Propoxyphene Dosage

Applies to the following strengths: napsylate 100 mg; hydrochloride 65 mg

Usual Adult Dose for:

Pain

Additional dosage information:

Renal Dose Adjustments
Liver Dose Adjustments
Dose Adjustments
Precautions
Dialysis
Other Comments

Usual Adult Dose for Pain

Propoxyphene was voluntarily withdrawn from the US market by the manufacturer in November 2010 due to new data showing that the drug can cause serious toxicity to the heart, even when used at therapeutic doses.
The following dosage information applied to when the drug was available in the US:

65 mg (HCl) orally every 4 hours as needed or
100 mg (Napsylate) orally every 4 hours as needed.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Initial dose: 50 mg of propoxyphene napsylate orally once.

Because of the risk of accumulation of propoxyphene in patients with liver disease and because patients with liver disease may be particularly sensitive to the sedative properties of this drug, use of multiple doses of propoxyphene is not recommended.

If this patient has hepatic failure, use of propoxyphene is not recommended.

Because the elimination of propoxyphene is significantly impaired in patients with liver disease, and because dosage forms of propoxyphene hydrochloride do not readily accommodate small doses, use of propoxyphene hydrochloride is not recommended for the treatment of this patient."

Dose Adjustments

Doses should be titrated to appropriate analgesic effect with consideration of severity of pain and patient size.

If a patient on prolonged therapy, then discontinuation should be gradual. Propoxyphene should be reduced by 25% to 50% daily and the patient should be carefully monitored for signs/symptoms of withdrawal.