title: [Long-term-treatment of chronic pain patients with flupirtine--on hepatotoxicity and persistent effectiveness from 7 months to 22 years].
abstract: BACKGROUND
  After an extended series of investigations in animals, healthy volunteers and pain patients with different methods, flupirtine was introduced in 1986 into the German market. Flupirtine has a unique chemical structure and differs in its profile of effects and side effects from established NSAIDs (non-steroidal anti-inflammatory drugs) on the one hand and from opioids on the other hand. In the years after introduction, muscle relaxing effects were observed and experimentally shown. They were therapeutically utilized in tension-associated pain. Evidence of the efficacy in acute and chronic musculoskeletal pain syndromes was verified in many controlled and in open studies.
  
  
  METHODS
  Experience report and case presentation
  
  
  RESULTS
  The report in this paper of long-term treatment of chronic pain patients from 7 months to 22 years principally confirms its persistent effectiveness and tolerability. Tiredness and dizziness are frequent side effects. Flupirtine-associated hepatotoxicities are rare events.
  
  
  CONCLUSIONS
  For pain patients for which NSAIDs or opioids are contraindicated or in appropriate, flupirtine is a necessary option.
authors.forename: Roland
authors.initials: R
authors.lastname: Wörz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000631:Aminopyridines / Q000009:adverse effects* / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000631:Aminopyridines; C034161:flupirtine