After the FDA's recent decision to pull Darvon and Darvocet off the market even though it has been used successfully for pain relief by millions of patients since 1957, I can't help but wonder what will be next.
In his commentary on the Darvon (propoxyphene) decision, Dr. S.B. Leavitt of Pain-Topics.org suggested that it may be methadone. He pointed out several similarities between the two medications:
- Methadone and propoxyphene are “chemical cousins.”
- Both have been in use for decades. (Methadone has been used since the 1940s.)
- Both are generic drugs, so very little has been spent on education regarding safe prescribing and use.
- There have been published, abeit controversial, allegations of lethal methadone-induced cardiotoxicity at typical therapeutic doses. Propoxyphene was pulled for that very reason.
- In the past, citizen groups have petitioned for severely restricting or banning both.
Another negative for methadone is that there have been increasing numbers of deaths that have involved methadone abuse and overdose.
On the plus side, methadone is a more effective pain reliever than propoxyphene. It is also widely used in opioid addiction treatment. Hopefully those benefits will be seen as outweighing the risks.
What lies ahead regarding pain relief and the FDA is hard to guess. Although they pay lip service to caring about people in pain, their actions show they are far more concerned about those irresponsible people who may abuse opioids than they are about the patients who suffer with unrelenting pain every day. Only time will tell.
Leavitt SB. Propoxyphene Products Withdrawn in USA. Why? Pain-Topics.org News/Research UPDATES. 11/19/2010.
Published On: November 29, 2010