Propoxyphene Abuse, Addiction & Treatment

Is Propoxyphene Available in the United States?

In 2010, the Food and Drug Administration (FDA) removed propoxyphene products due to its effects on heart health.⁴ 

A multiple-ascending dose (MAD) study was completed comparing healthy volunteers who took 600 mg and 900 mg of propoxyphene for 11 days. The study found propoxyphene's effects on the heart were dangerous through an electrocardiogram (EKG).

Doctors have also stopped prescribing propoxyphene for other pain medications, such as codeine and hydrocodone. 

Side Effects of Propoxyphene

The most common side effects of propoxyphene use include:

Severe Side Effects of Propoxyphene

More severe and dangerous effects include:

• Cardiac arrest
• Congestive heart failure
• Myocardial infarction (heart attack)
• Abnormal heart rhythm
• Coma
• Suicide
• Respiratory arrest
• Convulsions

Risks of Propoxyphene

Propoxyphene is classified as a Schedule IV drug by the Drug Enforcement Administration (DEA). These drugs have a low potential for abuse and a low risk of dependence.¹

However, propoxyphene can have serious cardiac effects, leading to severe hypotension (low blood pressure). This can be especially dangerous for patients with difficulties maintaining blood pressure or those with low blood volume.

If you have a head injury, propoxyphene can elevate cerebrospinal fluid, which can become dangerous. The drug can also pass through breast milk, so pregnant people (and those planning to be) should avoid propoxyphene. 

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Propoxyphene Overdose

It's possible to overdose on opioid analgesics like propoxyphene, especially if you abuse or use them without a doctor's prescription. You can also overdose on it accidentally if you take more than the recommended doses.

A propoxyphene overdose can cause respiratory depression, making breathing slow and ineffective. It can also affect breathing rate and rhythm. 

Other signs of propoxyphene overdose include:

• Limp body
• Purple/blue lips and fingernails
• Vomiting
• Pale and clammy skin
• Inability to wake or speak

If any of these symptoms are observed, call emergency medical services immediately.

Darvocet Overdose

It's also possible to overdose on Darvocet, resulting in potentially fatal liver damage. Signs of an acetaminophen overdose include:

• Nausea and vomiting
• Abdominal pain
• General discomfort or unease
• Increased sweating

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Propoxyphene Addiction Symptoms

Although propoxyphene has a low potential for abuse and addiction, it can be addictive. Prolonged use can lead to psychological and physical dependence.

Because the drug is an opioid agonist, it can bind to the opioid receptors in the brain and block your body from feeling pain. This can lead to feelings of relaxation and euphoria, which can be very addictive.

Signs of opioid addiction and abuse include:

• Drowsiness
• Changes in sleep patterns
• Frequent flu-like symptoms
• Changes in exercise habits
• Money problems
• Lack of hygiene
• Isolation from family or friends
• Weight loss
• Decreased libido
• Stealing from family, friends, or businesses
• Associating with people who encourage addiction

Propoxyphene Withdrawal Symptoms

People who use propoxyphene for an extended period can become physically and psychologically dependent on it. They would need to take the drug to feel and function normally.

If they suddenly stop using propoxyphene, they'll experience withdrawal symptoms, including: 

Talk to your doctor about quitting propoxyphene, and don't attempt to quit alone. Withdrawal symptoms can be dangerous and require immediate medical attention. In severe cases, it can lead to death.

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Opioid Addiction Treatment

One supervised method of stopping propoxyphene use is tapering off the drug. This process reduces the dosing slowly over some time to prevent shock to the body’s systems, minimizing withdrawal symptoms.

Your doctor may also provide medications to help you detox from propoxyphene. Talk to a doctor or an addiction specialist; they can recommend treatment programs that cater to your needs.

Available treatment options for opioid addiction include:

• Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
• Outpatient treatment: A program where you are freely allowed to leave the rehab facility
• Cognitive behavioral therapy: A short-term therapy technique that explores the link between thought patterns and addiction
• Medication-assisted treatment: Involves using medication, counseling, and therapy to treat addiction
• Support groups and aftercare programs: Provide a much-needed community to help maintain sobriety after treatment

Who Should Avoid Propoxyphene?

Avoid propoxyphene if you have a history of suicidal thoughts or actions. You should also avoid using propoxyphene if you experience the following:

• Asthma, sleep apnea, or other breathing disorders
• Liver or kidney problems
• Mental illness
• History of substance use disorders (SUD)

Drug Interactions

Propoxyphene is a central nervous system (CNS) depressant that slows down the body’s systems. Mixing it with other drugs can increase the risk of severe side effects or change the medication's effects.

A drug interaction with propoxyphene can lead to severe breathing problems like respiratory depression and even death. Because of this, you should avoid combining propoxyphene with the following:

• Antidepressants (Monoamine oxidase inhibitors)
• Sedatives
• Tranquilizers
• Muscle relaxants
• Opioids and opiates
• Barbiturates

Propoxyphene is metabolized by the enzyme CPY3A4, which breaks down other medications and food. Avoid grapefruit juice and the actual fruit while taking the drug, and check with your doctor about other medicines that may cause problems.

What Is Propoxyphene?

Propoxyphene (dextropropoxyphene) is a narcotic analgesic that can relieve mild to moderate pain. It was also used as a cough suppressant and muscle relaxant.

Xanodyne Pharmaceuticals manufactured propoxyphene under the brand name Darvon or Darvon-N. There's also a variant that combines it with acetaminophen (Tylenol) called Darvocet.

Propoxyphene Dosage

Darvon is manufactured in 65-milligram (mg) capsules containing the drug in powder form with other inactive ingredients. 

Darvocet comes in tablet form in two different formulations:

• Darvocet-N 50: Contains 50 mg propoxyphene napsylate and 325 mg acetaminophen
• Darvocet-N 100: Contains 100 mg propoxyphene napsylate and 650 mg acetaminophen

Summary

Propoxyphene (dextropropoxyphene) is an opioid pain reliever used to treat mild to moderate pain. However, propoxyphene and propoxyphene-containing products are no longer available in the U.S. due to their effects on heart health.

Although propoxyphene is a Schedule IV controlled substance, it can still cause addiction and dependence. Abusing propoxyphene can lead to dangerous side effects, including cardiac arrest and other heart problems.

If you become dependent on propoxyphene, you may experience withdrawal symptoms when you stop using it. Talk to your doctor about quitting propoxyphene; they can help you taper off the drug and recommend treatment options that cater to your needs.

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