-
American Journal of Hospital Pharmacy Apr 1977A critical analysis of information on propoxyphene that has been published since the drug's introduction is presented. Propoxyphene is discussed with regard to its... (Review)
Review
A critical analysis of information on propoxyphene that has been published since the drug's introduction is presented. Propoxyphene is discussed with regard to its chemistry, metabolism and pharmacokinetics, analgesic efficacy, analgesic efficacy of combination products, nonanalgesic uses, adverse effects, overdosage, and dependence and abuse. Both the hydrochloride and napsylate salts are covered. It is doubtful that propoxyphene hydrochloride 65 mg provides an analgesic effect equal to that of aspirin 650 mg. There is no conclusive evidence that combinations of propoxyphene with other analgesics are more effective than propoxyphene or other analgesics alone.
Topics: Acetaminophen; Analgesics; Aspirin; Caffeine; Chemical Phenomena; Chemistry; Dextropropoxyphene; Drug Combinations; Drug Incompatibility; Heroin Dependence; Humans; Kinetics; Phenacetin; Substance-Related Disorders
PubMed: 16489
DOI: No ID Found -
Journal of the Indian Medical... Jan 1988
-
JAMA Apr 1979
Topics: Dextropropoxyphene; Drug Evaluation; Drug Interactions; Humans; Legislation, Drug; United States; United States Dept. of Health and Human Services
PubMed: 430728
DOI: 10.1001/jama.241.16.1689 -
Annals of Internal Medicine Nov 1976Propoxyphene napsylate differs from the hydrochloride salt in several ways. It is much less soluble and bitter and poses few stability problems when capsulated or...
Propoxyphene napsylate differs from the hydrochloride salt in several ways. It is much less soluble and bitter and poses few stability problems when capsulated or tableted with aspirin. There is some evidence in several animal species that the pattern and severity of poisoning may be different with the two salts. Equimolar doses of the two salts are probably interchangeable in the relief of pain. The role of propoxyphene in clinical medicine and the questions of propoxyphene abuse and propoxyphene-related fatalities are discussed.
Topics: Analgesics; Animals; Dextropropoxyphene; Dogs; Drug Combinations; Drug Compounding; Humans; Mice; Rabbits; Rats; Substance-Related Disorders
PubMed: 10824
DOI: 10.7326/0003-4819-85-5-619 -
American Journal of Therapeutics 2006Propoxyphene (dextropropoxyphene) is a synthetic weak opioid introduced into the United States in 1957. It is most frequently prescribed in combination with... (Review)
Review
Propoxyphene (dextropropoxyphene) is a synthetic weak opioid introduced into the United States in 1957. It is most frequently prescribed in combination with acetaminophen and/or aspirin. After its ubiquitous introductory phase, it was soon discovered that this drug's iatrogenic events (cardiotoxicity, seizures, etc.) far outweighed any perceived therapeutic benefit. Propoxyphene analgesia was equated with that of merely acetaminophen or aspirin independently. The propoxyphenes euphorigenic component has created a problem in its prescribing. Use of this agent in the elderly should be avoided because of its complex pharmacokinetics and pharmacodynamics. The pharmacokinetics, pharmacodynamics, and pharmacology of this drug are discussed thoroughly in this article, including its arrhythmogenicity. Additional noncardiovascular pharmacotherapies that produce QTc prolongation or arrhythmogenicity are described. A list of the cytochrome P450 2D6 pharmacotherapies that will interact with propoxyphene is provided in the article. The use of this agent is highly discouraged. The rationale for this is discussed fully within this article. The toxicity of this drug is partially related to nor-propoxyphene a non-opioid cardiotoxic metabolite. The mere warnings of fatalities within the package insert should alert any cautious prescriber on the dangers of this agent and dampen its prescribing potential.
Topics: Analgesics, Opioid; Arrhythmias, Cardiac; Dextropropoxyphene; Drug Interactions; Drug Labeling; Drug Prescriptions; Humans; Opioid-Related Disorders; Risk Assessment; Seizures
PubMed: 17122535
DOI: 10.1097/01.mjt.0000253850.86480.fb -
Journal of Pharmaceutical Sciences Jan 1979
Topics: Biological Availability; Dextropropoxyphene
PubMed: 581500
DOI: 10.1002/jps.2600680104 -
The American Journal of Drug and... 1979
Topics: Dextropropoxyphene; Humans; Opioid-Related Disorders; Substance-Related Disorders
PubMed: 517496
DOI: 10.3109/00952997909007049 -
Annals of Internal Medicine Aug 1969
Topics: Dextropropoxyphene; Humans
PubMed: 5800303
DOI: 10.7326/0003-4819-71-2-428_1 -
American Family Physician May 1979
Topics: Consumer Organizations; Dextropropoxyphene; Humans; Substance-Related Disorders; United States; United States Food and Drug Administration
PubMed: 443170
DOI: No ID Found -
Expert Opinion on Pharmacotherapy Jul 2012d-Propoxyphene, which was previously available in many single-agent and combination products, was recently voluntarily withdrawn from the US market following an FDA... (Review)
Review
INTRODUCTION
d-Propoxyphene, which was previously available in many single-agent and combination products, was recently voluntarily withdrawn from the US market following an FDA recommendation based partly on the concern that the risk associated with QT prolongation exceeded the clinical benefit of the drug. The drug had previously been withdrawn from European markets. These recent actions prompt the question: what is known about QT prolongation and analgesic drugs?
AREAS COVERED
A systematic search was conducted of 50 opioid and non-opioid analgesic drugs using PubMed, the FDA website, and the Internet. Search terms for opioids, NSAIDs, acetaminophen and other analgesics were used (including both generic and brand names), along with QTc, QTc prolongation, QTc interval, hERG, torsades de pointes (TdP), ventricular arrhythmias, and other relevant terms.
EXPERT OPINION
There is a paucity of available information on the QT interval for most analgesics. Of those for which there is a lot of data, only methadone, oxycodone, and LAAM (levo--acetylmethadol) appear to have a known and accepted level of effect on the QT interval.
Topics: Analgesics; Animals; Dextropropoxyphene; Humans; Long QT Syndrome; Structure-Activity Relationship
PubMed: 22568597
DOI: 10.1517/14656566.2012.682150