Dextromoramide

Dextromoramide2DACS

Dextromoramide is a potent synthetic opioid analgesic developed in the 1950s. It is primarily used for the treatment of severe pain. Dextromoramide has a rapid onset of action and a short duration of effect. It is known under the trade name Palfium among others and has been prescribed in various forms, including tablets and injectables.

Pharmacology

Dextromoramide acts on the central nervous system (CNS) by binding to the mu-opioid receptor, which is involved in the perception of pain and reward. Its analgesic potency is higher than that of morphine, making it effective in relieving severe pain. However, its high potency also means that it has a significant potential for addiction and abuse. Dextromoramide's mechanism of action is similar to other opioids, involving the modulation of neurotransmitter release and reducing the transmission of pain signals within the nervous system.

Medical Use

Dextromoramide is indicated for the management of severe pain that cannot be controlled by other analgesics. Its use is generally reserved for cases where other treatments have failed, are contraindicated, or when pain is expected to be short-lived, such as post-operative pain or terminal cancer pain. Due to its potency and risk of dependence, dextromoramide is typically prescribed for short-term use under strict medical supervision.

Side Effects

Like other opioids, dextromoramide can cause a range of side effects, including nausea, vomiting, constipation, drowsiness, and respiratory depression. Its use can also lead to physical dependence and, with prolonged use, addiction. The risk of overdose is significant, particularly when combined with other CNS depressants such as alcohol or benzodiazepines.

Legal Status

The legal status of dextromoramide varies by country, but it is generally classified as a controlled substance due to its potential for abuse and dependence. In some jurisdictions, its medical use is highly restricted or banned altogether.

Conclusion

Dextromoramide is a powerful opioid analgesic with a high potential for abuse and dependence. While it can be effective in managing severe pain, its use is limited by its side effects and the risk of addiction. Healthcare providers must weigh the benefits and risks carefully when prescribing dextromoramide and monitor patients closely for signs of abuse and dependence.