce natriuretic effect of furosemide and thiazide diuretics. Monitor patients to ensure diuretic efficacy including antihypertensive effects.

ADVERSE REACTIONS

The most common adverse reactions in controlled clinical trials occurring in ≥ 2% of patients treated with ANJESO and at a greater frequency than placebo include: constipation, gamma-glutamyl transferase increased, and anemia.

USE IN SPECIFIC POPULATIONS

Pregnancy: Use of NSAIDs, including ANJESO, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. Because of these risks, limit dose and duration of ANJESO use between about 20 and 30 weeks of gestation and avoid ANJESO use at about 30 weeks of gestation and later in pregnancy.

Infertility: NSAIDs are associated with reversible infertility. Consider withdrawal of ANJESO in women who have trouble conceiving.

Please see full Prescribing Information, including Boxed Warning at www.anjeso.com.

References: 1. ANJESO [package insert]. Malvern, PA: Baudax Bio, Inc.; 2021. 2. Silinsky JD, Marcet JE, Anupindi VR, et al. Preoperative intravenous meloxicam for moderate-to-severe pain in the immediate post-operative period: a phase IIIb randomized clinical trial in 55 patients undergoing primary open or laparoscopic colorectal surgery with bowel resection and/or anastomosis. Pain Manag. 2021;11(1):9-21. doi:10.2217/pmt-2020-0061 3. Berkowitz RD, Steinfeld R, Sah AP, et al. Safety and efficacy of perioperative intravenous meloxicam for moderate-to-severe pain management in total knee arthroplasty: a randomized clinical trial. Pain Med. Published online January 27, 2021. doi:10.1093/pm/pnab016 4. Pollak RA, Gottlieb IJ, Hakakian F, et al. Efficacy and safety of intravenous meloxicam in patients with moderate-to-severe pain following bunionectomy: a randomized, double-blind, placebo-controlled trial. Clin J Pain. 2018;34(10):918-926. doi:10.1097/AJP.0000000000000609 5. Bergese SD, Melson TI, Candiotti KA, et al. A phase 3, randomized, placebo-controlled evaluation of the safety of intravenous meloxicam following major surgery. Clin Pharmacol Drug Dev. 2019;8(8):1062-1072. doi:10.1002/cpdd.666 6. Singla N, Bindewald M, Singla S, et al. Efficacy and safety of intravenous meloxicam in subjects with moderate-to-severe pain following abdominoplasty. Plast Reconstr Surg Glob Open. 2018;6(6):e1846. doi:10.1097/GOX.0000000000001846 7. Data on file. Baudax Bio. 8. American Society of Anesthesiologists Task Force. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012;116(2):248-273. doi:10.1097/ALN.0b013e31823c1030 9. Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131-157. doi:10.1016/j.jpain.2015.12.008 10. Gelman D, Gelmanas A, Urbanaitė D, et al. Role of multimodal analgesia in the evolving enhanced recovery after surgery pathways. Medicina (Kaunas). 2018;54(2):20. doi:10.3390/medicina54020020 11. Krenzischek DA, Wilson L; ASPAN. An introduction to the ASPAN pain and comfort clinical guideline. J Perianesth Nurs. 2003;18(4):228-236. doi:10.1016/s1089-9472(03)00128-x 12. Jarzyna D, Jungquist CR, Willens JS, et al. American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Manag Nurs. 2011;12(3):118-145.e10. doi:10.1016/j.pmn.2011.06.008 13. American Geriatrics Society Panel on the Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009;57(8):1331-1346. doi:10.1111/j.1532-5415.2009.02376.x 14. Majumder A, Fayezizadeh M, Neupane R, Elliott HL, Novitsky YW. Benefits of multimodal enhanced recovery pathway in patients undergoing open ventral hernia repair. J Am Coll Surg. 2016;222(6):1106-1115. doi:10.1016/j.jamcollsurg.2016.02.015 15. Price G, Patel DA. Drug bioavailability. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 20, 2020. 16. Mobic [package insert]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc; 2020.