Nefopam hydrochloride

Pharmacological properties

Nefopam (3,4,5,6-tetrahydro-5-methyl-1-phenyl-1n-2,5-benzoxazocine hydrochloride) is a strong and fast-acting non-narcotic analgesic, a new representative of centrally acting drugs, different from other painkillers such as morphine, codeine, pentazocine, etc. unlike narcotic analgesics, nefopam does not cause respiratory depression. according to the results of clinical studies, no effect of addiction to the drug was revealed. possesses weak anticholinergic, antihistamines and sympathomimetic properties.

The onset of action of the drug is 15–20 minutes, the maximum concentration in blood plasma is 1.5–2 hours after administration. The elimination half-life is 4-6 hours. The main metabolites are excreted in urine and bile.

Indications

Relief of acute and chronic pain, including pain in the postoperative period, toothache, myalgia, acute pain of traumatic and spastic origin (renal and other colic), pain in cancer patients. Nefopam is used for the prevention and relief of chills, in particular in the postoperative period, as well as for premedication before painful medical procedures.

Application

In / m once administered 20 mg (1 ml) of nefopam. if necessary, the administration is repeated every 6 hours. The maximum daily dose is 120 mg. for premedication in oil 15-20 minutes before surgery or painful procedure, 20 mg of nefopam is administered. treatment initiated with parenteral administration of nefopam can be continued by taking nefopam tablets orally. 2 tablets of nefopam (60 mg) are approximately equivalent to i / m administration of 20 mg of nefopam (contents of 1 ampoule).

Contraindications

History of seizures, concomitant use of MAO inhibitors. Nefop should not be prescribed to children under the age of 12 years, and also used in the treatment of myocardial infarction due to the lack of clinical experience with its use.

Side effects

Nausea, irritability, dry mouth. rarely, when using Nefopam, vomiting, blurred vision, drowsiness, excessive sweating, insomnia, tachycardia occur.

special instructions

It is used with caution in case of liver and renal failure, since in these conditions the metabolism and excretion of nefopam from the body can be impaired. when performing nefopam injection, the patient should be lying. Before the introduction of the drug, it is necessary to carry out aspiration to make sure that the needle does not enter the blood vessel. after injection, the patient should remain in a prone position for 15-20 minutes. the patient should rise from a horizontal position very slowly. rapid administration of nefopam can lead to loss of consciousness.

Interactions

Side effects of nefopam can be enhanced with the simultaneous use of drugs with anticholinergic or sympathomimetic effects. special care must be taken when using nefopam in combination with tricyclic antidepressants.

Storage conditions

In a dry place at a temperature of 15–20 ° C.