Darvocet

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Basic Information:

Darvocet (Propoxyphene) is a medication used for treating pain. It is an opioid analgesic (related to opium) chemically similar to methadone.

Information:

DRUG CLASS AND MECHANISM:

Propoxyphene is a medication for treating pain. It is an opioid analgesic (related to opium) chemically similar to methadone. The use of opium is at least 2300 years old. In 1806, the first alkaloid of opium was isolated by Serturner. He called it morphine, after the Greek god of dreams, Morpheus. Codeine, another opioid analgesic was identified in 1832. Propoxyphene is half to two- thirds as potent as codeine, meaning that 90 to 120mg of propoxyphene provides as much pain relief as 60mg of codeine. This is comparable to the pain relief achieved by 600mg of aspirin. Opioid analgesics, including propoxyphene, reduce pain by blocking the receptors in the brain that are involved in the perception (sensing) of pain.

PRESCRIPTION:

yes

GENERIC AVAILABLE:

yes

PREPARATIONS

Capsules

65 mg propoxyphene and 325 mg acetaminophen; 32 mg propoxyphene and 325 mg acetaminophen; Darvocet A500 capsules

100 mg propoxyphene and 500 mg acetaminophen.

STORAGE

Capsules should be stored at room temperature, between 15° (59°F) and 30°C (86°F).

PRESCRIBED FOR

Propoxyphene and acetaminophen is used for the treatment of mild to moderate pain.

DOSING

Propoxyphene and acetaminophen usually are given every 4 hours as needed for the relief of pain.

DRUG INTERACTIONS

Opioids such as propoxyphene can reduce the activity of intestinal muscles. When combined with medications that possess anticholinergic activity, this effect on intestinal muscles may be accentuated leading to constipation. Such drugs include dicyclomine (Bentyl), some antihistamines [carbinoxamine (Rondec), clemastine (Tavist), diphenhydramine (Benadryl), promethazine (Phenergan)], some phenothiazines [e.g. thioridazine (Mellaril), triflupromazine (Stelazine)], some tricyclic antidepressants [e.g. amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), protriptyline (Vivactil)], clozapine (Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace).

Propoxyphene adds to the sedating effects of alcohol and other drugs that can cause sedation such as the benzodiazepine class of anti-anxiety drugs (e.g., Valium, Ativan, Klonopin, Xanax), the tricyclic class of antidepressants (e.g., Elavil, Tofranil, Norpramin), dicyclomine (Bentyl), certain antihistamines (Benadryl, Vistaril, Atarax, Tavist), and certain antihypertensive medications (e.g., Catapres, Inderal).

PREGNANCY

There is very little information about the effects on the fetus of propoxyphene given to pregnant women. Physicians may use it if they consider its benefits to outweigh potential (and unknown) risks.

NURSING MOTHERS

Low concentrations of propoxyphene have been measured in the breast milk of mothers taking propoxyphene. It is not known whether these small amounts can cause side effects in nursing infants.

SIDE EFFECTS

The most frequent adverse reactions of propoxyphene include lightheadedness, dizziness, sedation, nausea, and vomiting. Other side effects include drowsiness, constipation, and spasm of the ureter, which can lead to difficulty in urinating.

Propoxyphene can depress breathing and, therefore, is used with caution in elderly, debilitated patients and in patients with serious lung disease. Propoxyphene can impair thinking and the physical abilities required for driving or operating machinery. Propoxyphene may be habit forming. Mental and physical dependence can occur but are unlikely when it is used short-term.

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