Nefopam and medical uses

Nefopam,sold under brand names such as Acupan, is a centrally acting, non-opioid pain reliever primarily used to treat moderate to severe pain.Nefopam acts on the brain and spinal cord to reduce pain through novel mechanisms: analgesic effects of triple monoamine reuptake inhibition, and antihyperalgesic activity through modulation of glutamatergic transmission.

Medical use

Nefopam is effective in preventing chills during or after surgery.Nefopam was significantly more effective as an analgesic than aspirin in a clinical trial,although side effects such as sweating, dizziness, and nausea were more frequent, especially at high doses hour.The estimated relative potency of Nefopam and morphine showed that 20 mg Nefopam hydrochloride was as effective as 12 mg morphine,or oxycodone ,while Nefopam tends to produce fewer side effects, does not produce respiratory depression,and is much less likely to be abused, and thus can be used as an alternative to opioid analgesics,or as a Adjunctive therapy used with opioids or other types of pain medication.Nefopam is also used to treat severe hiccups.

Contraindications

Nefopam is contraindicated in patients with convulsive disorders, who have received irreversible monoamine oxidase inhibitors (such as phenelzine, tranylcypromine, or isocarboxazid) within the past 30 days,and in patients with myocardial infarction pain,mainly because of the lack of safety data in these cases.

Side effects

Common side effects include nausea, nervousness, dry mouth, dizziness, and urinary retention.Less common side effects include vomiting, blurred vision, drowsiness, sweating, insomnia, headache, confusion, hallucinations, tachycardia, worsening angina, and rarely transient benign pink skin discoloration or pleomorphism Sexual erythema.

Overdose

Overdose and death have been reported with Nefopam.Overdose usually presents with convulsions,hallucinations, tachycardia, and hyperdynamic cycling.Treatment is usually supportive, with beta-blockers to manage cardiovascular complications and activated charcoal to limit absorption.

Interactive

It has additive anticholinergic and sympathomimetic effects with other drugs with these properties.People who are taking certain types of antidepressants (tricyclic antidepressants or monoamine oxidase inhibitors) should avoid it because of the potential for serotonin syndrome or hypertensive crisis.