Prodine, also known by the brand names Prisildine and Nisentil, is a synthetic opioid, analgesic drug used to provide pain relief, most commonly during labor and delivery, for minor surgical procedures, and in dentistry. It has a similar but not identical chemical structure to the opioid drug pethidine, or meperidine, which is more commonly known in North America by the brand name Demerol. There are two types of prodine with somewhat different properties — alphaprodine and betaprodine — but only alphaprodine was ever used by physicians and made available as a pharmaceutical drug. Prodine is no longer commonly used, because the risk of serious complications, including death, is considered too high, especially when compared to similar drugs. One of the major risks when using this drug, even at a medically approved dosage, is respiratory depression, meaning severe breathing problems that can cause oxygen deprivation and eventually death.
Opioid analgesic drugs, such as morphine, methadone, and prodine, share many characteristics. They provide pain relief by affecting both the central and peripheral nervous systems, thereby changing the perception and tolerance of pain, as well as the reaction to it. These drugs also produce sedation, meaning they have a calming effect, and can also give a feeling of euphoria. Common side effects of prodine include itchy skin, nausea, and breathing problems.
Alphaprodine, the form of prodine used for medical purposes, is usually administered by a subcutaneous injection, meaning the drug is injected just below the skin. Compared to meperidine, alphaprodine starts providing pain relief faster, but for a shorter period of time. At a normal dose, it usually provides pain relief and sedation for one to two hours before wearing off. The other type of prodine, betaprodine, was a much more potent drug than alphaprodine, but its effects wore off more quickly. In the United States, betaprodine is listed as a Schedule I drug, meaning it is not considered safe to use for medical or other purposes, and it is illegal to manufacture or distribute it.
For many years, prodine was commonly administered to women during childbirth, and was also used to provide sedation of both adults and children for dental procedures. In obstetrics, it has largely been replaced by other synthetic opioid drugs, such as butorphanol, nalbuphine and fentanyl. The decline in the use of this drug is the result of scientific studies, as well as clinical experience by physicians, linking it to a higher risk of disease, disability, and death, than similar drugs.