nefopam hydrochloride

CLINICAL USE

Analgesic for moderate pain

DOSE IN NORMAL RENAL FUNCTION

Oral: 30–90 mg 3 times a day

PHARMACOKINETICS

Molecular weight :289.8

%Protein binding :73

%Excreted unchanged in urine : <5

Volume of distribution (L/kg) :No data

half-life – normal/ESRD (hrs) :4

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antidepressants: avoid MAOIs; tricyclics possibly increased risk of side effects

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Avoid repeated or chronic administration in end stage renal disease and dialysis patientsIn the elderly a dose of 30 mg 8 hourly is recommended due to reduced metabolism and increased susceptibility to side effects. Renal patients may also have reduced metabolism and excretion so may also have the same problems – always start with the lower doseActive metabolites excreted in the urine .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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