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Dextropropoxyphene Facts

Opioid; Depressant; Diphenylpropylamine; Mu-opioid receptor agonist

Description

Dextropropoxyphene (propoxyphene) — sold as Darvon — is a synthetic opioid of the diphenylpropylamine class. It activates opioid receptors in the brain, suppressing pain signals and producing mild sedation.

Subjective effects include mild pain suppression, gentle warmth, light sedation, and a quiet easing of anxiety. The experience is that of a weak, short-lived opioid — modest comfort without the heavy drowsiness or depth of stronger compounds.

Dextropropoxyphene produces moderate physical and psychological dependence,[1] and fatal overdose can occur within an hour at doses only slightly above the therapeutic range.[2] A cardiotoxic metabolite — norpropoxyphene — blocks the heart's electrical signaling in a way naloxone cannot reverse, making standard opioid overdose protocols insufficient.[3]

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 15 mgLight30 – 65 mgCommon65 – 100 mgStrong100 – 200 mgHeavy200+ mg

Starts in 20 – 30 minLasts 4 – 6 hoursAfter-effects 1 – 6 hours

Body and dependence

Acute toxicity
High
Chronic toxicity
High
Physical dependence
Moderate
Psychological dependence
Moderate
Withdrawal
Moderate
Compulsive redosing
Moderate

Tolerance

Builds
Moderate
Fully resets after
1.5 weeks
Carries over to
opioids

Effectslikely at a common dose

Perception
none likely · 1 possible, including Visual acuity suppression
Body
Pain suppression; Pupil constriction; Sedation; +17 possible, including Motor control impairment, Dizziness, Nausea
Thinking
none likely · 10 possible, including Cognitive impairment, Decision impairment, Information processing suppression
Feeling
none likely · 3 possible
Self
none likely · 2 possible, including Craving

Who shouldn't take it

Absolute
Pre-existing cardiac conduction abnormalities; Monoamine oxidase inhibitors; Chronic renal failure; Concurrent CNS depressants
Relative
QTc-prolonging medications; Respiratory disease; Hepatic impairment; CYP3A5 poor expressers; Elderly patients; CYP2D6 substrate medications

Combinations62 recorded

Lethal (7)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Ibogaine; Ketamine; Local anesthetics; Tramadol
Dangerous (40)
Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antihistamines; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Clonidine, Guanfacine; Ephedrine, Pseudoephedrine; Gabapentin, Pregabalin; MAOIs; MDMA, Amphetamines; MDMA, MDA; Naltrexone; Nicotine; NRIs; SNRIs; SSRIs; Stimulants; THC; 5-HTP, Tryptophan; Antipsychotics; Atypical antipsychotics; Buspirone; and 16 more, see full page
Caution (10)
See full page: psychedex.org/substances/dextropropoxyphene
Not graded (5)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Collins GB, Kiefer KS (1981) Propoxyphene dependence: an update — Postgraduate Medicine PMID:7312731
  2. [2]
    ^Whittington RM (1984) Dextropropoxyphene deaths: coroner's report — Human Toxicology PMID:6480014
  3. [3]
    ^Ulens C, Daenens P, Tytgat J (1999) Norpropoxyphene-induced cardiotoxicity is associated with changes in ion-selectivity and gating of HERG currents — Cardiovascular Research PMID:10690289
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