When the Food and Drug Administration (FDA) banned drugs containing propoxyphene, known by the brand names Darvon and Darvocet, the drug had become one of the most prescribed painkillers in the country. Patients may be surprised by the sudden discontinuation, but both the safety and efficacy of propoxyphene had put the drug in the hot seat for years.
It was data from a study on the effects of propoxyphene on the heart that led the FDA to remove the drug from the U.S. market. The study showed that drugs containing propoxyphene put users at greater risk of developing potentially fatal heart rhythm abnormalities.
As a painkiller, the drug has also gotten a bad rap. A meta-analysis of 26 trials revealed that the combination pill of propoxyphene and acetaminophen was no more effective at treating arthritis, musculoskeletal, and postoperative pain than acetaminophen alone. Other studies suggest that propoxyphene with acetaminophen was as effective as tramadol, and that ibuprofen was the most effective at treating the pain.
When it comes to finding an alternative medication to propoxyphene, patients may be assessed to see if they truly need an opiate. If possible, they may be given acetaminophen dosed around the clock, or an NSAID, like ibuprofen, if no contraindications exist. If stronger medication is needed to quell pain, acetaminophen combined with codeine or hydrocodone, such as Vicodin, may fill the bill.
Before any changes are made, however, patients should talk to their doctors about the safest way to wean off propoxyphene so that no withdrawal symptoms occur.