PROPIRAM - A REVIEW OF ITS PHARMACODYNAMIC AND PHARMACOKINETIC PROPERTIES, AND CLINICAL USE AS AN ANALGESIC

Propiram is an orally administered opioid analgesic with partial morph ine-like agonist and weak antagonist properties. Analgesic efficacy of propiram, usually 50 or 100mg, appears comparable to that of standard dosages of other oral opioid drugs [i.e. pentazocine, pethidine (mepe ridine)] in patients with acute pain of moderate to severe intensity a rising from various gynaecological and surgical procedures, and may be superior to codeine in gynaecological and postoperative dental pain. Some evidence of a more rapid onset of action for propiram than for th ese opioid agents, and a longer duration of action for propiram than f or codeine, is encouraging but remains to be substantiated in more ext ensive clinical use. The tolerability profile of propiram resembles th ose of others in its class, with drowsiness, nausea and vomiting, and dizziness experienced most frequently in controlled trials. The appare ntly low propensity of propiram for development of physical dependence and psychotomimetic effects requires confirmation with wider clinical experience. Available data thus indicate that propiram is an effectiv e, orally administered opioid analgesic suitable for providing relief of acute moderate to severe pain arising from various surgical or gyna ecological procedures, and that the drug is likely to become a useful alternative in such conditions where opioid analgesia is appropriate.