Meds and you

27 September 2013

Dextropropoxyphene and Paracetamol

The combination of dextropropoxyphene and paracetamol is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.


The combination of dextropropoxyphene and paracetamol is the active ingredients found in Distalgesic (Nappi code: 720615-003) and Doxyfene (Nappi code: 721212-018/026).

General information
The combination of dextropropoxyphene and paracetamol is a potent analgesic. An analgesic is a substance which reduces or eliminates pain.

In South Africa this combination is registered for the treatment of mild to moderate pain. It is also effective in reducing fever.

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever. It is suited for both adults and children and, as it does not cause stomach irritation, it is safe to use by those who suffer from peptic ulcers and those who cannot take aspirin.

When taken by mouth it is rapidly absorbed into the body and will be effective within 30 minutes. Paracetamol is safe for occasional use by those being treated with anticoagulants.

Dextropropoxyphene is effective in relieving pain that does not respond, and by combining it with paracetamol, dextropropoxyphene provides an additive analgesic effect. It should be used with caution in those patients with a history of alcohol or drug abuse, as definitive risk of dependency does exist.

It should be noted that pain is a symptom and not a disease, and although this combination may be useful for short-term pain management, long-term relief often requires treatment of the underlying cause. None of the ingredients in this combination cures the underlying condition responsible for pain or fever, but simply keeps the symptoms under control.

A combination product such as this is helpful in reducing the number of tablets taken for pain management.

How does this combination work?
Paracetamol blocks the production of chemicals in the body that are responsible for pain and fever, while propoxyphene exerts its effect by acting on parts of the central nervous system which process pain signals.

Fast facts

Drug schedule: schedule 5
Available as: the combination of dextropropoxyphene and paracetamol is available as tablets and capsules
What does it do? the combination of dextropropoxyphene and paracetamol reduces or eliminates pain.
Overdose risk: high
Dependence risk: high
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information

Onset of effect: within 60 minutes
Duration of action: up to 6 hours
Stopping this medicine: treatment with this combination can be safely stopped if no longer needed. If it has been used for extended periods of time your doctor may need to gradually reduce your dose.
Prolonged use: the likelihood of adverse effects increase with prolonged use. Prolonged use is furthermore not advised tolerance and dependence may occur.

Consult your doctor before using this drug if:

  • you have asthma

  • you have kidney or liver disease

  • you have a history of alcohol or drug abuse

  • you have a head injury

  • you have epilepsy

  • you have difficulty urinating

  • you have a bleeding disorder

  • you have a thyroid disorder

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: this medication is safe to use.
Infants and children: this medication is not intended for use in children.
The elderly: caution is advised in the elderly as an increased risk of adverse effects exists.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication as it may worsen stomach irritation and sedative effects.

Possible side effects

Side Effect
Consult your doctor

Only if severe
In all cases


nausea / vomiting


drowsiness/ dizziness/ light-headedness/ sedation




visual disturbance




change in mood


rash/itchy skin


slurred speech


difficulty breathing






yellow-tinged skin and eyes




Drug interactions:

blood pressure medication reduced pressure-lowering effect
alcohol increased risk of liver damage
warfarin risk of bleeding
atropine and related drugs increased risk of constipation, urinary retention, etc.
carbamzepine increased risk of carbamazepine toxicity
cholestyramine reduced effect of paracetamol
drugs that may cause sedation increased risk of sedation
drugs for treating diarrhoea risk of severe constipation
monoamine oxidase inhibitors increased risk of low blood pressure
chlorpromazine increased painkilling effect
isoniazid risk of paracetamol toxicity; therapeutic doses may not be safe
metoclopramide, domperidone risk of paracetamol toxicity
oral contraceptives reduced paracetamol effect

Disease interactions
Consult your doctor before using this drug if you have asthma, kidney or liver disease, a history of alcohol or drug abuse, a head injury, epilepsy, difficulty urinating, a bleeding disorder, or if you have a thyroid disorder.

Overdose action
An overdose of this medication can be fatal. Seek immediate emergency medical attention.

Recommended dosage
Dosage should not exceed that recommended for each individual agent.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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