In the presence of amphetamine, propoxyphene overdose increases CNS stimulation and may cause fatal convulsive seizures. It may also account for mood- or thought-altering effects. Excessive opioid receptor stimulation is responsible for the CNS depression, respiratory depression, aspiration pneumonia, miosis, and gastrointestinal effects seen in propoxyphene poisoning. Overdose is commonly broken into two categories - liver toxicity (from paracetamol poisoning) and dextropropoxyphene overdose.Īn overdose of dextropropoxyphene may lead to various systemic effects. It also acts as a potent, noncompetitive α 3β 4 neuronal nicotinic acetylcholine receptor antagonist, as well as a weak serotonin reuptake inhibitor. ĭextropropoxyphene acts as a mu-opioid receptor agonist. This is especially true when the drug is combined with alcohol. Severe toxicity can occur with small increments above the therapeutic dose including cardiotoxicity, and fatal overdoses. It is not intended for use in patients who are prone to suicide, anxiety, panic, or addiction. Contraindications ĭextropropoxyphene is contraindicated in patients allergic to paracetamol (acetaminophen) or dextropropoxyphene, and in alcoholics. Restless legs syndrome ĭextropropoxyphene has been found to be helpful in relieving the symptoms of restless legs syndrome. Like codeine, is a weak opioid, however it has one-third to one-half its analgesic activity. (+)-1,2-Diphenyl-2-propionoxy- 3-methyl-4-di-methylaminobutaneĭextropropoxyphene is generally considered a weak analgesic, with several studies finding its efficacy is no better than acetaminophen.Alpha-d-4-dimethylamino-3-methyl-1,2-diphenyl-2-butanol propionate.The paracetamol combination(s) are known as Capadex or Di-Gesic in Australia, Lentogesic in South Africa, and Di-Antalvic in France (unlike co-proxamol, which is an approved name, these are all brand names).ĭextropropoxyphene is known under several synonyms, including: the generic name of the active ingredient) of the paracetamol/dextropropoxyphene preparation is co-proxamol (sold under a variety of brand names) however, it has been withdrawn since 2007, and is no longer available to new patients, with exceptions. Trade names include Darvocet-N, Di-Gesic, and Darvon with APAP (for dextropropoxyphene and paracetamol). ĭextropropoxyphene is sometimes combined with acetaminophen. Its onset of analgesia (pain relief) is said to be 20–30 minutes and peak effects are seen about 1.5–2.0 hours after oral administration. It is still available in Australia, albeit with restrictions after an application by its manufacturer to review its proposed banning. The drug has been taken off the market in Europe and the US due to concerns of fatal overdoses and heart arrhythmias. It is intended to treat mild pain and also has antitussive (cough suppressant) and local anaesthetic effects. It is an optical isomer of levopropoxyphene. Dextropropoxyphene is an analgesic in the opioid category, patented in 1955 and manufactured by Eli Lilly and Company.
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