nefopam / Generic mfg. - LARVOL DELTA

Multimodal Pharmacologic Strategies for Chronic Cancer Pain: A Systematic Review. (PubMed, Cureus) - "In one trial, duloxetine was associated with clinically meaningful pain-response rates, although its primary mean pain-score analysis was not statistically significant. Low-dose gabapentin plus imipramine reduced pain and rescue-morphine use. Pregabalin reduced the morphine dose required to maintain pain control in one crossover trial, while other pregabalin studies showed numerical or non-significant benefits. Neither nabiximols trial met its primary efficacy endpoint, and nefopam did not significantly improve pain response or morphine consumption...Overall, the evidence remains heterogeneous and insufficient to support a standard multimodal pharmacological regimen. Selected antidepressant and gabapentinoid strategies, particularly in neuropathic cancer pain, may benefit selected patients."

Journal • Review • Addiction (Opioid and Alcohol) • Oncology • Pain

A randomized trial of nefopam for postoperative pain management in obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty. (PubMed, Eur Arch Otorhinolaryngol) - "Nefopam is not recommended for pain management following UPPP as it did not significantly reduce morphine consumption or improve pain-related outcomes."

Journal • Cardiovascular • Obstructive Sleep Apnea • Pain • Respiratory Diseases • Sleep Disorder

The safety and efficacy of peri-operative nefopam for analgesia in hip and knee arthroplasty: A systematic review and meta-analysis. (PubMed, Eur J Clin Pharmacol) - "Nefopam reduced pain during movement and improved early knee range of motion at 24 h but did not reduce acute opioid consumption or drug-related adverse effects after hip or knee arthroplasty."

Clinical • Journal • Retrospective data • Review • Orthopedics • Pain

Prophylactic Efficacy of Intravenous Nefopam Versus Ondansetron in Preventing Post-Spinal Shivering in Parturients Undergoing Elective Caesarean Section: A Double-Blind Randomised Controlled Trial. (PubMed, Niger Med J) - "Group N received intravenous nefopam (0.15 mg/kg), Group O received intravenous ondansetron (0.1 mg/kg), and Group P received 10 mL of normal saline as a placebo...Side effects and the need for rescue medication (intravenous pethidine 0.5 mg/kg) were also recorded...Intravenous nefopam and ondansetron are similarly effective in preventing post-spinal shivering and reducing rescue analgesia requirements during caesarean section under spinal anaesthesia. Ondansetron showed better antiemetic effect, while nefopam was associated with mild injection-site discomfort."

Journal • Review • Anesthesia • Obstetrics • Pain

Network Pharmacology-guided Target Evaluation of Nefopam for Alzheimer's Disease: Insights from Docking and Molecular Dynamics Simulations. (PubMed, Curr Comput Aided Drug Des) - "Overall, this computational analysis confirms that nefopam can target multiple proteins linked to AD. These results show that more experimental research is necessary to validate nefopam's therapeutic potential and provide positive support for its repositioning in AD treatment."

Journal • Alzheimer's Disease • CNS Disorders • Inflammation • Pain • HTR2A • OPRM1 • SLC6A3 • SLC6A4

Response to "Comment on Opioid-based versus opioid-sparing patient-controlled analgesia using ketorolac and nefopam after total knee arthroplasty: a randomized, double-blind, non-inferiority trial". (PubMed, Korean J Anesthesiol) - No abstract available

Clinical • Head-to-Head • Journal • Orthopedics • Pain

Suspected serotonin toxicity following combined nefopam and tramadol use in an older adult. (PubMed, Clin Toxicol (Phila)) - No abstract available

Journal

Impact of multimodal analgesia using intravenous non-opioid agents on immediate postoperative rescue analgesic use following minor general surgery: a retrospective study. (PubMed, Korean J Pain) - "The primary outcome was the use of rescue analgesics within 4 hours after surgery, comparing triple (acetaminophen [AAP] + nonsteroidal anti-inflammatory drugs [NSAIDs] + nefopam), dual (AAP + NSAIDs, AAP + nefopam, or NSAIDs + nefopam), and single agent regimens...Triple agent intraoperative non-opioid analgesia was associated with the greatest reduction in postoperative rescue analgesic use, with a stepwise benefit observed across single, dual, and triple regimens. These findings support the active use of multimodal non-opioid analgesia in minor general surgery."

Journal • Retrospective data • Pain

Adding nefopam to oxycodone-based patient-controlled analgesia provides noninferior analgesia with opioid sparing after laparoscopic surgery. (PubMed, Sci Rep) - "In this single-blind trial, adding nefopam to oxycodone-based IV PCA provided non-inferior analgesia while substantially reducing opioid consumption after laparoscopic abdominal surgery. These results require confirmation in a double-blind trial with a fixed-opioid-dose design.Trial Registration: This study was registered at the Clinical Research Information Service of the Korean National Institute of Health (CRIS, http//cris.nih.go.kr), with registration number KCT0003896."

Journal • Anesthesia • CNS Disorders • Depression • Pain • Psychiatry

PHARMACOLOGIC STRATEGIES FOR CHRONIC CANCER PAIN: A SYSTEMATIC REVIEW OF MULTIMODAL APPROACHES IN ADULT PATIENTS (MASCC-ISOO 2026) - "Duloxetine added to opioids and Pregabalin significantly improved pain control and pain-related quality of life. Low-dose Gabapentin combined with Imipramine achieved greater pain reduction and reduced opioid rescue use compared with monotherapy. Amitriptyline-Tramadol and Gabapentin-Tramadol provided comparable analgesia...In contrast, nefopam and subcutaneous lidocaine cannot currently be recommended outside clinical trials. Overall, the limited evidence base highlights an urgent need for high-quality studies to inform sustainable long-term pain management in cancer survivors."

Clinical • Review • Oncology • Pain

Pain Outcomes and Predictors in Transoral Vestibular Thyroidectomy. (PubMed, Pain Manag Nurs) - "In this cohort, 59.2% of patients who underwent TOETVA experienced moderate to severe pain. Intraoperative nefopam was associated with lower pain scores, suggesting it may be a beneficial analgesic adjunct for TOETVA."

Journal • Anesthesia • Pain

The safety and efficacy of perioperative nefopam for analgesia in spine surgery: A systematic review and meta-analysis of randomised controlled trials. (PubMed, Neurosurg Rev) - "Perioperative nefopam did not reduce acute morphine use, pain scores, hospital stay, or drug-related adverse events in spine surgery, though most studies used doses below the median effective dose, limiting conclusions on its efficacy and safety."

Clinical • Journal • Retrospective data • Review • Anesthesia • Neuralgia • Orthopedics • Pain

Dose-Dependent Efficacy of Nefopam for Preventing Catheter-Related Bladder Discomfort in Patients Undergoing Transurethral Ureteroscopic Lithotripsy: A Retrospective Case-Control Observational Study. (PubMed, J Clin Med) - "No significant differences were observed among the groups in terms of intraoperative hemodynamic stability or postoperative nausea and vomiting. The administration of nefopam 40 mg significantly reduced the incidence and severity of CRBD compared with no premedication."

Journal • Observational data • Retrospective data • Anesthesia

Opioid-sparing effect of postoperative continuous intravenous nefopam in multilevel degenerative lumbar spinal fusion: a randomized double-blind placebo-controlled trial. (PubMed, Asian Spine J) - "All patients received standardized multimodal analgesia, including intravenous morphine patient-controlled analgesia, acetaminophen, and nonsteroidal anti-inflammatory drugs. In patients undergoing multilevel degenerative lumbar spinal fusion, continuous intravenous nefopam infusion significantly reduced postoperative opioid requirements without worsening adverse events. Nefopam may be a useful opioid-sparing adjunct in multimodal postoperative pain protocols for major spine surgery."

Clinical • Journal • Cardiovascular • Musculoskeletal Diseases • Orthopedics • Pain

Comment on "Opioid-based versus opioid-sparing patient-controlled analgesia using ketorolac and nefopam after total knee arthroplasty". (PubMed, Korean J Anesthesiol) - No abstract available

Journal • Orthopedics • Pain

Continous Infusion of Nefopam for Patients Undergoing Pancreatoduodenectomy (clinicaltrials.gov) - P4 | N=93 | Recruiting | Sponsor: Iuliu Hatieganu University of Medicine and Pharmacy | Not yet recruiting ➔ Recruiting

Enrollment open • Pain

NEFOPAIN kinet: Pharmacokinetic Study of the Use of Nefopam 30 mg Tablets in Patients Suffering From Acute Pain in Rheumatology (clinicaltrials.gov) - P4 | N=24 | Not yet recruiting | Sponsor: University Hospital, Rouen

New P4 trial • Musculoskeletal Pain • Pain • Rheumatology

CHDR2501: Research into new test methods to measure pain with two existing drugs (nefopam and oxycodone) (clinicaltrialsregister.eu) - P1 | N=24 | Completed | Sponsor: Centre for Human Drug Research | Recruiting ➔ Completed

Trial completion • Pain

Clinical Applications and Safety Analysis of Nefopam and Flupirtine as Examples of Non-Opioid Analgesics. (PubMed, Curr Pharm Des) - "Although these agents are beneficial in reducing opioid consumption, their use should be tailored to each patient, with careful follow-up. Patients receiving NOAAs should be monitored for adverse effects, particularly during treatment initiation. Monitoring is also essential for elderly patients and those with cardiovascular or neurological conditions to ensure safe administration. In conclusion, the clinical use of NOAAs requires careful consideration of potential adverse effects, contraindications, and drug interactions. Further well-designed studies are needed to better define these agents' characteristics, limitations, and comparisons with alternative pain management approaches."

Journal • Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Depression • Pain • Psychiatry

CHDR2501: Research into new test methods to measure pain with two existing drugs (nefopam and oxycodone) (clinicaltrialsregister.eu) - P1 | N=24 | Recruiting | Sponsor: Centre for Human Drug Research

New P1 trial • Pain

2022/0355/HP: Pharmacokinetic study of the use of Nefopam 30 mg tablet in patients suffering from acute pain in rheumatology - NEFOPAIN kinetics (clinicaltrialsregister.eu) - P4 | N=29 | Not yet recruiting | Sponsor: Centre Hospitalier Universitaire Rouen

New P4 trial • Musculoskeletal Pain • Pain • Rheumatology

Continous Infusion of Nefopam for Patients Undergoing Pancreatoduodenectomy (clinicaltrials.gov) - P4 | N=93 | Not yet recruiting | Sponsor: Iuliu Hatieganu University of Medicine and Pharmacy

New P4 trial • Pain

Opioid-based versus opioid-sparing patient-controlled analgesia using ketorolac and nefopam after total knee arthroplasty: a randomized, double-blind, non-inferiority trial. (PubMed, Korean J Anesthesiol) - "In this prospective, randomized, double-blind, non-inferiority study, 98 patients undergoing TKA under spinal anesthesia received either opioid-based PCA (continuous infusion of 1200 μg fentanyl, n = 49) or opioid-sparing PCA (continuous infusion of 150 mg ketorolac tromethamine and 100 mg nefopam hydrochloride, n = 49). Nausea and vomiting on POD 1 were more frequent with opioid-based group (34.7% vs. 12.2%, P = 0.009). Opioid-sparing PCA with ketorolac and nefopam provides non-inferior analgesia to opioid-based PCA, while reducing opioid consumption and drug-related adverse effects after TKA."

Clinical • Head-to-Head • Journal • Addiction (Opioid and Alcohol) • Anesthesia • Musculoskeletal Pain • Orthopedics • Pain

Effect of combined acetaminophen and nefopam on postoperative pain in patients undergoing robot-assisted urological surgery: a retrospective propensity score-matched analysis. (PubMed, J Robot Surg) - "Rescue opioid consumption was lower in the preventive group during the PACU (2.5 vs. 7.5 mg morphine equivalent, P < 0.001) and 24-h periods (5 vs. 10 mg, P < 0.001). Their PACU stay was also shorter (34 vs. 40.5 min, P < 0.001). Preventive acetaminophen-nefopam administration was associated with significantly lower postoperative pain severity and opioid requirements and faster recovery after robot-assisted urological surgery."

Journal • Retrospective data • Anesthesia • Pain

Analgesic effect of intravenous nefopam for postoperative pain in spine surgery: a meta-analysis of RCTs. (PubMed, Int J Physiol Pathophysiol Pharmacol) - "The use of intra-venous nefopam offers a small analgesic benefit in spine surgery, which is best seen when applied intermittently or as a bolus rather than as a continuous infusion. Though it is not particularly effective as a standalone agent, bolus does have potential as an adjunct and should be included as part of a more multimodal analgesia approach. Further high quality RCTs with larger sample sizes are warranted to better define the optimal application of nefopam and dosing in patients undergoing spinal surgery."

Journal • Retrospective data • Review • Anesthesia • CNS Disorders • Depression • Orthopedics • Pain • Psychiatry