Yes

Analgesic, Narcotic

Dental: Management of postoperative pain

Medical: Management of mild to moderate pain

C-IV

C

Hypersensitivity to propoxyphene, acetaminophen, or any component; patients with known G-6-PD deficiency

When given in excessive doses, either alone or in combination with other CNS depressants, propoxyphene is a major cause of drug-related deaths; do not exceed recommended dosage; give with caution in patients dependent on opiates, substitution may result in acute opiate withdrawal symptoms

1% to 10%:

Gastrointestinal: Nausea, vomiting

Neuromuscular & skeletal: Weakness

Miscellaneous: Psychologic and physical dependence

Decreased effect with charcoal, cigarette smoking; increased toxicity with cimetidine, CNS depressants; increased toxicity/effect of carbamazepine, phenobarbital, TCAs, MAO inhibitors, benzodiazepines

Propoxyphene is a weak narcotic analgesic which acts through binding to opiate receptors to inhibit ascending pain pathways

Propoxyphene, as with other narcotic (opiate) analgesics, blocks pain perception in the cerebral cortex by binding to specific receptor molecules (opiate receptors) within the neuronal membranes of synapses. This binding results in a decreased synaptic chemical transmission throughout the CNS thus inhibiting the flow of pain sensations into the higher centers. Mu and kappa are the two subtypes of the opiate receptor which propoxyphene binds to cause analgesia.

Acetaminophen inhibits the synthesis of prostaglandins in the CNS and peripherally blocks pain impulse generation; produces antipyresis from inhibition of hypothalamic heat-regulating center

Onset of action: 15-60 minutes

Time to peak serum concentration: 2-2.5 hours

Duration: 4-6 hours

Serum half-life:

Propoxyphene: 6-12 hours

Norpropoxyphene: 30-36 hours

Adults: Oral:

Darvocet-N® 100: 1 tablet every 4 hours as needed; maximum: 600 mg propoxyphene napsylate/day

Should be taken with water on an empty stomach

Dizziness, drowsiness, insomnia, and paradoxical excitement are common; may cause nervousness, restlessness, confusion; may rarely cause depression or hallucinations

Concurrent use with psychotropics may produce additive sedation as well as increase their serum levels; monitor for altered clinical response or preferably, use a different analgesic

No information available to require special precautions

No effects or complications reported

See individual agents. Pregnancy precautions: Inform prescriber if you are or intend to get pregnant.

Monitor pain relief, respiratory and mental status, blood pressure, excessive sedation

Tablet:

Darvocet-N® 100: Propoxyphene napsylate 100 mg and acetaminophen 650 mg

Genagesic®, Wygesic®: Propoxyphene hydrochloride 65 mg and acetaminophen 650 mg