Pentazocine Nefopam

Guanethidine Monosulphate Mepacrine Hydrochloride Methaqualone Hydrochloride Morphine Sulphate Piperazine Adipate Sulfaquinoxaline Indoramin Hydrochloride Dexamethasone Triclocarban Racemorphan T ryptamine Hydrochloride Nefopam Hydrochloride Pentazocine Hydrochloride Protoveratrine B Morphine Bufylline... 

Severe pain in an opioid addict presents a special problem. High-efficacy opioid may be ineffective (tolerance) or overdose may result low-efficacy opioids will not only be ineffective but may induce withdrawal symptoms, especially if they have some antagonist effect, e.g. pentazocine. This leaves as drugs of choice nonsteroidal anti-inflammatory drugs (NSAIDs), e.g. indometacin, and nefopam (which is neither opioid nor NSAID). 

The manufacturer states that nefopam should not be given to patients taking non-selective MAOIs and caution should be used in those taking tricyclic antidepressants, antimuscarinics and sym-pathomimetics. The intensity and incidence of adverse effects are somewhat increased when nefopam is given with codeine, pentazocine or dextropropoxyphene (propoxyphene), and the CNS depressant effect of dihydrocodeine may have contributed to a fatal overdose with nefopam. However, a morphine-sparing effect has been reported. Nefopam may also have a synergistic analgesic effect with ketoprofen. 

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