What are the therapeutic alternatives to dextropropoxyphene in France? A prescribers' survey.
About a year after dextropropoxyphene (DXP) withdrawal from the French market, we conducted a survey among members of the French Society of Anesthesia & Intensive Care Medicine (Sfar) and of the French Society of the Study and Treatment of Pain (SFETD) to identify the indications for which this WHO level II analgesic had been prescribed, the prescriber's feedback following withdrawal, and the substitutive analgesics prescribed. DXP had been prescribed by more than 75% of the 430 anaesthesiologists and 230 pain specialists interviewed, mainly for acute and chronic non-cancer pain of moderate intensity. While two thirds of pain specialists were not satisfied with DXP withdrawal, this decision did not affect the majority of anaesthesiologists. In both groups, the main substitutive analgesic was tramadol combined with acetaminophen, while only 24% of prescribers considered acetaminophen alone as a substitute.
Department of Anesthesiology and Critical Care, Université Claude-Bernard-Lyon 1, hospices civils de Lyon, CHU de Lyon, groupe hospitalier Nord-hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address: frederic.aubrun@chu-lyon.fr.
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Aubrun
Department of Anesthesiology and Critical Care, Université Claude-Bernard-Lyon 1, hospices civils de Lyon, CHU de Lyon, groupe hospitalier Nord-hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
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Chrétien
Université Claude-Bernard-Lyon 1, collège universitaire de médecine générale, 8, avenue Rockefeller, 69373 Lyon cedex 08, France.
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Letrilliart
Université Claude-Bernard-Lyon 1, UMR CNRS 5558, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France.
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Ginoux
Université Claude-Bernard-Lyon 1, UMR CNRS 5558, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France.
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Belhassen
Department of Pain Management, université Nice-Sophia-Antipolis, Inserm/UdA, U1107, Neuro-Dol, université d'Auvergne, pôle neurosciences cliniques, CHU de Nice, hôpital de Cimiez, 4, avenue Reine-Victoria, 06000 Nice, France.
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Lanteri-Minet
Université Claude-Bernard-Lyon 1, UMR CNRS 5558, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France; Hospices civils de Lyon, CHU de Lyon, groupe hospitalier Nord-hôpital de la Croix-Rousse, service de pneumologie, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
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Van Ganse
Université Rennes 1, CHU de Rennes, pôle d'anesthésie-Samu-urgences-réanimations, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
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Beloeil
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid; D000072080:Anesthesiologists; D000776:Anesthesiology; D003422:Critical Care; D011431:Dextropropoxyphene; D004338:Drug Combinations; D011307:Drug Prescriptions; D005260:Female; D005602:France; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management; D012955:Societies, Medical; D014147:Tramadol / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D004338:Drug Combinations; D000082:Acetaminophen; D014147:Tramadol; D011431:Dextropropoxyphene
Dextropropoxyphene; Pain; Treatment