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Pronunciation |
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(proe
POKS i feen & AS pir
in) |
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U.S. Brand
Names |
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Bexophene®; Darvon® Compound-65
Pulvules® |
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Generic
Available |
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Yes |
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Canadian Brand
Names |
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Darvon-N® With ASA; Novo-Propoxyn Compound
(contains caffeine); Darvon-N® Compound (contains
caffeine) |
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Synonyms |
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Propoxyphene Hydrochloride and Aspirin; Propoxyphene Napsylate and
Aspirin |
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Pharmacological Index |
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Analgesic, Combination (Narcotic) |
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Use |
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Dental: Management of postoperative pain
Medical: Management of mild to moderate pain |
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Restrictions |
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C-IV |
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Pregnancy Risk
Factor |
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D |
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Contraindications |
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Hypersensitivity to propoxyphene, aspirin or any
component |
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Warnings/Precautions |
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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; because of aspirin component, children and teenagers should
not use for chickenpox or flu symptoms before a physician is consulted about
Reye's syndrome |
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Adverse
Reactions |
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1% to 10%:
Gastrointestinal: Nausea, vomiting
Neuromuscular & skeletal: Weakness
Miscellaneous: Psychologic and physical dependence |
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Drug
Interactions |
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Decreased effect with charcoal, cigarette smoking; increased toxicity with
cimetidine, CNS depressants; increased toxicity/effect of carbamazepine,
phenobarbital, TCAs, warfarin, MAO inhibitors, benzodiazepines, warfarin
(bleeding); see Aspirin |
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Mechanism of
Action |
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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.
Aspirin inhibits prostaglandin synthesis by decreasing the activity of the
enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin
precursors, acts on the hypothalamic heat-regulating center to reduce fever,
blocks thromboxane synthetase action which prevents formation of the
platelet-aggregating substance thromboxane A2 |
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Pharmacodynamics/Kinetics |
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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 |
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Usual Dosage |
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Oral:
Adults: 1-2 capsules every 4 hours as needed |
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Dietary
Considerations |
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No data reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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Use with caution in patients with platelet and bleeding disorders, renal
dysfunction, erosive gastritis, or peptic ulcer disease, previous nonreaction
does not guarantee future safe taking of medication; use with caution in
impaired hepatic function; do not use aspirin in children <16 years of age
for chickenpox or flu symptoms due to the association with Reye's syndrome
Elderly are a high-risk population for adverse effects from nonsteroidal
anti-inflammatory agents. As much as 60% of elderly with GI complications to
NSAIDs can develop peptic ulceration and/or hemorrhage asymptomatically. Also,
concomitant disease and drug use contribute to the risk for GI adverse effects.
Use lowest effective dose for shortest period possible. Consider renal function
decline with age. Use with caution in patients with history of asthma
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Patient
Information |
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See individual agents. Pregnancy/breast-feeding precautions: Inform
prescriber if you are or intend to get pregnant. Consult prescriber if
breast-feeding. |
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Nursing
Implications |
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Monitor pain relief, respiratory and mental status, blood
pressure |
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Dosage Forms |
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Capsule: Propoxyphene hydrochloride 65 mg and aspirin 389 mg with caffeine
32.4 mg
Tablet (Darvon-N® with A.S.A.): Propoxyphene napsylate
100 mg and aspirin 325 mg |
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Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
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