Detailed Drug Information:

DRUG CLASS AND MECHANISM: Propoxyphene is a medication for pain.It is an opioid analgesic (related to opium) similar to methadone. The useof opium is at least 2300 years old. In 1806, the first alkaloid of opiumwas isolated by Serturner. He called it morphine, after the Greek god ofdreams, Morpheus. Codeine was identified in 1832. Propoxyphene is half totwo-thirds as potent as codeine, meaning that 90 to 120mg of propoxypheneprovides as much pain relief as 60mg of codeine. This is comparable to thepain relief achieved by 600mg of aspirin. Opioid analgesics, includingpropoxyphene, reduce pain by blocking the receptors in the brain that areinvolved in the perception (sensing) of pain. Because combinations ofopioids (such as propoxyphene or codeine) and either aspirin oracetaminophen produce additive pain relieving effects, they are oftenfound in combination in drugs.

PREPARATIONS: Capsules: 65mg.

STORAGE: Capsules should be stored at room temperature, between15° (59°F) and 30°C (86°F).

PRESCRIBED FOR: Propoxyphene is used for the symptomatictreatment of mild to moderate pain.

DOSING: Propoxyphene usually is given every 4 hours as neededfor the relief of pain.

DRUG INTERACTIONS: Opioids such as propoxyphene can slow bowelmotility. When combined with medications that possess anticholinergicactivity, this affect on the bowel may be accentuated, leading to markedconstipation. 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 has additive sedating effects with alcohol and with otherdrugs that can cause sedation such as the benzodiazepine class ofanti-anxiety drugs (e.g., Valium, Ativan, Klonopin, Xanax), the tricyclicclass of antidepressants (e.g., Elavil, Tofranil, Norpramin), dicyclomine(Bentyl), certain antihistamines (Benadryl, Vistaril, Atarax, Tavist), andcertain antihypertensive medications (e.g. Catapres, Inderal).

PREGNANCY: There is very little information about the effects onthe fetus of propoxyphene given to pregnant women. Physicians may use itif its benefits are felt to outweigh the potential (and unknown) risks.

NURSING MOTHERS: Low concentrations of propoxyphene have been measured in the breast milk of mothers taking propoxyphene. It is notknown whether these small amounts can cause side effects in nursinginfants.

SIDE EFFECTS: The most frequent adverse reactions ofpropoxyphene include lightheadedness, dizziness, sedation, nausea, andvomiting. Other side effects include drowsiness, constipation, and spasmof the ureter, which can lead to difficulty in urinating.

Propoxyphene can depress breathing, and is used with caution in elderly,debilitated patients and in patients with serious lung disease.Propoxyphene can impair thinking and the physical abilities required fordriving or operating machinery. Propoxyphene may be habit forming. Mentaland physical dependence can occur, but are unlikely when used forshort-term pain relief.