Home Drug Guide Propoxyphene Hydrochloride with Aspirin and Caffeine

Drug Guide

Generic Name

Propoxyphene Hydrochloride with Aspirin and Caffeine

Brand Names Darvon Compound, Darvon Compound-65, Propoxyphene Compound 65, Compound 65

Classification

Therapeutic: Analgesic, Non-opioid combination

Pharmacological: NSAID analgesic combination

FDA Approved Indications

Relief of mild to moderate pain

Mechanism of Action

Propoxyphene is a narcotic analgesic that acts on the CNS to produce analgesia and sedation. Aspirin provides anti-inflammatory, analgesic, and antipyretic effects via inhibition of cyclooxygenase enzymes. Caffeine acts as a central nervous system stimulant, enhancing the analgesic effect and reducing fatigue.

Dosage and Administration

Adult: As prescribed, usually 65-130 mg every 4 hours as needed, not exceeding 6 grams per day.

Pediatric: Not recommended for children due to safety concerns.

Geriatric: Use caution; start at lower doses and monitor closely for adverse effects.

Renal Impairment: Adjust dose as necessary, monitor renal function.

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

Pharmacokinetics

Absorption: Rapid after oral administration.

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

Metabolism: Metabolized in the liver.

Excretion: Excreted mainly via the kidneys.

Half Life: Propoxyphene approximately 6-8 hours; caffeine approximately 3-7 hours.

Contraindications

Hypersensitivity to propoxyphene, aspirin, caffeine.
Use in respiratory depression, acute asthma, or nasal polyps.

Precautions

History of opioid addiction, history of hepatic disease, bleeding disorders, or gastrointestinal bleeding. Use with caution in the elderly and patients with compromised renal or hepatic function.

Adverse Reactions - Common

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

Adverse Reactions - Serious

Respiratory depression (Rare)
Hepatotoxicity (Rare)
Allergic reactions including skin rash (Rare)

Drug-Drug Interactions

MAO inhibitors, other CNS depressants, anticoagulants
Caffeine (with other stimulants)

Drug-Food Interactions

Avoid alcohol, which can increase sedation and risk of gastrointestinal bleeding

Drug-Herb Interactions

Potential interactions with St. John's Wort, valerian, or other CNS-active herbs

Nursing Implications

Assessment: Monitor pain relief, respiratory status, hepatic and renal functions.

Diagnoses:

Impaired breathing, risk of drug dependence, risk for gastrointestinal bleeding.

Implementation: Administer with food if gastrointestinal upset occurs. Monitor for signs of opioid toxicity. Educate patient on avoiding other CNS depressants.

Evaluation: Assess pain relief, respiratory status, and adverse effects periodically.

Patient/Family Teaching

Inform about potential for drowsiness, dizziness, and sedation.
Advise against alcohol and other CNS depressants.
Warn about signs of overdose and when to seek medical help.

Special Considerations

Black Box Warnings:

Addiction, abuse, and misuse leading to overdose and death.
Risk of respiratory depression.
Potential for accidental overdose in children.

Genetic Factors: Genetic variations affecting CYP2D6 enzyme may influence metabolism of propoxyphene.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Respiratory depression, somnolence, pinpoint pupils, coma, hypotension.

Treatment: Supportive care; possibly naloxone for opioid overdose, activated charcoal to prevent absorption, ventilatory support.

Storage and Handling

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

Stability: Stable under recommended storage conditions.