Propoxyphene

  • Generic Name or Active Ingridient: Propoxyphene
Drug Class: Propoxyphene > Fully Synthetic Opioid > Opioids > Opioid Agonist > Analgesic.

Propoxyphene is used to treat mild to moderate pain. Propoxyphene is also a cough suppressant and causes sedation and respiratory depression. One of the components of propoxyphene, acetaminophen, relieves mild pain and reduces fever. Learn More About Propoxyphene Uses

Administration/Dosage

Propoxyphene comes in a tablet, capsule and liquid form. Shake the liquid form well before dispensing. It is typically ordered to be taken every four hours by mouth as needed for pain. Always take propoxyphene as directed.

Each propoxyphene contains 50 to 100 mg of propoxyphene with 325 to 650 mg of acetaminophen, and the doses express the varying proportions of the individual drugs. Propoxyphene is available in 50/325, 65/650, 100/325, 100/500 and 100 mg/650 mg tablets. For example, a 100/325 mg tablet contains 100 mg of propoxyphene and 325 mg of acetaminophen.

The typical prescription is one to two tablets every four hours as needed for pain. Do not exceed six 100/650 mg tablets in a 24-hour period.

Propoxyphene is typically taken on an as-needed basis so there are usually no concerns regarding missed doses. If you are in pain and enough time has passed since your last dose, simply take another dose. If you are taking propoxyphene on a regular schedule and miss a dose, take a dose as soon as you remember, providing it is not nearly time to take another dose. Never double up on doses in an effort to catch up.

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Action

Researchers do not know exactly how propoxyphene works to reduce pain, but it is believed this drug stimulates opioid receptors in the brain. Propoxyphene decreases discomfort and increases pain tolerance but the brain is still aware of the pain. Acetaminophen reduces pain by elevating the pain threshold so that you can tolerate more pain. It also brings down a fever through its action on the heat regulating center in the brain. Together, acetaminophen and propoxyphene manage pain better than either medicine alone. More About How Propoxyphene Works

Precautions

Tell your doctor if you are allergic to propoxyphene or any other medication, especially if you are allergic to narcotics. Seek immediate medical attention at first sign of an allergic reaction. Symptoms of an allergic reaction include swelling of the face, mouth, and throat, difficulty breathing, itching or rash.

You may not be able to take propoxyphene if you have had certain medical conditions, including brain disorders, such as head injury, tumor or seizures. Talk with your physician about breathing problems such as asthma, sleep apnea, chronic obstructive pulmonary disease-COPD. Propoxyphene may not be recommended if you have ever had kidney or liver disease, mental or mood disorders such as confusion, depression and a personal or family history of regular use or abuse of drugs or alcohol. Make sure your doctor knows about any stomach or intestinal problems such as blockage, constipation, diarrhea due to infection or paralytic ileus or difficulty urinating, such as due to enlarged prostate.

Propoxyphene can make you drowsy. Do not operate a vehicle or heavy machinery until you know how propoxyphene affects you. Do not consume alcohol while taking propoxyphene. Drinking alcohol may increase drowsiness.

This drug can be habit-forming, especially if you take it for long periods of time.

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Warnings

Propoxyphene, taken in high doses alone or in combination with other drugs, is associated with an elevated risk for death. Do not take propoxyphene with other drugs that make you drowsy, including alcohol, sleep aides, tranquilizers, antidepressants or antihistamines. Do not take propoxyphene in higher doses or longer than prescribed by your physician. Before taking propoxyphene, tell your doctor about all the medications you are taking, including prescriptions, over-the-counter and herbal remedies. Specifically, notify your physician about your use of other pain relievers, antidepressants, antihistamines, medications for cough, cold, or allergies, muscle relaxants and sedatives. Share a list of current medicines with your doctor, such as seizure medications, sleeping pills, tranquilizers and vitamins. Notify your professional caregiver and pharmacist about your use of anticoagulants such as warfarin, otherwise known as Coumadin.

Quitting propoxyphene suddenly might cause uncomfortable withdrawal symptoms. Whenever possible, wean yourself slowly from propoxyphene by taking smaller doses further apart. If you cannot comfortably stop using propoxyphene, consult with your doctor or qualified in-patient or out-patient rehabilitation center. More Warnings About Using Propoxyphene

Drug Interactions

Propoxyphene increases the effect of drugs that slow brain functioning, like alcohol, barbiturates and muscle relaxants. Using propoxyphene in combination with these drugs may lead to greater respiratory depression, a life-threatening condition marked by slowed and shallow breathing. Taking propoxyphene with the anti-seizure medication carbamazepine, brand name Tegretol, may have severe effects on the brain, including coma.

Propoxyphene causes constipation. Using anti-diarrheal medication like Lomotil and Imodium along with propoxyphene can cause severe constipation.

Some drugs, like Talwin, Nubain, Stadol and Buprenex may bind with opiate receptors in a way that reduces the effect of propoxyphene. You may experience withdrawal symptoms if you take propoxyphene along with these drugs.

Your liver metabolizes, or gets rid of, acetaminophen. Some medications increase liver enzymes that metabolize acetaminophen, causing a reduction in acetaminophen levels and subsequently a decrease in pain-relieving action. Drugs that increase liver enzymes include carbamazepine, isoniazid and rifampin.

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Side effects

You may experience side effects while taking propoxyphene. Seek emergency medical assistance if you have trouble breathing after taking propoxyphene. Some side effects are less serious. Tell your doctor if these side effects become more acute or if they do not go away on their own:

  • Dizziness.
  • Lightheadedness.
  • Drowsiness.
  • Upset Stomach.
  • Vomiting.
  • Constipation.
  • Stomach Pain.
  • Skin Rash.
  • Mood Changes.
  • Headache.

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Overdose

If you suspect that you or someone you know has taken an overdose of propoxyphene, seek emergency assistance immediately. Contact your local poison control center at 1-800-222-1222 or go to the emergency room. Overdose is a serious, life-threatening medical condition. Overdose symptoms include slow breathing, slow or irregular heartbeat, loss of consciousness and seizure.

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Abuse

Propoxyphene is no longer available on the US market. This opioid carries a significant risk for abuse and physical as well as psychological dependence. Pharmaceutical companies can no longer legally manufacture propoxyphene for licit use as a pain reliever. Read More About Propoxyphene Abuse

Withdrawal

You might experience uncomfortable withdrawal symptoms when you stop taking propoxyphene, especially if you have been using large doses or taking the opioid for more than a few weeks. Symptoms vary in intensity from person to person. Withdrawal symptoms are normal, predictable, physical signs of dependency. Dependency is not necessarily a sign of willful abuse. Unpleasant withdrawal symptoms might prevent you from stopping propoxyphene use without the help of professionals. Withdrawal symptoms include restlessness, watering eyes, runny nose, nausea, sweating and muscle aches.

Detox

Dependency and addiction to narcotics, including propoxyphene, is often difficult to overcome on your own. In-patient and out-patient treatment facilities are staffed with trained professionals who can minimize withdrawal symptoms, detoxify your body and help you live a drug-free life. Detoxification, rehabilitation and counseling are effective therapies to treat addiction to propoxyphene and other opiates.

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Storage

Keep propoxyphene at room temperature, 59 to 86 degrees Fahrenheit. Store propoxyphene away from children, pets and adults who might accidently or purposefully consume the drug. Do not share propoxyphene with others. Dispose of propoxyphene when you no longer need to take the medicine.

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Miscellaneous information

Propoxyphene, otherwise known as Darvon, was used to relieve mild to moderate pain before being pulled from the U.S. market after November 19, 2010. This ban arose because of the high incidence of severe liver damage and allergic reactions associated with one of the ingredients in propoxyphene, acetaminophen. Miscellaneous Information About Propoxyphene