Nefopam Viatris (Nefopam Hydrochloride)

Nefopam Hydrochloride is indicated for pain management within the acute and postoperative pain pathways.

• Moderate acute pain: provides effective analgesia for sudden, non‑chronic pain episodes, improving patient comfort and functional ability.
• Postoperative pain: reduces pain intensity after surgical procedures, facilitating early mobilization and recovery in the postoperative period.
• Trauma‑related pain: helps control pain following injuries such as fractures or soft‑tissue damage, supporting analgesic needs in emergency settings.

• Nefopam Hydrochloride exerts its central analgesic effect by inhibiting the reuptake of serotonin, norepinephrine and dopamine, thereby increasing synaptic concentrations of these neurotransmitters. It also blocks voltage‑gated sodium channels and reduces calcium influx in neuronal membranes, which diminishes neuronal excitability and pain signal transmission. The combined actions result in modulation of pain pathways without direct opioid receptor involvement.

Nefopam Hydrochloride may be associated with a range of adverse reactions, varying in frequency and severity.

Common Side Effects

• Nausea: mild to moderate feeling of queasiness.
• Sweating: increased perspiration without exertion.
• Tachycardia: elevated heart rate.
• Dry mouth: reduced salivation causing discomfort.

Serious or Rare Side Effects

• Seizures: rare occurrence of convulsive episodes.
• Severe hypotension: marked drop in blood pressure.
• Allergic reactions: including rash, urticaria, or anaphylaxis.

When using Nefopam Hydrochloride, clinicians should observe specific precautions to ensure patient safety.

• Cardiovascular monitoring: observe heart rate and blood pressure, especially in patients with pre‑existing cardiac conditions.
• Seizure risk assessment: avoid use in individuals with a history of seizures or epilepsy.
• Drug interactions: review concomitant medications that affect monoamine levels.
• Renal/hepatic function: adjust use in patients with significant impairment.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Store at ambient temperature: keep vials below 25 °C, protect from light and moisture, and retain in original packaging.

Nefopam Hydrochloride can interact with several medicines; awareness of major and moderate interactions helps prevent adverse events.

Major Interactions (Avoid)

• MAO inhibitors: concurrent use may cause hypertensive crisis or serotonin syndrome.
• Tricyclic antidepressants: increased risk of cardiovascular side effects and serotonin toxicity.
• SSRIs/SNRIs: heightened potential for serotonin syndrome.

Moderate Interactions (Monitor Closely)

• Antihypertensives: may enhance hypotensive effects.
• Anticonvulsants: possible reduction in seizure threshold.
• Diuretics: may increase risk of dehydration and electrolyte imbalance.