The effectiveness and side-effect liability of propoxyphene hydrochloride and propoxyphene napsylate in patients with postpartum uterine cramping

Analgesic Efficacy of Dextropropoxyphene and Dextropropoxyphene-containing Combinations: a Review

“…On the other hand, certain of these models such as rheumatoid and osteoarthritis, oral surgery pain (Cooper & Beaver, 1976), dysmenorrhea and, possibly, uterine cramp pain (Bloomfield et al, 1976) are relatively less sensitive to codeine and other opioids than to the aspirin-like drugs. This is evidently a matter of degree rather than a general lack of response to narcotics because the usual doses of codeine and dextropropoxyphene have been shown to be significantly superior to placebo in all of these pain states (Beaver, 1966;Strumia & Babbini, 1973;Forbes et al,1982;Cooper, 1983;Larkin et al, 1979;Morrison et al, 1980;Beaver & McMillan, 1980;Baptisti et al, 1971;Gruber et al, 1971a,c).…”

“…I will therefore discuss the results of those newer studies of apparently suitable scientific design that meet at least the minimum criteria for a valid clinical assay of analgesic activity (Beaver, 1965;Houde et al, 1965Houde et al, ,1966Wallenstein & Houde, 1975;Beaver, 1983), and I will comment on only a few of the studies included in my previous review (Beaver, 1966). 192S hydrochloride or the equivalent 100 mg dose of dextropropoxyphene napsylate is statistically significantly superior to placebo in relieving postoperative and trauma pain (Sunshine et al, 1970(Sunshine et al, , 1971Young, 1978), postpartum uterine cramping (Baptisti et al, 1971;Gruber et al,1971c), postpartum episiotomy pain (Hopkinson et al, 1973;Berry et al, 1975;Gruber, 1977;Bloomfield et al, 1980;Hopkinson, 1980), dysmenorrhea (Larkin et al, 1979;Morrison et al, 1980), postoperative pain in oral surgery outpatients (Winter et al, 1973;Forbes et al, 1982;Cooper, 1983), osteoarticular pain (Strumia & Babbini, 1973), musculoskeletal pain (Messick, 1979) and chronic pain of mixed aetiology (Wang, 1974).…”

“…(Adapted from Gruber et al, 1971c) 193S Dextropropoxyphene dose-response curve and dextropropoxyphene napsylate Several additional studies have also confirmed the existence of a significant positive slope for the dose-response curve of dextropropoxyphene. These studies have incorporated graded doses of the hydrochloride salt from 32 to 200 mg or the equivalent doses of the napsylate salt from 50 to 300 mg (Sunshine et al, 1970(Sunshine et al, , 1971(Sunshine et al, ,1978Baptisti et al,1971;Gruber et al, 1971c).…”

“…Gruber et al (1971c) evaluated analgesia over an 8 h time period while Sunshine et al ( 1971 ) terminated their observations at 6 h, but there is no evidence of a different shape for the time-effect curves of the two salts in the latter investigators' study ( Figure 3). Baptisti et al (1971) also studied graded doses of dextropropoxyphene hydrochloride and napsylate for an 8 h period in postpartum uterine cramp pain. Although the outcome of their assay was not as satisfactory as that of the two studies already discussed (Gruber et al, 1971c;Sunshine et al, 1971), their results were consistent with those of Sunshine et al (1971) in demonstrating a greater than predicted potency for the napsylate as compared with the hydrochloride salt of dextropropoxyphene.…”

Mild analgesics‐a re‐evaluation, Geneva, October 1979.

“…The number of patients in our episiotomy and uterine cramp subgroups was relatively small, but the differential response was statistically significant for virtually every measure of effect, and this difference was consistent for both of (Baptisti, Gruber & Santos, 1971;Bauer, Baptisti & Gruber, 1974) or episiotomy pain (Hopkinson, Bartlett, Steffens, McGlumpy, Macht & Smith, 1973;Hopkinson, 1978;Levin, Bare, Berry & Miller, 1974). It is therefore evident that both types of postpartum pain can respond to oral narcotics.…”