Yes

Analgesic, Combination (Narcotic)

Dental: Management of postoperative pain

Medical: Management of mild to moderate pain

C-IV

D

Hypersensitivity to propoxyphene, aspirin or any component

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

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, warfarin, MAO inhibitors, benzodiazepines, warfarin (bleeding); see Aspirin

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

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

Oral:

Adults: 1-2 capsules every 4 hours as needed

No data reported

No information available to require special precautions

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

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to get pregnant. Consult prescriber if breast-feeding.

Monitor pain relief, respiratory and mental status, blood pressure

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