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Rediscovery of Nefopam for the Treatment of Neuropathic Pain
Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the non-sedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmi...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Pain Society
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990817/ https://www.ncbi.nlm.nih.gov/pubmed/24748937 http://dx.doi.org/10.3344/kjp.2014.27.2.103 |
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author | Kim, Kyung Hoon Abdi, Salahadin |
author_facet | Kim, Kyung Hoon Abdi, Salahadin |
author_sort | Kim, Kyung Hoon |
collection | PubMed |
description | Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the non-sedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain. |
format | Online Article Text |
id | pubmed-3990817 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Korean Pain Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-39908172014-04-18 Rediscovery of Nefopam for the Treatment of Neuropathic Pain Kim, Kyung Hoon Abdi, Salahadin Korean J Pain Review Article Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the non-sedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain. The Korean Pain Society 2014-04 2014-03-28 /pmc/articles/PMC3990817/ /pubmed/24748937 http://dx.doi.org/10.3344/kjp.2014.27.2.103 Text en Copyright © The Korean Pain Society, 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Kim, Kyung Hoon Abdi, Salahadin Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title | Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title_full | Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title_fullStr | Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title_full_unstemmed | Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title_short | Rediscovery of Nefopam for the Treatment of Neuropathic Pain |
title_sort | rediscovery of nefopam for the treatment of neuropathic pain |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990817/ https://www.ncbi.nlm.nih.gov/pubmed/24748937 http://dx.doi.org/10.3344/kjp.2014.27.2.103 |
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