Common brand names: Propoxyphene is a narcotic pain reliever found in Darvon, Darvocet N-100 and Darvon Compound-65.


Description: Propoxyphene is chemically unrelated to the codeine derivatives (codeine, hydrocodone or oxycodone). Propoxyphene is available as two preparations: propoxyphene hydrochloride (HCl) and propoxyphene napsylate. Approximately 65 milligrams of propoxyphene hydrochloride is equal to 100 milligrams of propoxyphene napsylate in terms of pain relief and side effects, with both preparations being equivalent to or slightly weaker than 60 milligrams of codeine.


When used alone at these dosages (as in Darvon), the analgesic effect is inferior to two aspirin or two Tylenol. Propoxyphene is most effective when it is combined with acetaminophen (as in Darvocet N-100) or aspirin (as in Darvon Compound-65).


Dental Uses: Propoxyphene is most commonly prescribed for relief of pain following dental surgery and for temporary relief of toothache.


Dosages for dental purposes: Generally effective prescriptions of propoxyphene include acetaminophen 650 milligrams plus propoxyphene napsylate 100 milligrams (Darvocet N-100), one tablet every four to six hours; or aspirin 389 milligrams, caffeine 32.4 milligrams and propoxyphene hydrochloride 65 milligrams (Darvon Compound-65), one tablet every four hours.


Concerns and possible side effects: Propoxyphene and other oral narcotics (codeine, hydrocodone and oxycodone) produce a relatively high incidence of dizziness, drowsiness, nausea, vomiting and constipation. Dental patients prescribed drugs containing oral narcotics should not operate dangerous machinery or drive automobiles. Alcohol consumption must be avoided while taking narcotics because the combination greatly increases the risk of drowsiness, impaired thinking and unconsciousness. Alcohol consumption also increases the risk for stomach bleeding and ulcers (from aspirin/propoxyphene combinations) and liver damage (from acetaminophen/propoxyphene combinations).


Short-term use of narcotic analgesics (a few days) for post-surgical dental pain does not lead to drug addiction. Concern among some health professionals about the ability of chronic narcotic therapy (of weeks or months duration) to lead to addiction in some patients is largely unfounded, but it is still the subject of debate.


Patients with allergies to acetaminophen should not consume Darvocet N-100, while those allergic to aspirin should avoid Darvon Compound-65. Allergic reactions can range from a mild rash to life-threatening closure of the airway and a fall in blood pressure.

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