Medicines & treatments centre

NEFOPAM WARNINGS

Nefopam should be used with caution in:

• elderly,
• kidney disease,
• liver disease,
• difficulty passing urine,
• pregnancy,
• breast feeding.

It should not be used in:

• fits or seizures (convulsive disorder),
• your pain is due to a heart attack (myocardial infarction),
• patients taking mono-amine-oxidase inhibitors,
• children under 12 years of age should not take this medication.

Also see list of precautions and interactions

STORAGE

Store below 30ºC.

NEFOPAM USES

What is it used for?

• Nefopam is used to relieve pain.
• It is a powerful and rapidly-acting analgesic, sometimes known as a pain-killer.
• It is used to treat moderate pain.
• In general this drug is used in a wide range of painful conditions.
• Benefits of being on this drug can include pain relief.

Listed below are the typical uses of nefopam:

• the relief of acute and chronic pain, including pain after an operation, dental pain, musculo-skeletal pain, acute traumatic pain and cancer pain.

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

How often do I take it?

• Take the number of tablets, as advised by your doctor, by mouth usually 3 times a day, with a glass of water.
• Use this medication for the duration of the prescription in order to get the most benefit from it.
• Remember to use it at the same time each day - unless specifically told not to by your doctor.
• It may take up to 3 hours before the full benefit of this drug takes effect.
• Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

• Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

• This medicine may make you feel light headed, dizzy or faint. If affected by these side effects, or any other side effects that may impair your abilities, you should not drive or operate machinery. Consult your doctor or pharmacist for more details.

When can I stop?

• Always complete the full course as prescribed by your doctor.

NEFOPAM SIDE EFFECTS

• Feeling sick (nausea),
• lightheadedness,
• dizziness,
• nervousness,
• fainting,
• a decrease in blood pressure,
• numbness or tingling hands and/or feet,
• difficulty passing urine,
• dry mouth,
• convulsions (fits),
• tremor,
• confusion,
• hallucinations.

If any of these persist or you consider them severe then inform your doctor.

Tell your doctor immediately if you develop any of the following symptoms:

• No specific major side effects known, see also symptoms of a serious allergic reaction below.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

NEFOPAM PRECAUTIONS

Before taking nefopam, tell your doctor or pharmacist if you are allergic to it; or to other pain killers; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:

• fits or seizures (convulsive disorder),
• your pain is due to a heart attack (myocardial infarction),
• patients taking mono-amine-oxidase inhibitors,
• children under 12 years of age should not take this medication.

Before using this medication tell your doctor or pharmacist your medical history, especially any of the following:

• kidney disease,
• liver disease,
• difficulty passing urine,
• pregnancy,
• breast feeding.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

• Alcohol intake is not known to affect nefopam.

The elderly: nefopam should be used with caution in the elderly as it may cause hallucinations and confusion. A lower starting dose of one tablet three times daily is recommended.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

The safety of nefopam has not been established during pregnancy. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Nefopam is not safe to take if you are breastfeeding

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

NEFOPAM INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

• mono-amine-oxidase inhibitors.

If you are currently using any such medicine, tell your doctor or pharmacist before starting nefopam.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

• anti-cholinergics,
• sympathomimetics,
• tricyclic antidepressants.

This information does not contain all possible interactions. Therefore, before using nefopam, tell your doctor or pharmacist of all the products you use.

NEFOPAM OVERDOSE

An overdose of nefopam may cause fits, hallucinations, agitation, a rapid heartbeat with an increased pulse and blood pressure.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of nefopam or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.