"Toxicity of DXP (Darvon & Darvocet) could occur at dosages as low as twice the therapeutic level"

A short time after the introduction on the market, evidence of high DXO- toxicity began to be reported (Cann and Verhulst, 1960, Hyatt, 1962, Qureshi, 1964, McCarty and Keenan, 1964). It was found that intoxication causing death could occur at dosages as low as twice the therapeutic level (Young and Lawson, 1980, Obafunwa, 1994) and that the acute overdosage produced a pattern of clinical signs very similar to those of morphine poisoning (Young, 1983). 

Further, it was discovered that all the central nervous system effects are markedly potentiated by other central depressants such as alcohol or besodiazepines. If DXP is taken together with alcohol, even doses within the therapeutic range can be lethal (Lund and Nielsen, 1972, Christensen, 1977, Whittington, 1984). DXP and its metabolite, norpropoxyphene, also prolong atrioventricular conduction and slow the heart rate (Inturrisi et al,. 1982)

In fatal DXP poisonings deaths characteristically occurs rapidly, as little as one hour after ingestion of the drug and usually before hospital treatment can be initiated. The rapid absorption of DXP from the gastrointestinal tract may explain why cardiorespiratory arrest can occur as soon as 15 minutes after ingestion of an overdose (Young, 1983, Whittington, 1984).

During the last three decades - (This text was written year 2000) - an overwhelming number of reports of DXP poisoning have been published worldwide.

(Sturner and Garriot, 1973, Simonsen and Pedersen, 1975, 1976, Hudson et al., 1977, Carson and Carson, 1977, Wetli and Bednarczyk, 1980, Oliver et al., 1980, Jöldal and Halvorsen, 1982, Young, 1983, Osselton et al., 1984, Meredith and Vale, 1984, Buckley and Vale, 1984, Whittington, 1984, Shou 1986, Lawson and Northrigde, 1987, Segest, 1987, Melsen and Schurizek, 1987, Shou, 1987; Kaa and Dalgaard, 1987, Raune el al., 1989, Theilade, 1989, Kaa and Dalgaard, 1989, Ott et al., 1994)

Excerpts from “Studies on Dextropropoxyphene With Special Reference to Dependence Among Chronic Pain Patients, Classification of the Manner of Death in Fatal Poisonings, and Characteristics of the Fatal Poisoning Victims” by Birgitta Jonasson. Acta Universitatis Upsalienses, Uppsala 2000.

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