Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: propoxyphene
BRAND NAME: Darvon, Darvon-N, Dolene
DRUG CLASS AND MECHANISM: Propoxyphene is a narcotic pain-reliever and cough
suppressant but is weaker than morphine, codeine, and hydrocodone. The precise
mechanism of action is not known but may involve stimulation of opioid
(narcotic) receptors in the brain. Propoxyphene increases pain tolerance and
decreases discomfort but the presence of pain still is apparent. In addition to
pain reduction, propoxyphene also causes sedation and respiratory depression.
The FDA approved propoxyphene in August 1957.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablet: 100 mg; Capsules: 65 mg
STORAGE: Capsules and tablets should be stored at room temperature, between
15- 30 C (59-86 F).
PRESCRIBED FOR: Propoxyphene is used for the treatment of mild to moderate
pain.
DOSING: The recommended adult dose is 1 capsule (65 mg) or 1 tablet (100 mg)
every 4 hours as needed for relief of pain. Doses should not exceed 390 mg
(capsule) or 600 mg (tablets) in a 24-hour period.
DRUG INTERACTIONS: Propoxyphene, like other narcotic pain-relievers,
increases the effect of drugs that slow brain function, such as alcohol,
barbiturates, skeletal muscle relaxants, for example, carisoprodol (Soma) and
cyclobenzaprine (Flexeril), and benzodiazepine sedatives, for example, diazepam
(Valium) and lorazepam (Ativan). Combined use of muscle relaxants and
propoxyphene may lead to increased respiratory depression.
Combining propoxyphene with carbamazepine
(Tegretol, Tegretol XR, Equetro, Carbatrol) may have extreme effects on the
brain including coma.
Since propoxyphene causes constipation, the use of antidiarrheals, for
example, diphenoxylate (Lomotil) and loperamide (Imodium), in persons taking
propoxyphene, can lead to severe constipation.
Drugs which both stimulate and block opioid receptors, for example
pentazocine (Talwin), nalbuphine (Nubain),
butorphanol (Stadol), and
buprenorphine (Buprenex) may reduce the effect of propoxyphene and may
precipitate propoxyphene withdrawal symptoms.
PREGNANCY: There are no adequate studies of propoxyphene in
pregnant women.
NURSING MOTHERS: Low concentrations of propoxyphene have been measured in the
breast milk of mothers taking propoxyphene. It is not known whether these small
amounts can cause side effects in nursing infants.
SIDE EFFECTS: The most frequent adverse reactions of propoxyphene include
lightheadedness, dizziness, sedation,
nausea, and vomiting. Other side effects
include drowsiness, constipation, and spasm of the ureter, which can lead to
difficulty in urinating.
Propoxyphene can depress breathing and should be used with caution in
elderly, debilitated patients and in patients with serious lung disease.
Propoxyphene can impair thinking and the physical abilities required for driving
or operating machinery. Propoxyphene may be habit forming. Mental and physical
dependence can occur but are unlikely when used for short-term pain relief.
Reference: FDA Prescribing Information
Last Editorial Review: 10/13/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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