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American Society for Action on Pain

UI - 000240

AU - Hartman B

AU - Miyada DS

AU - Pirkle H

AU - Sedgwick P

AU - Cravey RH

AU - Tennant FS Jr.

AU - Wolen RL

TI - Serum propoxyphene concentrations in a cohort of opiate addicts on long-term propoxyphene maintenance therapy. Evidence for drug tolerance in humans

AB - AB - Propoxyphene, norpropoxyphene, and cyclic dinorpropoxyphene concentrations in the sera of

eight opiate addicts were measured by gas chromatography. The addicts were enrolled in a propoxyphene

maintenance program and had received 800-1600 mg of propoxyphene napsylate daily for 13-50 months.

Serum propoxyphene and norpropoxyphene ranged from 127 to 1070 ng/mL and 814 to 2638 ng/mL,

respectively, and their ratio ranged from 0.1 to 0.4. A roughly linear dose-to-serum-concentration

relationship was found for serum propoxyphene and norpropoxyphene in the cohort. Cyclic

dinorpropoxyphene was detected in three of the subjects' sera. Because tolerance to propoxyphene occurs,

knowledge of prior drug exposure is necessary to determine whether an elevated propoxyphene or

norpropoxyphene concentration is toxic to patients or decedents with apparent propoxyphene overdose.

Serum norpropoxyphene concentration exceeds that of propoxyphene following chronic propoxyphene use.

Measurable cyclic dinorpropoxyphene implies chronic propoxyphene use but its absence does not exclude

chronic use AD - Department of Pathology AD - Los Angeles County High Desert Hospital AD - Lancaster

AD -CA UI - 88173501

SO - J Anal Toxicol 1988;12:25-29