DARRELL R. ABERNETHY, M.D., Ph.D.; DAVID J. GREENBLATT, M.D.; KNIGHT STEEL, M.D.; RICHARD I. SHADER, M.D.
Propoxyphene, a widely used analgesic, may act synergistically with other centrally active drugs resulting in unexpectedly severe or sometimes fatal central nervous system depression (1). The mechanism of such an interaction has not been defined. In-vitro data suggest inhibition of cytochrome P-450 hepatic oxidative drug metabolism by propoxyphene (2), but conclusive in-vivo data showing propoxyphene impairment of human oxidative drug metabolism are not reported.
We report a doxepin-treated patient whose doxepin plasma levels were monitored before and during propoxyphene therapy. The pharmacokinetic interaction was further assessed by a study of antipyrine metabolism, used as a marker for drug oxidation (3),
ABERNETHY DR, GREENBLATT DJ, STEEL K, SHADER RI. Impairment of Hepatic Drug Oxidation by Propoxyphene. Ann Intern Med. ;97:223–224. doi: 10.7326/0003-4819-97-2-223
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Published: Ann Intern Med. 1982;97(2):223-224.
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