What is Propoxyphene?

Propoxyphene (Darvon® or Darvocet®) is a pain-reliever prescription medication introduced to the public in the 1950s. It is most often used strictly as a pain reliever, and may occasionally be combined with other medications as a cough suppressant. It has properties that make it addictive if used for long periods and it also has been indicated in an increased risk of suicide for people who have mental disorders. In November 2010, the manufacturer of Darvocet® and Darvon® agreed to voluntarily withdraw these drugs from the US market due to concerns that propoxyphene may cause heart rhythm abnormalities.

There are many medications and medical conditions that contraindicate use of propoxyphene. Special care needs to be taken that Darvon® isn’t co-administered with other medicines that act as depressants to the central nervous system (CNS), since Darvon® has similar action. Taking two or more CNS depressants poses strong risk of causing suppression of breathing that can quickly become medically urgent. Patients given propoxyphene are additionally advised to avoid alcohol or use of any CNS depressant street drug.

Some prescribed and over-the-counter medications that are usually not co-administered with Darvon® included tranquilizers (benzodiazepines), antipsychotics, many antidepressants, antihistamines, and other opioid pain relievers. Other drugs that are usually not used with any form of Darvon® include some anti-seizure and mood-stabilizing medications, a few antibiotics, antivirals, and antifungals, and blood thinners like warfarin. Patients are advised to fully discuss with a physician all medications used and to be forthcoming if they intend to continue to use alcohol during treatment.

A number of conditions also contraindicate use of propoxyphene. Its potential high lethality in overdose makes it a poor drug choice for those who are actively suicidal. It’s also not recommended for people with mental health conditions of other types. People who were or are alcoholic or addicted to drugs, those who have present head injuries, and pregnant women should all avoid this medication.

People who can safely take propoxyphene may have different dosages depending on the need. It’s important not to exceed maximum daily dose and to speak with doctors if the medication is not adequately addressing pain. Most people take this medication for a short time to avoid dependence. If the medication is needed for a longer amount of time, dependence is only problematic if larger than safe doses are required or if a person suddenly loses access to the drug. Extended use requires tapering of the medication to avoid withdrawal.

Propoxyphene has several expected common side effects. The most likely one is constipation. Others can include stomach upset, headache, dizziness, drowsiness, rash, and blurred vision. More serious side effects deserve immediate medical attention and include jaundice, seizures, suicidality, confusion, and reduced heart and/or respiratory rate.