Nefopam

Indications
 Oral
Moderate acute and chronic pain
Adult: Initially, 60 mg but may range from 30-90 mg tid. Max: 300 mg daily.
Elderly: Initially, 30 mg tid.
Intramuscular
Moderate acute and chronic pain
Adult: 20 mg repeated every 6 hr if required. Patient should be lying down while receiving inj and should remain so for 15-20 min.
Intravenous
Moderate acute and chronic pain
Adult: 20 mg by slow IV inj every 4 hr. Max 120 mg daily. Patient should be lying down while receiving inj and should remain so for 15-20 min.
Contraindications
 History of convulsive disorders.
Warnings / Precautions
 Glaucoma, urinary retention, hepatic or renal impairment. Elderly. Pregnancy.
Adverse Reactions
 Nausea, vomiting, sweating, drowsiness, insomnia, urinary retention, dizziness, hypotension, tremor, paraesthesia, palpitations, lightheadedness, nervousness, mental confusion, blurred vision, headache, dry mouth, angioedema, tachycardia, euphoria, hallucinations, convulsions, temporary pink discolouration of the urine.
Overdose Reactions
 Symptoms: Deep coma with bundle branch block, fever, mydriasis, oliguria, renal failure, ventricular arrhythmia, seizures. Management: Symptomatic and supportive.
Drug Interactions
 Adverse effects increased with antimuscarinic or sympathomimetic drugs. Increased risk of seizures with TCAs. Increased CNS depressant effects with other sedatives.
Potentially Fatal: Additive sympathomimetic effects with MAOIs.
See Below for More nefopam Drug Interactions
Mechanism of Actions
 Nefopam is a non-opioid analgesic and though it acts centrally, its mechanism is not defined. It also exerts antimuscarinic and sympathomimetic actions.
Onset:
Absorption: Well-absorbed from the GI tract. Peak plasma concentrations after 1-3 hr (oral), 1 hr (IM).
Distribution: Protein-binding: 73%. Distributed into breast milk.
Excretion: Primarily via urine (5% as unchanged drug); via faeces. Elimination half-life: Approx 4 hr.
Administration
 May be taken with or without food. (May be taken w/ meals if GI discomfort occurs.)
Storage Conditions
 Oral: Store below 30°C.
ATC Classification
 N02BG06 - nefopam ; Belongs to the class of other analgesics and antipyretics.
Storage
 Oral: Store below 30°C.
Available As
  • Nefopam 20 mg
  • Nefopam 30 mg

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