Propoxyphene (PPX) is a weak opioid analgesic (pain reliever) that can additionally be used as a local anesthetic and anti-tussive (cough suppressant). Its properties are similar to other weak opioids such as codeine, and until very recently was used in several pharmaceutical preparations that also contained large amounts of aspirin, caffeine or acetaminophen.

In November 2010 the FDA requested that all manufacturers withdraw propoxyphene from sale. Recent clinical studies have concluded that propoxyphenes (such as Darvocet-N® and Di-Gesic®) can put users at risk of serious and sometimes life threatening heart arrhythmia. It is estimated that over 10 million patients have used these products in the United States, and as a result have been instructed to return to their doctors for alternative medications.

Recreationally, propoxyphene is used for its ability to produce euphoria, pain relief and drowsiness. PPX is usually taken orally and its effects peak approximately 1-2 hours after it is taken. Common physiological short-term side effects can include constipation, drowsiness, constricted pupils, respiratory depression, nausea, sore throat, itching, impaired alertness, confusion and possible life-threatening heart arrhythmia.

Continued use can result in tolerance, as well as physical and psychological dependence. Common effects due to a PPX overdose can result in severe damage to the brain and the body’s organs. Side effects include slow and shallow breathing, sweating, severe euphoria, convulsions, coma and/or possible death. Withdrawal symptoms can include cold or flu-like symptoms, irritability, tremors, panic attacks, nausea, chills, drowsiness and a loss of appetite.