propoxyphene

Pronunciation

Generic Name: propoxyphene (pro POX i feen)
Brand Name: Darvon, Darvon-N, PP-Cap

What is propoxyphene?

Propoxyphene was withdrawn from the U.S. market in November 2010.

Propoxyphene is in a group of drugs called narcotic pain relievers.

Propoxyphene is used to relieve mild to moderate pain.

Propoxyphene may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about propoxyphene?

Propoxyphene was withdrawn from the U.S. market in November 2010.

Do not use this medication if you have a history of suicidal thoughts or actions. Propoxyphene should never be taken together with a sedative (such as Valium or Xanax) or an antidepressant if you are also drinking large amounts of alcohol.

Propoxyphene may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it.

Slideshow: Are You at Risk of Prescription Drug Addiction?

Do not drink alcohol while you are taking propoxyphene. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol.

Never take more than your prescribed dose of propoxyphene. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Propoxyphene can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Do not stop using propoxyphene suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

What should I tell my healthcare provider before taking propoxyphene?

Do not use this medication if you have a history of suicidal thoughts or actions. Propoxyphene should never be taken together with a sedative (such as Valium or Xanax) or an antidepressant if you are also drinking large amounts of alcohol.

Propoxyphene may be habit-forming and should be used only by the person it was prescribed for. Never share propoxyphene with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

If you have any of these other conditions, you may need a dose adjustment or special tests:

  • asthma, COPD, sleep apnea, or other breathing disorders;

  • liver or kidney disease;

  • a history of head injury or brain tumor;

  • mental illness; or

  • a history of drug or alcohol addiction.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Propoxyphene passes into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medicine.

How should I take propoxyphene?

Take this medication exactly as it was prescribed for you. Never take propoxyphene in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take each dose with a full glass of water.

Take propoxyphene with food or milk if it upsets your stomach.

Do not stop using propoxyphene suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store propoxyphene at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Propoxyphene is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since propoxyphene is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of propoxyphene can be fatal, especially if you are also drinking alcohol or taking a sedative or antidepressant.

Overdose symptoms may include extreme drowsiness, pinpoint or dilated pupils, confusion, cold and clammy skin, blue lips, weak pulse, slow or uneven heart rate, shallow breathing, fainting, or breathing that stops.

What should I avoid while taking propoxyphene?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol.

Propoxyphene may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Grapefruit and grapefruit juice may interact with propoxyphene and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Propoxyphene side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • shallow breathing, slow heartbeat;

  • feeling light-headed, fainting;

  • confusion, hallucinations, unusual thoughts or behavior;

  • seizure (convulsions); or

  • jaundice (yellowing of the skin or eyes).

Less serious side effects include:

  • feeling dizzy or drowsy;

  • nausea, vomiting, stomach pain, constipation;

  • headache, muscle pain;

  • blurred vision; or

  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Propoxyphene dosing information

Usual Adult Dose for Pain:

Propoxyphene was voluntarily withdrawn from the US market by the manufacturer in November 2010 due to new data showing that the drug can cause serious toxicity to the heart, even when used at therapeutic doses.
The following dosage information applied to when the drug was available in the US:

65 mg (HCl) orally every 4 hours as needed or
100 mg (Napsylate) orally every 4 hours as needed.

What other drugs will affect propoxyphene?

Do not take propoxyphene with other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Tell your doctor about all other medicines you use, especially:

  • amiodarone (Cordarone, Pacerone);

  • aprepitant (Emend);

  • bosentan (Tracleer);

  • conivaptan (Vaprisol);

  • dexamethasone (Decadron, Hexadrol);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • St. John's wort;

  • an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), rifampin (Rifadin, Rifater, Rifamate), or telithromycin (Ketek);

  • antifungal medication such as clotrimazole (Mycelex Troche), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), or voriconazole (Vfend);

  • an antidepressant such as nefazodone;

  • a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);

  • a blood thinner such as warfarin (Coumadin);

  • heart or blood pressure medication such as diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;

  • HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), saquinavir (Invirase), or ritonavir (Norvir);

  • medicines to treat narcolepsy, such as armodafanil (Nuvigil) or modafanil (Progivil); or

  • seizure medication such as carbamazepine (Carbatrol, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or phenytoin (Dilantin), or primidone (Mysoline).

This list is not complete and other drugs may interact with propoxyphene. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about propoxyphene.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.02. Revision Date: 2010-12-15, 5:01:39 PM.

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