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Propoxyphene (Darvon)
(prescription opioids)
Summary of Opioids
Opioids are commonly prescribed because of their effective
analgesic, or pain relieving, properties. Studies have shown that
properly managed medical use of opioid analgesic compounds is safe
and rarely causes addiction. Taken exactly as prescribed, opioids
can be used to manage pain effectively.
Among the compounds that fall within this class—sometimes referred
to as narcotics—are morphine, codeine, and related medications.
Morphine is often used before or after surgery to alleviate severe
pain. Codeine is used for milder pain. Other examples of opioids
that can be prescribed to alleviate pain include oxycodone (OxyContin—an
oral, controlled release form of the drug); propoxyphene (Darvon);
hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine
(Demerol), which is used less often because of its side effects. In
addition to their effective pain relieving properties, some of these
medications can be used to relieve severe diarrhea (Lomotil, for
example, which is diphenoxylate) or severe coughs (codeine).
Opioids act by attaching to specific proteins called opioid
receptors, which are found in the brain, spinal cord, and
gastrointestinal tract. When these compounds attach to certain
opioid receptors in the brain and spinal cord, they can effectively
change the way a person experiences pain.
In addition, opioid medications can affect regions of the brain that
mediate what we perceive as pleasure, resulting in the initial
euphoria that many opioids produce. They can also produce
drowsiness, cause constipation, and, depending upon the amount
taken, depress breathing. Taking a large single dose could cause
severe respiratory depression or death.
Opioids may interact with other medications and are only safe to use
with other medications under a physician's supervision. Typically,
they should not be used with substances such as alcohol,
antihistamines, barbiturates, or benzodiazepines. Since these
substances slow breathing, their combined effects could lead to
life-threatening respiratory depression.
Propoxyphene
Dextropropoxyphene is an
analgesic in the
opioid category. It is used to treat mild
to moderate pain and as an
antitussive. It can be used to ease pain
before, during and after an operation. It is often combined with
paracetamol (Acetaminophen) in the
preparation
co-proxamol, however, there is no evidence
that this combination is any more effective than paracetamol alone (This
combination is known as Darvocet in the
US and Capadex or Di-Gesic in
Australia). It is manufactured and marketed
by
Eli Lilly and Company.
Dextropropoxyphene, like
codeine, is a "weak" opioid. Codeine is
more commonly used; however, some individuals (approximately 10-20% of the
Caucasian population) are unable to
metabolize it, due to poor functioning of the enzyme
CYP2D6. It is in these people that
dextropropoxyphene is particularly useful, as its metabolism does not
require CYP2D6.
In the
United States, dextropropoxyphene HCl is
available as a prescription formulation with
acetaminophen in ratio anywhere from 30mg /
600mg to 100mg / 650mg, respectively. These are usually named "Darvocet." On
the other hand, "Darvon" is a pure Propoxyphene preparation available in the
U.S. that does not contain acetaminophen.
Darvon, a dextropropxyphene made by
Eli Lilly, which had been on the market for
25 years, came under heavy fire in 1978 by consumer groups that said it was
associated with
suicide. Darvon was never withdrawn from
the market, but Lilly has waged a sweeping, and largely successful, campaign
among doctors, pharmacists and Darvon users to defend the drug as safe when
it is used in proper doses and not mixed with alcohol.
* page last updated 5/21/2008
Source:
National Institute on Drug
Abuse (NIDA), Wikipedia, various other sources
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