propoxyphene (Oral route)

Pronunciation

proe-POX-i-feen

Oral route(Capsule)

Do not prescribe propoxyphene for patients who are suicidal or addiction-prone. Prescribe propoxyphene with caution for patients taking tranquilizers or antidepressant drugs, and patients who use alcohol in excess. Patients should not exceed the recommended dose and alcohol intake should be limited. Propoxyphene products in excessive doses, either alone or in combination with other CNS depressants, including alcohol, are a major cause of drug-related deaths .

Oral route(Tablet)

Do not prescribe propoxyphene for patients who are suicidal or addiction-prone. Prescribe propoxyphene with caution for patients taking tranquilizers or antidepressant drugs, and patients who use alcohol in excess. Patients should not exceed the recommended dose and alcohol intake should be limited. Propoxyphene products in excessive doses, either alone or in combination with other CNS depressants, including alcohol, are a major cause of drug-related deaths .

Commonly used brand name(s)

In the U.S.

  • Darvon
  • Darvon-N
  • Pp-Cap

Available Dosage Forms:

  • Capsule
  • Tablet
  • Suspension

Therapeutic Class: Analgesic

Chemical Class: Opioid

Uses For propoxyphene

Propoxyphene is used to relieve mild to moderate pain. It belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain.

When propoxyphene is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

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Products containing propoxyphene were withdrawn from the U.S. market starting November 19, 2010.

propoxyphene was available only with your doctor's prescription.

Before Using propoxyphene

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For propoxyphene, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to propoxyphene or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of propoxyphene in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of propoxyphene in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems which may require caution and an adjustment in the dose for patients receiving propoxyphene.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking propoxyphene, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using propoxyphene with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Naltrexone
  • Rasagiline
  • Selegiline

Using propoxyphene with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Adinazolam
  • Alfentanil
  • Alprazolam
  • Amobarbital
  • Anileridine
  • Aprobarbital
  • Bromazepam
  • Brotizolam
  • Buprenorphine
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Carbamazepine
  • Carisoprodol
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorzoxazone
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Codeine
  • Dantrolene
  • Dezocine
  • Diazepam
  • Estazolam
  • Ethchlorvynol
  • Fentanyl
  • Flunitrazepam
  • Flurazepam
  • Fospropofol
  • Halazepam
  • Hydrocodone
  • Hydromorphone
  • Ketazolam
  • Levorphanol
  • Lorazepam
  • Lormetazepam
  • Medazepam
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methocarbamol
  • Methohexital
  • Midazolam
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nitrazepam
  • Nordazepam
  • Opium
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Pentazocine
  • Pentobarbital
  • Phenobarbital
  • Prazepam
  • Propoxyphene
  • Quazepam
  • Remifentanil
  • Secobarbital
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Temazepam
  • Thiopental
  • Triazolam

Using propoxyphene with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Doxepin
  • Metoprolol
  • Propranolol
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of propoxyphene. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, history of or
  • Breathing problems (e.g., chronic obstructive pulmonary disease [COPD], cor pulmonale, hypoxia) or
  • Drug dependence, especially narcotic abuse or dependence, or history of—Use with caution. May increase risk for more serious side effects.
  • Brain tumor or
  • Head injuries or
  • Increased pressure in the head—Some of the side effects of propoxyphene can cause serious problems in people who have these medical problems.
  • Breathing problems (e.g., asthma, hypercapnia), severe or
  • Emotional problems or
  • Paralytic ileus (intestinal blockage) or
  • Respiratory depression (hypoventilation or slow breathing) or
  • Suicidal ideation (thoughts of hurting or killing oneself), or history of—Should not be used in patients with these conditions.
  • Hypotension (low blood pressure) or
  • Pancreatitis (inflammation of the pancreas)—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of propoxyphene

Take propoxyphene only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This is especially important for elderly patients, who may be more sensitive to the effects of pain medicines. If too much of propoxyphene is taken for a long time, it may become habit-forming (causing mental or physical dependence).

propoxyphene should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Dosing

The dose of propoxyphene will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of propoxyphene. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or tablets):
    • For mild to moderate pain:
      • Adults—One capsule or tablet every 4 hours as needed. However, the dose is usually not more than 6 capsules or tablets per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of propoxyphene, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw any unused medicine by mixing it with used coffee grounds or kitty litter and place it in a sealable bag, empty can, or container.

Precautions While Using propoxyphene

It is very important that your doctor check your progress while you are taking propoxyphene. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Talk to your doctor first before you stop taking propoxyphene and changing to another pain medicine.

propoxyphene can cause changes in heart rhythms, such as conditions called PR, QRS, and QT prolongation. It may change the way your heart beats and cause fainting, dizziness, lightheadedness, or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

propoxyphene will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the other medicines listed above while you are using propoxyphene.

propoxyphene may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

propoxyphene may make you dizzy, drowsy, or lightheaded. Make sure you know how you react to propoxyphene before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Do not change your dose or suddenly stop using propoxyphene without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Using propoxyphene while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your child has the following symptoms: abnormal sleep pattern, diarrhea, high-pitched cry, irritability, shakiness or tremor, weight loss, vomiting, or failure to gain weight.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

propoxyphene Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
  • Abdominal or stomach pain
  • chills
  • clay-colored stools
  • dark urine
  • dizziness
  • fever
  • headache
  • itching
  • loss of appetite
  • nausea
  • rash
  • unpleasant breath odor
  • unusual tiredness or weakness
  • vomiting of blood
  • yellow eyes or skin
Incidence not known
  • Bloating
  • bloody or black, tarry stools
  • bloody or cloudy urine
  • change in consciousness
  • chest pain or discomfort
  • confusion
  • constipation
  • darkened urine
  • decreased urine output
  • difficult or troubled breathing
  • dilated neck veins
  • drowsiness
  • extreme fatigue
  • fainting
  • fast, slow, pounding, or irregular heartbeat or pulse
  • fever with or without chills
  • hives
  • hoarseness
  • indigestion
  • irregular, fast or slow, or shallow breathing
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • light-colored stools
  • loss of consciousness
  • muscle tremors
  • no blood pressure or pulse
  • no breathing
  • pain or discomfort in the arms, jaw, back, or neck
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale or blue lips, fingernails, or skin
  • rapid, deep breathing
  • redness of the skin
  • restlessness
  • right upper abdominal or stomach pain and fullness
  • severe stomach pain
  • shakiness and unsteady walk
  • shortness of breath
  • stomach cramps
  • stopping of the heart
  • sudden decrease in the amount of urine
  • swelling of the eyelids, face, fingers, lips, hands, lower legs, or feet
  • thoughts of suicide
  • tightness in the chest
  • troubled breathing or swallowing
  • unconsciousness
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • vomiting of blood or material that looks like coffee grounds
  • weight gain
  • wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Bluish color of the fingernails, lips, skin, palms, or nail beds
  • convulsion
  • coughing that sometimes produces a pink frothy sputum
  • decreased awareness or responsiveness
  • difficult, fast, or noisy breathing, sometimes with wheezing
  • dilated pupils
  • muscle tremors
  • pale skin
  • pounding or rapid pulse
  • rapid, deep breathing
  • severe sleepiness
  • sleepiness or unusual drowsiness
  • slow to respond
  • slurred speech
  • weight loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Relaxed and calm
Incidence not known
  • Abnormal behavior
  • blurred or loss of vision
  • diarrhea
  • disturbed color perception
  • double vision
  • false or unusual sense of well-being
  • halos around lights
  • mental depression or anxiety
  • muscular pain, tenderness, wasting, or weakness
  • night blindness
  • nightmares or unusually vivid dreams
  • overbright appearance of lights
  • seeing, hearing, or feeling things that are not there
  • swelling of the eye
  • tunnel vision

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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