Goodbye Darvon?
Because I am a strong advocate of medication-free strategies for stress management, wellness, and a life of excellence, people often assume I am altogether anti-medication. I am not. I believe some medications have a valuable role in our world, and I believe those medications should be prescribed, dispensed, and utilized in a very safe and prudent manner. That being said, I am still a strong advocate for medication-free strategies when appropriate.
Darvon (propoxyphene), a pain medication more often seen as Darvocet (propoxyphene + acetaminophen) has been been around since 1957. However, a Food and Drug Administration advisory board recently voted to recommend its withdrawal from the market.
A review of 26 studies involving 2231 patients showed that Darvocet (propoxyphene + acetaminophen), a pain medication, has proven to be no more effective than acetaminophen alone.(1) Acetaminophen is the active ingredient in the over-the-counter pain medication, Tylenol. Likewise, an evaluation of patients showed Darvocet to be less effective at controlling pain than taking two over-the-counter ibuprofen tablets — the active ingredient in the medications, Advil and Motrin.(2,3)
So, propoxyphene is a miserable pain reliever. So what? Well, it just so happens that it has a nasty safety profile, too. Between 1981 and 2002, this medication has been linked to 7109 deaths. 2110 of these deaths were accidental.(4) It’s side effects may be most prevalent in the elderly.(5) Unfortunately, a review of 21,380 nursing home residents with persistent pain showed that propoxyphene was prescribed for close to 20% of these patients.(6)
For years I’ve said this medication is not the best choice for pain management. There are many medication-free strategies, and many medications that are safer and significantly more effective than propoxyphene. As a proponent of safe and prudent medication-free strategies, and of safe and prudent medication usage, I strongly support the recommendation of the advisory board to remove this dangerous and ineffective medication from the market. How long will it take for the FDA to heed the advice of their appointed advisory board?
Be well -
Chad Simpson
The opinions and information provided by Chad Simpson and/or The Chad Simpson Group are for entertainment and informational purposes only. These opinions and information are not intended to treat, diagnose, or render medical advice. They are not a substitute for medical advice or treatment from your physician or health care practitioner. Always check with your physician before starting any exercise or physical therapy program. Never start, stop, or make changes to your medication or health care regimen without first checking with your physician.
References:
1. Li Wan Po A, Zhang WY. Systematic overview of co-proxamol to assess analgesic effects of addition of dextropropoxyphene to paracetamol. BMJ. 1997; 315:1565-71.
2. The Oxford League. Table of analgesic efficacy. Available at: http://www.jr2.ox.ac.uk/bandolier/booth/painpag/Acutrev/Analgesics/lftab.html (accessed 2008 Oct 8).
3. Collins SL, Edwards JE, Moore RA et al. Single dose dextropropoxyphene, alone and with paracetamol (acetaminophen), for postoperative pain. Cochrane Database Syst Rev. 2000; (2):CD001440.
4. Public Citizen Health Research Group. Petition to the U.S. Food and Drug Administration. February 28, 2006. Available at: http://www.citizen.org/publications/release.cfm?ID=7420 (accessed 2008 Oct 8).
5. McEvoy GK, ed. Propoxyphene hydrochloride/propoxyphene napsylate. In: AHFS Drug Information 2008. Bethesda, MD: American Society of Health-System Pharmacists; 2008:2207-8.
6. Won AB, Lapane KL, Vallow S et al. Persistent nonmalignant pain and analgesic prescribing patterns in elderly nursing home residents. J Am Geriatr Soc. 2004; 52:867-74.