Propoxyphene

A to Z Drug Facts

Propoxyphene

  Action
  Indications
  Contraindications
  Route/Dosage
  Interactions
  Lab Test Interferences
  Adverse Reactions
  Precautions
Patient Care Considerations
  Administration/Storage
  Assessment/Interventions
  Patient/Family Education


(pro-POX-ee-feen)
Propoxyphene Hydrochloride
Darvon-N, Darvon Pulvules
Class: Narcotic analgesic

 Action Relieves pain by stimulating opiate receptors in CNS; also causes respiratory depression, peripheral vasodilation, inhibition of intestinal peristalsis, sphincter of Oddi spasm, stimulation of chemoreceptors that cause vomiting and increased bladder tone.

 Indications Relief of mild-to-moderate pain.

 Contraindications Upper airway obstruction; acute asthma; diarrhea caused by poisoning or toxins.

 Route/Dosage

PROPOXYPHENE HYDROCHLORIDE

ADULTS: PO 65 mg q 4 hr prn; not to exceed 390 mg/day.

PROPOXYPHENE NAPSYLATE

ADULTS: PO 100 mg q 4 hr prn; not to exceed 600 mg/day.

 Interactions

Carbamazepine: Increased carbamazepine serum concentrations. Charcoal: Charcoal decreases the GI absorption of propoxyphene. Cigarette smoking: Decreased propoxyphene effect caused by liver enzyme induction. CNS depressants (eg, alcohol, barbiturate anesthetics, sedatives, tranquilizers): Additive CNS depression. Protease inhibitors: Avoid combination with propoxyphene. Warfarin: Potentiation of hypoprothrombinemic effect.

 Lab Test Interferences Increased amylase and lipase for up to 24 hr after administration.

 Adverse Reactions

CV: Hypotension. CNS: Lightheadedness; dizziness; sedation; disorientation; incoordination; paradoxical excitement; hallucinations; euphoria; dysphoria; insomnia. DERM: Sweating; pruritus; urticaria. GI: Nausea; vomiting; constipation; abdominal pain. GU: Urinary retention or hesitancy. HEPA: Jaundice; abnormal liver function tests. RESP: Depression of cough reflex. OTHER: Tolerance; psychological and physical dependence with chronic use; weakness.

 Precautions

Pregnancy: Category C. Category D-if used for long periods. Lactation: Excreted in breast milk. Children: Not recommended for children. Elderly: The rate of propoxyphene metabolism may be reduced in some patients. Consider increased dosing interval. Special risk patients: Use with caution in patients with myxedema, acute alcoholism, acute abdominal conditions, ulcerative colitis, decreased respiratory reserve, head injury or increased intracranial pressure, hypoxia, supraventricular tachycardia, depleted blood volume or circulatory shock. Drug dependence: Has abuse potential. Fatalities: Excessive doses of propoxyphene alone or with other CNS depressants (including alcohol) are major cause of drug-induced death. Do not use in patients who are suicidal or addiction prone. Hepatic or renal impairment: Duration of action may be prolonged; may need to reduce dose.


PATIENT CARE CONSIDERATIONS


 Administration/Storage

 Assessment/Interventions

OVERDOSAGE: SIGNS & SYMPTOMS
  CNS depression (stupor to coma), respiratory depression, hypotension, seizures, pulmonary edema, cardiac arrhythmias, respiratory-metabolic acidosis

 Patient/Family Education

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© 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts