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- What is propoxyphene and acetaminophen, and how does it work (mechanism of action)?
- Is propoxyphene and acetaminophen available as a generic drug?
- Do I need a prescription for propoxyphene and acetaminophen?
- What are the side effects of propoxyphene and acetaminophen?
- What is the dosage for propoxyphene and acetaminophen?
- Which drugs or supplements interact with propoxyphene and acetaminophen?
- Is propoxyphene and acetaminophen safe to take if I'm pregnant or breastfeeding?
- What else should I know about propoxyphene and acetaminophen?
What is propoxyphene and acetaminophen, and how does it work (mechanism of action)?
Propoxyphene is a strong narcotic pain-reliever and cough suppressant but is weaker than other narcotics such as morphine, codeine, and hydrocodone. The precise mechanism of action is not known but may involve stimulation of opioid receptors in the brain. Propoxyphene increases pain tolerance and decreases discomfort, but the presence of pain is still apparent. In addition to pain reduction, propoxyphene also causes sedation and respiratory depression. Acetaminophen is a non-narcotic analgesic and antipyretic (fever reducer). Acetaminophen relieves pain by elevating the pain threshold. It reduces fever through its action on the heat-regulating center of the brain. The combination of propoxyphene and acetaminophen achieves greater pain relief than either taken separately. For more information on acetaminophen, please see acetaminophen (Tylenol). The FDA first approved propoxyphene/acetaminophen combinations in October 1972.
What are the side effects of propoxyphene and acetaminophen?
The most frequent adverse reactions of propoxyphene include:
Other side effects include:
- constipation, and
- spasm of the ureter, which can lead to difficulty in urinating.
Propoxyphene can depress breathing and, therefore, is 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 it is used short-term.
Quick GuideChronic Pain Syndrome: Treatment and Management for CPS
What is the dosage for propoxyphene and acetaminophen?
The recommended adult dose is 1-2 tablets every 4 hours as needed for relief of pain. The total dose should not exceed six 100/650 mg tablets or twelve 50/325 mg tablets in a 24-hour period.
Which drugs or supplements interact with propoxyphene and acetaminophen?
: 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 greater respiratory depression than either drug alone.
Combining propoxyphene with carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) may have severe 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 or may precipitate withdrawal symptoms from propoxyphene. Acetaminophen is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore drugs that increase the action of liver enzymes that metabolize acetaminophen, for example, carbamazepine (Tegretol), isoniazid (INH, Nydrazid, Laniazid), and rifampin (Rifamate, Rifadin, Rimactane), reduce the levels of acetaminophen and therefore may decrease its action. Doses of acetaminophen greater than the recommended doses are toxic to the liver and may result in severe liver damage. The potential for acetaminophen to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver.
Cholestyramine (Questran) reduces the effect of acetaminophen by decreasing its absorption into the body from the intestine. Therefore, acetaminophen should be administered 3 to 4 hours after cholestyramine or one hour before cholestyramine. Acetaminophen doses greater than 2275 mg per day may increase the blood thinning effect of warfarin (Coumadin) by an unknown mechanism. Therefore, prolonged administration or large doses of acetaminophen should be avoided during warfarin therapy.
Is propoxyphene and acetaminophen safe to take if I'm pregnant or breastfeeding?
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.
What else should I know about propoxyphene and acetaminophen?
What preparations of propoxyphene and acetaminophen are available?
Tablets: propoxyphene/acetaminophen 50/325, 65/650, 100/325, 100/500, and 100 mg/650 mg
How should I keep propoxyphene and acetaminophen stored?
Tablets should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
Propoxyphene and acetaminophen (Darvocet A500; Darvocet-N, Wygesic are no longer available in the U.S.) is a drug prescribed for the treatment of mild to moderate pain. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.
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Drug-Induced Liver Disease
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Tylenol Liver Damage
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Treatment & Diagnosis
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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.
Top propoxyphene and acetaminophen Related Articles
Acetaminophen is a drug that reduces fever and relieves pain. It is available alone, or in combination with hundreds of other drugs available both over-the-counter (without a prescription) or that that may require a prescription from your doctor, for example, acetaminophen and hydrocodone (Vicodin, Norco) or acetaminophen and oxycodone (Percocet).
Acetaminophen treats a variety of diseases or other medical problems that cause pain or fever. Examples of conditions acetaminophen treats include, headache, minor arthritis pain, back pain, tooth pain, menstrual cramps, PMS, osteoarthritis, common cold, tension headache, chronic pain, hip pain, shoulder and neck pain, sore throat, sinus infection, teething, TMJ, bites and stings, and sprains and strains.
Acetaminophen generally has no side effects when taken as prescribed. When side effects are experienced, the most common are headache, rash, and nausea.
In 2014, the FDA recommended that doctors and other health care professionals only prescribe acetaminophen in doses of 325 mg or less. This warning highlights the potential for allergic reactions, for example, face, mouth, and throat swelling, difficulty breathing, itching, or rash. This action also will help reduce the risk of severe liver injury and serious allergic reactions associated with this drug. Other possible serious side effects adverse effects include anemia, kidney damage, thrombocytopenia (a reduced number of platelets in the blood), and liver problems.
Other patient information. Do not take more than one product that contains acetaminophen at the same time. Do not take more than one acetaminophen-containing drug than directed. Do not drink alcohol while taking medicine that contains acetaminophen due to severe liver damage.
REFERENCE: FDA Prescribing Information.
Acetaminophen vs Ibuprofen Side Effects
Acetaminophen (Tylenol and many other brand names is an pain reliever (analgesic) and fever reducer (antipyretic ). Scientists do not know the exact mechanism of action of acetaminophen. Ibuprofen (Advil) is an NSAID (nonsteroidal inti-inflammatory drug) used for the treat inflammation, fever, and mild pain. Ibuprofen works in relieving mild pain, inflammation, and fever by blocking an enzyme that makes chemicals released in the body that promote inflammation (prostaglandins). Prostaglandins promote inflammation in the body.
Common side effects of both acetaminophen and ibuprofen include rash, nausea, and headache.
Side effects specific to acetaminophen include kidney damage, anemia, thrombocytopenia, serious skin reactions, and liver failure.
Side effects of specific to ibuprofen include tinnitus (ringing in the ears), dizziness, drowsiness, stomach pain, constipation, and heartburn.
Dosage depends upon whether the person using acetaminophen or ibuprofen.
ArthritisArthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Chronic PainChronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Drug Induced Liver DiseaseDrug-induced liver diseases are diseases of the liver that are caused by:
- physician-prescribed medications,
- OTC medications,
- illicit (recreational) drugs, and
- environmental toxins.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
Pain ManagementPain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include:
- complex regional pain syndrome,
- interstitial cystitis,
- and irritable bowel syndrome.
propoxyphenePropoxyphene (Darvon, Darvon-N, Dolene) is a drug prescribed for the treatment of mild to moderate pain. Side effects, warnings and precautions, drug interactions, and patient information should be reviewed prior to taking any medication.
Tylenol Liver DamageTylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Signs and symptoms of acetaminophen-induced liver damage may include:
- kidney failure,
- bleeding disorders,
- coma, and