| Drug Index |
| GENERIC NAME : |
| propoxyphene |
| BRAND NAMES : |
| Darvon Pulvules, Darvon Compound-65, Darvon-N, E-Lor, PC-CAP, Darvocet A500, Darvocet-N 100, Darvocet-N 50, Propacet 100, Wygesic |
| STREET NAMES : |
| BRIEF DESCRIPTION : |
| Propoxyphene is a centrally acting opiate (narcotic) analgesic (pain killer). Propoxyphene is structurally related to methadone. The potency of propoxyphene hydrochloride is from two thirds to equal that of codeine. Peak plasma concentrations of propoxyphene are reached in 2 to 2 1/2 hours. Repeated doses of propoxyphene at 6-hour intervals lead to increasing plasma concentrations, with a plateau after the ninth dose at 48 hours. Propoxyphene is metabolized in the liver to yield norpropoxyphene. Propoxyphene has a half-life of 6 to 12 hours, whereas that of norpropoxyphene is 30 to 36 hours. Norpropoxyphene has substantially less central-nervous-system-depressant effect than propoxyphene but a greater local anesthetic effect. NOTE: This summary will focus solely on propoxyphene and will not include descriptions of all of the other medications combined with propoxyphene in the brand names listed above. For details on each brand-name medication please refer to other resources listed at the end of this article. |
| INDICATIONS FOR USE : |
| Propoxyphene is used for treatment of mild to moderate pain. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Use of propoxyphene poses a risk for abuse or dependence, particularly if taken in higher than recommended doses over a long period of time. Psychological dependence may occur early in use of this medication, but physical dependence and tolerance may develop upon repeated administration. When propoxyphene is abused, the individual is seeking the euphoric effect ("high"). As tolerance for the medication increases, larger dosages of the medication are required to produce euphoria. Tolerance for this drug can develop with use over several weeks or months (requiring larger or more frequent dosages of propoxyphene to produce relief of pain or achieve should the state of euphoria sought by addicts). This medication works well for short-term management of acute pain. However, when used for treatment of chronic pain for several weeks or months consecutively, tolerance often occurs. Once an individual has become dependent on propoxyphene, a primary driving force to continue using hydrocodone is to prevent the unpleasant neurochemical and physical withdrawal syndrome associated with discontinuing this drug. Symptoms usually associated with withdrawal may include • Abdominal pain • Muscle aches • Joint pain • Sleep problems (insomnia) • Agitation, Restlessness • Diarrhea • Dilated pupils • Goose bumps • Nausea • Runny nose • Sweating • Vomiting • Restlessness • Yawning • Loss of appetite (anorexia) • Rapid heart rate • Elevated blood pressure • Rapid breathing • Eyes or nose watering Withdrawal of propoxyphene is best handled by a physician that is skilled at assisting patients with opiate detoxification. Medications may be necessary to help control symptoms of withdrawal. A symptom that is easily detected with opiate use is pinpoint pupils (miosis). |
| OVERDOSAGE : |
| Acute overdose of propoxyphene can cause respiratory depression, extreme drowsiness or prolonged sleeping, stupor or coma, muscle flaccidity, cold/clammy skin, constricted pupils, slow heart rate (bradycardia), low blood pressure (hypotension), and death. When propoxyphene is used in combination with alcohol or other central nervous system depressants, the drugs potentiate (increase the effect of each drug) one another and can greatly enhance the risk for overdose. Because of the dangers associated with overdose, immediate medical attention should be sought. |
| CAUTIONS : |
| Any patient with a history of alcohol or substance dependence is at risk for developing addiction to propoxyphene. If use of this medication is considered necessary for the management of pain, the lowest dose of this medication that is sufficient to provide pain relief is warranted. It is also recommended that use of this medication in an addict be discontinued as soon as possible and pain management thereafter managed with non-addictive medications. Because the drug is primarily eliminated from the body through the kidneys, individuals with kidney (renal) impairment must be monitored because the concentration of propoxyphene in the bloodstream can be higher than in subjects with normal kidney function. Also, individuals with liver dysfunction show higher peak concentrations of propoxyphene and its metabolites compared with individuals with normal liver function. Propoxyphene is excreted in breast milk. |
| SIDE EFFECTS : |
| Milder side effects of propoxyphene use may include nausea, constipation, vomiting, and itching (pruritus). Adverse effects may include allergic reaction, abdominal pain, headache, confusion, weakness, lightheadedness, hallucinations, and mood changes. |
| FOR MORE INFORMATION : |
| *This is a condensed description of propoxyphene. For more details check with your physician, pharmacist, or resources such as The Physicians' Desk Reference (PDR) or http://www.drugs.com |
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