Nefopam Arrow (Nefopam Hydrochloride)

• Nefopam Arrow is indicated for pain conditions that involve central sensitization and musculoskeletal injury.
• Acute pain: provides rapid analgesia for short‑term severe pain.
• Postoperative pain: reduces need for opioid rescue medication after surgery.
• Musculoskeletal pain: alleviates pain associated with sprains, strains and soft‑tissue injuries.

• Nefopam inhibits the reuptake of norepinephrine, serotonin and dopamine in the central nervous system, thereby enhancing descending inhibitory pathways. It also blocks voltage‑sensitive sodium channels, which reduces neuronal excitability. These actions produce analgesic effects within minutes after intravenous administration and sustain relief for several hours.

Nefopam Arrow may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset, often transient.
• Sweating: increased perspiration, usually temporary and dose‑related.
• Tachycardia: elevated heart rate without underlying cardiac disease, may be self‑limiting.
• Dizziness: sensation of light‑headedness or imbalance, often occurring shortly after dosing.

Serious or Rare Side Effects

• Seizures: rare convulsive episodes, more likely with high plasma concentrations or pre‑existing seizure disorders.
• Severe hypotension: marked drop in blood pressure that may require medical intervention.
• Allergic reactions: skin rash, urticaria or anaphylaxis indicating hypersensitivity.

When prescribing Nefopam Arrow, clinicians should consider several precautionary measures to ensure safe use.

• Assess cardiac history: evaluate for arrhythmias or uncontrolled hypertension before initiation.
• Review seizure risk: avoid in patients with epilepsy or a history of convulsions.
• Monitor blood pressure: observe for hypotension, especially after rapid intravenous administration.
• Use caution in hepatic impairment: adjust therapy if liver function is compromised.
• Avoid concomitant MAO inhibitors: increased risk of serotonin syndrome when combined.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Nefopam Arrow can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• MAO inhibitors: risk of severe serotonin syndrome; concurrent use is contraindicated.
• Tricyclic antidepressants: additive anticholinergic effects and heightened cardiovascular stimulation.
• Anticonvulsants that lower seizure threshold: may increase seizure risk.

Moderate Interactions (Monitor Closely)

• SSRIs and SNRIs: possible enhancement of serotonergic activity, monitor for serotonin syndrome.
• Beta‑blockers: may blunt tachycardia response, observe heart rate.
• Diuretics: potential for additive hypotensive effects, check blood pressure regularly.