Adverse reactions associated with nefopam.
OBJECTIVE
To review postmarketing experience of adverse reactions associated with nefopam.


METHODS
Spontaneous reports of adverse reactions associated with nefopam over a 12 year period received by the New Zealand Centre for Adverse Reactions Monitoring were reviewed.


RESULTS
There were 70 reports of adverse reactions thought to be causally related to nefopam, most of which appear to be predictable extensions of the pharmacological effect of nefopam, and included confusion, hallucinations, convulsions, dizziness, headache, sweating, urinary retention, nausea, vomiting, tachycardia and palpitations. The first report of angina is described. Convulsions occurred in a stable epileptic in whom nefopam was contraindicated, and in another where the seizure threshold may have been lowered by a concomitant tricyclic antidepressant.


CONCLUSIONS
Nefopam can cause unpleasant adverse effects and there are important cautions and contraindications with this analgesic. A clearer presentation of its basic pharmacology in the datasheet should help to ensure appropriate use.
Pillans
P I
PI
Centre for Adverse Reactions Monitoring, University of Otago Medical School, Dunedin.
Woods
D J
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D000787:Angina Pectoris / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009340:Nefopam / Q000009:adverse effects*; D011358:Product Surveillance, Postmarketing; D012640:Seizures / Q000139:chemically induced
D018712:Analgesics, Non-Narcotic; D009340:Nefopam