Nefopam

Source: Wikipedia, the free encyclopedia.
Nefopam
Clinical data
Trade namesnefopam medisol
AHFS/Drugs.comInternational Drug Names
Routes of
administration		intramuscular, intravenous
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
Pharmacokinetic data
BioavailabilityLow[1]
Protein binding70–75% (mean 73%)[1][2]
MetabolismLiver (N-demethylation, others)[1]
MetabolitesDesmethylnefopam, others[1]
Elimination half-lifeNefopam: 3–8 hours[1]
Desmethylnefopam: 10–15 hours[1]
ExcretionUrine: 79.3%[1]
Feces: 13.4%[1]
Identifiers
  • (RS)-5-methyl-1-phenyl-1,3,4,6-tetrahydro-2,5-benzoxazocine
JSmol)
  • CN1CCOC(C2=CC=CC=C2C1)C3=CC=CC=C3
  • InChI=1S/C17H19NO/c1-18-11-12-19-17(14-7-3-2-4-8-14)16-10-6-5-9-15(16)13-18/h2-10,17H,11-13H2,1H3 ☒N
  • Key:RGPDEAGGEXEMMM-UHFFFAOYSA-N ☒N
 ☒NcheckY (what is this?)  (verify)

Nefopam, sold under the brand name Acupan among others, is a centrally acting, non-opioid painkilling medication, that is primarily used to treat moderate to severe pain.[3]

Nefopam acts in the brain and spinal cord to relieve pain via novel mechanisms:

antihyperalgesic activity through modulation of glutamatergic transmission.[4]

Medical uses

Nefopam is effective for prevention of shivering during surgery or recovery from surgery.

hiccups.[16] Nefopam is also used for the manufacture of a medicament for the treatment of an affective disorder and attention-deficit disorder.[17] Nefopam can also be used as a contradiction for the treatment of Parkinson’s disease. https://www.researchgate.net/publication/228540898_Biological_Peculiarities_of_the_Analgesic_Drug_Nefopam_in_Rats

Contraindications

Nefopam is contraindicated in people with convulsive disorders, those that have received treatment with irreversible

monoamine oxidase inhibitors such as phenelzine, tranylcypromine or isocarboxazid within the past 30 days and those with myocardial infarction pain, mostly due to a lack of safety data in these conditions.[18]

Side effects

Common side effects include nausea, nervousness, dry mouth, light-headedness and urinary retention.[18] Less common side effects include vomiting, blurred vision, drowsiness, sweating, insomnia, headache, confusion, hallucinations, tachycardia, aggravation of angina and rarely a temporary and benign pink discolouration of the skin or erythema multiforme.[18]

Overdose

activated charcoal.[18]

Interactions

It has additive anticholinergic and sympathomimetic effects with other agents with these properties.

hypertensive crises to result.[18]

Pharmacology

Nefopam[20][21]
Site Ki (nM)
SERTTooltip Serotonin transporter 29
NETTooltip Norepinephrine transporter 33
DATTooltip Dopamine transporter 531
5-HT2A
 1,685
5-HT2B
 330
5-HT2C
 56

Pharmacodynamics

The

calcium channels.[23][4]

Pharmacokinetics

The

terminal half-life is 3 to 8 hours, while that of its active metabolite, desmethylnefopam, is 10 to 15 hours.[1] It is eliminated mostly in urine, and to a lesser extent in feces.[1]

Chemistry

Nefopam is a

ring system of nefopam is a benzoxazocine system.[24][27]

Society and culture

Recreational use

Recreational use of nefopam has rarely been reported,[19] and is far less common than with opioid analgesics.[28]

Names

In the 1960s, when it was first developed, it had the generic name fenazoxine.[23]

See also

References

  1. ^
    S2CID 34603935
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  2. ISBN 978-94-011-3804-8
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  3. ^ Brayfield A, ed. (27 October 2016). "Nefopam hydrochloride". MedicinesComplete. London, UK: Pharmaceutical Press. Retrieved 4 September 2017.
  4. ^
    PMID 26475417
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  5. S2CID 52288008
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  6. PMID 14695722
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  7. S2CID 41618926
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  8. S2CID 25877487
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  9. PMID 7566787
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  10. S2CID 19051105
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  11. PMID 391253
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  12. ^
    S2CID 24713213
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  13. S2CID 40976610
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  14. S2CID 22220503
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  15. PMID 15616073
    .
  16. PMID 11186682
    .
  17. ^ WO2007012870A2, Lyne, Michael Harvey & Bannister, Robin Mark, "Use of nefopam for the treatment of affective disorders", issued 2007-02-01 
  18. ^ a b c d e f g "Data Sheet ACUPAN™ Nefopam hydrochloride 30 mg tablets 20 mg intramuscular injection" (PDF). Medsafe New Zealand. iNova Pharmaceuticals (New Zealand) Limited. 3 September 2007. Retrieved 10 March 2014.
  19. ^
    PMID 3448182
    .
  20. ^ Roth BL, Driscol J. "PDSP Ki Database". Psychoactive Drug Screening Program (PDSP). University of North Carolina at Chapel Hill and the United States National Institute of Mental Health. Retrieved 14 August 2017.
  21. ^
    PMID 22711801
    .
  22. ^ "New Zealand Data Sheet Acupan(TM)" (PDF). Medsafe. New Zealand The Ministry of Health. 17 May 2017. Retrieved 4 September 2017.
  23. ^
    PMID 24748937
    .
  24. ^
    ISBN 978-0-12-417213-5
    .
  25. ISBN 978-0-471-89979-2
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  26. ISBN 978-3-527-60402-9
    .
  27. ^ Cruz A (2014). Therapeutic Hypothermia. CRC Press. pp. 176–.
  28. PMID 12054367
    .