Nefopam Panpharma (Nefopam Hydrochloride)

Nefopam acts as a central analgesic for various pain conditions, providing relief through neurotransmitter modulation.

• Moderate acute pain: reduces intensity of sudden, severe pain episodes in adults.
• Post‑operative pain: facilitates recovery by alleviating surgical site discomfort.
• Musculoskeletal pain: eases chronic strain‑related discomfort in joints and muscles.

• Nefopam inhibits the reuptake of serotonin, norepinephrine and dopamine, increasing their synaptic concentrations, while also blocking voltage‑gated sodium and calcium channels in central neurons. This combined action diminishes neuronal excitability and modulates pain pathways, producing analgesia without engaging opioid receptors. The drug’s effect on monoamine levels enhances descending inhibitory pathways, and the ion‑channel blockade stabilizes neuronal membranes, together contributing to its central analgesic profile.

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

Common Side Effects

• Nausea: mild to moderate feeling of stomach upset.
• Dry mouth: reduced salivation causing throat discomfort.
• Sweating: increased perspiration without exertion.
• Dizziness: transient light‑headedness, especially when standing quickly.

Serious or Rare Side Effects

• Seizures: convulsive episodes requiring immediate medical attention.
• Severe hypotension: sudden drop in blood pressure that may cause fainting.
• Allergic reactions: rash, itching, swelling, or anaphylaxis.
• Stevens‑Johnson syndrome: rare skin disorder with blistering and mucosal involvement.

When prescribing nefopam, clinicians should evaluate patient history and monitor for specific safety concerns.

• Cardiovascular assessment: monitor heart rate and blood pressure for tachycardia or hypotension.
• Seizure risk: avoid use in patients with a history of epilepsy or convulsive disorders.
• Hepatic impairment: adjust therapy and observe liver function tests in patients with liver disease.
• Concomitant serotonergic agents: do not combine with MAO inhibitors, SSRIs, or SNRIs due to serotonin syndrome risk.
• Pregnancy and lactation: use only if the potential benefit justifies the potential risk; consult obstetric guidance.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Nefopam can interact with other medicines, altering its efficacy or increasing toxicity.

Major Interactions (Avoid)

• MAO inhibitors: concurrent use may precipitate severe serotonin syndrome.
• SSRIs, SNRIs, or tricyclic antidepressants: increase risk of serotonin toxicity.
• Anticholinergic drugs: may exacerbate dry mouth and urinary retention.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: nefopam may enhance blood‑pressure‑lowering effects, requiring dose adjustment.
• Anticholinergic medications: monitor for additive anticholinergic burden.
• CNS depressants: may potentiate dizziness or sedation, necessitating observation.