DEXTROPROPOXYPHENE

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Created May 2019 | Updated Oct 2020

DEXTROPROPOXYPHENE

  • [DARVON]
  • [PROPOXYPHENE]
  • [DARVOCET-N]
  • [DARVON-N]
  • [DOLENE]

DOSAGE FORMS

DEA CODE 9278: Schedule 2 Narcotic

Propoxyphene (Darvon, Darvon-N, Dolene) is a drug prescribed for the treatment of mild to moderate pain. It is a narcotic pain-reliever and cough suppressant but is weaker than morphine, codeine, and hydrocodone. Propoxyphene increases pain tolerance and decreases discomfort but the presence of pain still is apparent. In addition to pain reduction, propoxyphene also causes sedation and respiratory depression. The FDA approved propoxyphene in August 1957.

A synthetic opioid. Due to its euphoric and analgesic effects, dextropropoxyphene is known to be habit forming, albeit not to the same extent as other opioids such as morphine or heroin. Notably, dextropropoxyphene is also known to cause seizures and potentially fatal cardiac arrhythmia at high doses, which are not able to be reversed by naloxone. Today, dextropropoxyphene is rarely encountered on the streets.

Dextropropoxyphene, like codeine, is a weak opioid, known to cause dependency among recreational users. Codeine is more commonly used.


Dextropropoxyphene is a painkiller that is used to treat short- and long-term (chronic) pain. It is a weak opioid (opioids are medicines related to morphine) that relieves pain by acting on receptors in the brain and spinal cord. It has been available as a prescription-only medicine for about 40 years, both on its own and in combination, as tablets, capsules, suppositories and solutions for injection.

The CHMP concluded that the available data showed that dextropropoxyphene-containing medicines were weak painkillers, and only have limited effectiveness in the treatment of pain. Following the re-examination, the Committee confirmed that the benefits of non-parenteral forms of dextropropoxyphene containing medicines do not outweigh their risks and recommended their withdrawal.

Dextropropoxyphene
Duration:

An opioid analgesic that is an optical isomer of levopropoxyphene. Used to treat mild pain and often used for its antitussive properties. It has been taken off the market in Europe and US due to concerns of health issues relating to the Kidney, Liver, Heart and Respiratory Disorders. Just a bit stronger than Tramadol.

RouteOnsetDurationAfter Effects
Tripsit Factsheets
All ROAs:20-30 minutes1-3 hours1-6 hours
Dextropropoxyphene Duration
Aliases:
  • darvocet
  • co-proxamol
  • coproxamol
  • capadex
  • di-gesic
Avoid:
All CNS depressants. And all together if you have a history of issues with your Kidneys, Liver, Heart and any Respiratory Disorders.

Breastfeeding:

Summary of Use During Lactation:

Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system depression and even death.

Newborn infants seem to be particularly sensitive to the effects of even small dosages of propoxyphene may be particularly prone to causing these effects.

Propoxyphene should be avoided during breastfeeding.

Drug Levels:
Propoxyphene is metabolized to active norpropoxyphene (25%) and to several inactive metabolites.

Norpropoxyphene has a 30 to 36 hour half-life.

The oral bioavailability of norpropoxyphene is unknown. Propoxyphene is available in 2 salt forms: 65 mg of the hydrochloride form is equivalent to 100 mg of the napsylate.

Effects on Lactation and Breastmilk:

Narcotics can increase serum prolactin.

However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs to Consider:

Rxisk PDF Darvon-N

Propoxyphene should be used with extreme caution, if at all, in patients who have a history of substance/drug/alcohol abuse, depression with suicidal tendency, or who already take medications that cause drowsiness (e.g., antidepressants, muscle relaxants, pain relievers, sedatives, tranquilizers). Fatalities have occurred in such patients when propoxyphene was misused.

With the withdrawal of the barbiturate sleeping tablets from the medical prescribing list, propoxyphene has become the most common doctor-prescribed medication used by seriously ill people to end their lives."The slang name for the combination of propoxyphene and other drugs used for suicide is "Darvon cocktail".

  
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