Nefopam Jelfa (Nefopam Hydrochloride)

Nefopam is used to manage pain conditions that require moderate to severe analgesia without opioid therapy.

• Acute postoperative pain: reduces pain intensity after surgical procedures.
• Musculoskeletal pain: alleviates pain associated with strains, sprains, and inflammatory conditions.
• Moderate to severe non‑opioid‑preferred pain: provides effective relief when opioid use is to be avoided.

• Nefopam inhibits the reuptake of norepinephrine, serotonin and dopamine while also blocking voltage‑sensitive sodium channels. This multimodal action reduces central pain transmission without possessing anti‑inflammatory properties, resulting in analgesia across a range of moderate to severe pain states.

Nefopam may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: occasional upset stomach and vomiting.
• Dry mouth: reduced salivation leading to throat discomfort.
• Sweating: increased perspiration, especially in warm environments.
• Dizziness: light‑headed sensation, often transient.
• Constipation: slowed bowel movements.
• Blurred vision: temporary visual disturbances.

Serious or Rare Side Effects

• Tachycardia: rapid heart rate that may require monitoring.
• Seizures: rare occurrence, particularly in predisposed individuals.
• Severe hypotension: marked drop in blood pressure causing faintness.
• Allergic reactions: rash, itching, or swelling of face and throat.
• Agranulocytosis: extremely rare drop in white blood cells.

Before prescribing nefopam, clinicians should consider several safety factors.

• Renal function assessment: adjust use in patients with impaired kidney function.
• Blood pressure monitoring: watch for hypertension or hypotension.
• Seizure history: avoid in individuals with a known seizure disorder.
• Elderly patients: start at lower doses and monitor for confusion.
• Discontinuation: do not stop abruptly without medical advice.
• Store at ambient temperature: keep in the original pack, protect from moisture.

Nefopam can interact with several drug classes; awareness helps prevent adverse outcomes.

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): risk of severe hypertension.
• Selective serotonin reuptake inhibitors (SSRIs) or serotonin‑norepinephrine reuptake inhibitors (SNRIs): potential serotonin syndrome.
• Tricyclic antidepressants: increased risk of cardiovascular side effects.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: may enhance blood pressure‑lowering effects.
• Antipsychotics: possible additive central nervous system depression.
• Other analgesics (e.g., NSAIDs): monitor for cumulative side effects.
• Alcohol: may increase dizziness and hypotension.