Nefopam: A Review of its Pharmacological Properties and Therapeutic Efficacy

  title={Nefopam: A Review of its Pharmacological Properties and Therapeutic Efficacy},
  author={Rennie C. Heel and Rex N. Brogden and Gary E. Pakes and Trevor M. Speight and Graeme S. Avery},
SummarySynopsis: Nefopam1 is a non-narcotic analgesic not structurally related to other analgesic drugs. It is effective by the oral and parenteral routes, and when appropriate dose ratios were compared in short term studies it was shown to produce analgesia comparable to that with the oral analgesics aspirin, dextropropoxyphene and pentazocine, as well as that with ‘moderate’ doses of parenteral morphine, pethidine and pentazocine. However, when ‘higher’ dose ratios were compared, morphine and… 

Nefopam analgesia and its role in multimodal analgesia: A review of preclinical and clinical studies

A review of nefopam combinations including various analgesic drugs (opioids, NSAIDs and paracetamol) reveals that enhanced analgesia was demonstrated in most preclinical and clinical studies, suggesting a role for ne fopam in multimodal analgesia based on its distinct characteristics as an analgesic.

Rediscovery of Nefopam for the Treatment of Neuropathic Pain

The recently discovered dual analgesic mechanisms of action, namely, descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain.

Non-Steroidal Anti-Inflammatory Analgesics Other than Salicylates

Few clinically significant drug interactions are associated with concomitant administration of the arylalkanoic acids or piroxicam and other drugs, but there is a theoretical potential for displacement reactions with drugs that are used at plasma concentrations high enough to exceed the binding capacity of their own primary binding sites.

Intravenous Nefopam Reduces Postherpetic Neuralgia during the Titration of Oral Medications

An intravenous continuous infusion of NFP reduces spontaneous and evoked neuropathic pain with tolerable adverse effects during the titration of oral medications in inpatients with postherpetic neuralgia.

Nefopam and ketorolac: Isobolographic analysis of analgesic effect and pharmacokinetic profile in chicks

The net results indicated a synergistic interaction between nefopam and ketorolac in addition to an alteration in ne fopam pharmacokinetic parameters which may enhance nefipam therapeutic efficacy in chicks.

Status Epilepticus Caused by Nefopam

Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam, and identify the introduced drugs and exclude the possibility of an accidental misuse of other drugs.

Compartmental pharmacokinetics of nefopam during mild hypothermia.

A two-compartment mammillary model with moderate inter-individual variability and inter-occasional variability independent of covariates was found to best describe the pharmacokinetics of nefopam and could be implemented to drive automated pumps.

Nefopam Hydrochloride: A Fatal Overdose.

An autopsy was performed and femoral venous blood, heart blood, urine, and vitreous humor were submitted for toxicological analysis, attributing death to atherosclerotic coronary artery disease and therapeutic drug toxicity.

Old is Gold? Nefopam Hydrochloride, a Non-opioid and Non-steroidal Analgesic Drug and Its Practical One-Pot Synthesis in a Single Solvent for Large-Scale Production

Nefopam hydrochloride is extensively used in most of the European countries until today as an analgesic because of its non-opiate (non-narcotic) and non-steroidal action with fewer side effects

Population pharmacokinetics of nefopam in elderly, with or without renal impairment, and its link to treatment response.

Tachycardia and postoperative nausea and vomiting were best associated with maximal concentration and the rate of increase in nefopam plasma concentration, and Morphine requirement was related to exposure of ne fopam.



Buprenorphine: A Review of its Pharmacological Properties and Therapeutic Efficacy

Buprenorphine appears to produce side effects which are similar to those seen with other morphine- like compounds, including respiratory depression, and animal studies and a direct addiction study in a few volunteers suggest that the dependence liability of buprenorphines may be lower than that of other older morphine-like drugs.

Butorphanol: A Review of its Pharmacological Properties and Therapeutic Efficacy

Studies in animal models and in a few volunteers have suggested that butorphanol may have a lower dependence liability than narcotic drugs such as morphine or pethidine, and if this is indeed the case it will offer an important advantage over these agents.

Controlled Clinical Trial of Oral and Parenteral Nefopam Hydrochloride. A Novel and Potent Analgesic Drug

Nefopam is a potent analgesic of novel structure and unique physiologic properties that is distinctly superior to placebo in analgesic effectiveness, both in the initial single dose and in maintaining therapeutic benefit for the duration of the three-day trial.

Nefopam Hydrochloride*: New Analgesic Agent

Time-course action of the drugs revealed that aspirin 300 mg failed to achieve statistically significant analgesia at any post-treatment observation, whereas nefopam 60 mg was significantly better than placebo at one and three hours in terms of pain intensity and at one hour in termsof pain intensity difference scores.

Comparison of the Analgesic Dose‐Effect Relationships of Nefopam and Oxycodone in Postoperative Pain

Drowsiness and a decrease in the respiratory rate were the principal side‐effects of oxycodone, whereas tachycardia, restlessness, sweating and nausea were more frequent after nefopam.

Nefopam and morphine in man

A comparison was made of morphine and nefopam in 74 patients who required parenteral analgesia for moderate to severe postoperative and somatic pain, using a single administration, 2‐dose level, double‐blind design.

Oral nefopam and aspirin

Treatment effects were consistent and indicative of good dose response to both active medications, and pain relief scores were more variable but were generally in accordance with SPID values.

Comparison of nefopam and pethidine in postoperative pain.

A double-blind, between-patient, two-dose comparison was performed with pethidine and nefopam in 100 subjects, the majority of whom were recovering from upper abdominal surgery, finding the former being not more effective than neFopam 15 mg apart from the duration of analgesia which was longer.

Gastrointestinal Blood Loss Study with a New Analgesic Compound: Nefopam Hydrochloride

  • B. Baltes
  • Medicine
    Journal of clinical pharmacology
  • 1977
A new analgesic compound, nefopam HCl, was studied for possible gastrointestinal blood loss liabilities by Cr-51 red cell tagging and showed a significant increase in occult bleeding in the aspirin-treated subjects, compared with aspirin in usual therapeutic doses.