ALGHAPHAN Injection/Solution for

What is ALGHAPHAN

• Compound & Class: Dextropropoxyphene hydrochloride is a weak synthetic opioid analgesic, chemically related to methadone, used for mild to moderate pain relief and as an antitussive agent :contentReference[oaicite:1]{index=1}.
• Formulation: Provided as a sterile injectable solution in 2 mL ampoules (10 per pack), typically administered intravenously or intramuscularly in a clinical setting.
• History: First introduced in the late 1950s by Eli Lilly under brand names like Darvon; historically used both alone and in combination with analgesics like paracetamol :contentReference[oaicite:2]{index=2}.
• Regulatory Status: Withdrawn from many markets (including EU, US, UK) due to safety concerns, particularly risk of fatal arrhythmias and overdose; infusion forms may still be allowed in specific regions under strict conditions :contentReference[oaicite:3]{index=3}.
• Primary Use: Short-term management of mild to moderate pain, symptomatic relief pre/post procedure, and occasional use for cough suppression or easing mild opioid withdrawal :contentReference[oaicite:4]{index=4}.

How to use ALGHAPHAN

ALGHAPHAN must be administered under strict clinical supervision:

• Route: Administered via IV or IM injection by trained healthcare personnel.
• Preparation: Inspect the ampoule for damage or particulate matter, use aseptic technique.
• Dilution: May be administered as is or diluted per institutional protocol—verify concentration before dosing.
• Monitoring: Continuous assessment of respiration, oxygenation, blood pressure, heart rate, and ECG—given cardiovascular risk.
• Timing: Given based on pain intensity or procedural needs; not for routine outpatient use due to cardiovascular and overdose risk.
• Opioid Precautions: Monitor for respiratory depression; have naloxone available for overdose reversal.
• Discontinuation: Do *not* stop abruptly after repeated doses; tapering may be required to avoid withdrawal symptoms :contentReference[oaicite:5]{index=5}.

Mode of Action ALGHAPHAN

• Opioid Receptor Agonist: Stimulates mu-opioid receptors in the CNS to inhibit pain signal transmission :contentReference[oaicite:6]{index=6}.
• Antitussive Effect: Levo-isomer contributes to mild cough suppression :contentReference[oaicite:7]{index=7}.
• Local Anaesthetic Properties: Exhibits sodium-channel blocking effect (similar to lidocaine), contributing to analgesia and cardiac conduction effects :contentReference[oaicite:8]{index=8}.
• Metabolism: Primarily hepatic (CYP3A4), converted to norpropoxyphene—which has a long half-life and contributes to toxicity and cardiac effects :contentReference[oaicite:9]{index=9}.

ALGHAPHAN Interactions ALGHAPHAN

• CNS Depressants: Concomitant alcohol, benzodiazepines, barbiturates, or other opioids may enhance sedation and respiratory depression.
• Cardiotoxic Agents: Additive risk with antiarrhythmics or drugs prolonging QRS/QT intervals due to sodium-channel and cardiac conduction effects :contentReference[oaicite:10]{index=10}.
• CYP3A4 Modulators: Enzyme inhibitors (e.g., certain azoles, some macrolides) can increase drug levels; inducers (e.g., rifampin, carbamazepine) may reduce efficacy.
• Withdrawal Risk: Methadone or other opioids may overlap, but abrupt switching may precipitate withdrawal; careful transition protocols advised.

Dosage of ALGHAPHAN

• Adults: Typical starting dose ranges from 50–100 mg IV/IM, adjusted to pain control—roughly equivalent to 5–10 mg morphine.
• Elderly/Hepatic/Renal Impairment: Start at lower doses with extended intervals; due to accumulation risk of dextro- and norpropoxyphene.
• Max Limits: Cumulative dosing must be cautious—exceeding therapeutic range may lead to cardiotoxicity or overdose.
• Tapering: If used over time, gradually taper off to avoid withdrawal symptoms such as restlessness and cramps :contentReference[oaicite:11]{index=11}.

Possible side effects of ALGHAPHAN

• Common: Drowsiness, sedation, dizziness, nausea, constipation, sweating :contentReference[oaicite:12]{index=12}.
• Cardiovascular: Bradycardia, hypotension, QRS/QT prolongation, arrhythmias, syncope—especially from norpropoxyphene accumulation :contentReference[oaicite:13]{index=13}.
• Respiratory: Risk of respiratory depression—dose-dependent and needing monitoring.
• CNS Effects: Confusion, seizures (rare), potential dependency and withdrawal syndrome :contentReference[oaicite:14]{index=14}.
• Serious/Rare: Fatal overdose, circulatory collapse, pulmonary edema :contentReference[oaicite:15]{index=15}.

ALGHAPHAN Contraindications ALGHAPHAN

• Absolute: Known hypersensitivity, known or suspected cardiac conduction disorders (e.g., heart block, long-QT syndrome), respiratory depression.
• Relative: Severe hepatic or renal impairment, elderly, adolescents/children, respiratory conditions, concurrent CNS depressants.
• Withdrawn Products: Oral/parenteral forms often contraindicated in many countries; use only under tightly controlled clinical conditions :contentReference[oaicite:16]{index=16}.

Storage of ALGHAPHAN

• Temperature: Store between 15–25 °C; avoid freezing or heat exposure.
• Protection: Keep ampoules in original packaging to protect from light and contamination.
• Sterility: Use single-dose ampoules only once; discard any unused portions after opening.
• Expiry Monitoring: Discard expired units; adhere to institutional disposal protocols.