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Propoxyphene should not be nixed.

I strongly disagree with the conclusions presented on Darvon and Darvocet, 'Analgesics With Propoxyphene May Head Off Market," Feb. 15, 2009, p. 1).

Propoxyphene (Darvon) and its products have been available since 1957 for use as a supplementary analgesic for mild to moderate pain. I have prescribed Darvocet-N 100 and other Darvon compounds for moderate pain resulting from rheumatoid arthritis, osteoarthritis, and other painful musculoskeletal and rheumatic disorders for many years with considerable success. Undesirable and adverse side effects are usually minimal in both incidence and severity.

Unfortunately, there have not been any randomized, controlled (blinded) studies of efficacy with Darvon and congeners. The available data are chiefly anecdotal, based on clinical observations. I would understand if the Food and Drug Administration wanted to reduce the use of opiates and opioids in chronic nonmalignant rheumatic disease. These potent products can be responsible for serious adverse events and deaths. I do not prescribe hydrocodone preparations, including Percocet, fentanyl, oxycodone (OxyContin), and other morphine products for noncancer chronic disorders.

One to three or four tablets of Darvocet-N 100 daily are usually well tolerated. As to the potential problem of addiction, in my considerable experience, I have not seen a true Darvon addict.

David H. Neustadt, M.D.

Louisville, Ky.

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Title Annotation:LETTERS
Author:Neustadt, David H.
Publication:Family Practice News
Article Type:Letter to the editor
Date:Aug 1, 2009
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