Home Drug Guide Propoxyphene Hydrochloride

Drug Guide

Generic Name

Propoxyphene Hydrochloride

Brand Names Darvon W/ ASA

Classification

Therapeutic: Pain reliever (Analgesic)

Pharmacological: Opioid analgesic, N-Acyl-phenylethylamine derivative

FDA Approved Indications

  • Short-term management of mild to moderate pain

Mechanism of Action

Propoxyphene acts centrally on the brain to alter the perception of and response to pain stimuli. It binds to opioid receptors, producing analgesia and sedation.

Dosage and Administration

Adult: Initially 65 mg every 4 hours as needed; maximum 390 mg per day.

Pediatric: Not recommended for pediatric use.

Geriatric: Use with caution; consider lower doses due to increased sensitivity and risk of adverse effects.

Renal Impairment: Adjust dose as needed; monitor closely.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver via conjugation and other pathways.

Excretion: Excreted primarily in urine.

Half Life: Approximately 2-4 hours.

Contraindications

  • Hypersensitivity to propoxyphene or any component of the formulation.
  • Use in patients with respiratory depression, severe hepatic or renal impairment.
  • Use concomitantly with monoamine oxidase inhibitors (MAOIs).

Precautions

  • Use with caution in elderly, in cases of respiratory depression, head injury, or increased intracranial pressure. Prolonged use may lead to dependence.

Adverse Reactions - Common

  • Dizziness (Common)
  • Drowsiness (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Respiratory depression (Serious, less common)
  • Hepatic impairment (Serious, rare)
  • Allergic reactions including rash (Serious, rare)

Drug-Drug Interactions

  • Additive CNS depression with sedatives, hypnotics, tranquilizers, other opioids.
  • Increased risk of serotonin syndrome with serotonergic drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor pain levels, respiratory status, and for signs of CNS depression.

Diagnoses:

  • Risk for respiratory depression
  • Risk for addiction

Implementation: Administer orally with food to minimize GI upset. Monitor for adverse effects.

Evaluation: Assess pain relief, respiratory status, and consciousness periodically.

Patient/Family Teaching

  • Do not operate machinery or drive until response to medication is known.
  • Report any signs of respiratory depression, rash, or allergic reactions.
  • Avoid alcohol and other CNS depressants.
  • Take medication exactly as prescribed.

Special Considerations

Black Box Warnings:

  • Propoxyphene has a risk of cardiac arrhythmias and death, especially at high doses or with chronic use.
  • It is also associated with dependency.

Genetic Factors: Genetic variations can affect metabolism, potentially influencing efficacy and toxicity.

Lab Test Interference: May interfere with certain hepatic or renal function tests.

Overdose Management

Signs/Symptoms: Respiratory depression, pinpoint pupils, unconsciousness.

Treatment: Supportive care, airway management, naloxone administration if respiratory depression occurs.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.