How does it work?
Acupan tablets contain the active ingredient nefopam hydrochloride, which is a type of medicine known as a non-opioid painkiller.
It is not fully understood how nefopam works, but it interrupts the pain messages being sent to the brain and also acts in the brain to stop pain messages being felt.
Nefopam has fewer side effects than strong opioid painkillers such as codeine and morphine. It can be useful for the management of persistant pain that is not relieved by other non-opioid painkillers such as paracetamol or ibuprofen.
What is it used for?
- Relieving long-term ongoing moderate pain, such as joint or muscle pain or pain caused by cancer.
- Relieving acute moderate pain, such as pain after an operation, dental pain or pain following accidents or injuries.
How do I take it?
- Acupan tablets can be taken either with or without food. The tablets should be swallowed with a drink of water.
- The dose prescribed and how often the medicine needs to be taken depends on the severity of the pain you are experiencing. The usual starting dose in adults is two tablets taken three times a day. Elderly people may be more susceptible to side effects and will usually start on a maximum of one tablet taken three times a day. Your doctor may increase your dose up to a maximum of three tablets taken three times a day depending on your needs.
- It is important to follow the instructions given by your doctor. These will be printed on the dispensing label your pharmacist has put on the packet of medicine.
- This medicine may sometimes cause drowsiness, lightheadedness and blurred vision and so may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance. You should avoid drinking alcohol if you experience these types of side effect, as it is likely to make them worse.
- This medicine may colour the urine pink. This is normal and not harmful.
Use with caution in
- Elderly people.
- People with decreased kidney function.
- People with decreased liver function.
- People who have difficulty passing urine, for example men with an enlarged prostate gland.
Not to be used in
- Children under 12 years old.
- People with a history of convulsions or fits, for example due to epilepsy.
- People taking medicines called monoamine oxidase inhibitors (MAOIs). These include the antidepressants phenelzine, tranylcypromine, isocarboxazid and moclobemide; rasagiline and selegiline used in the treatment of Parkinson's disease; and the antibiotic linezolid.
This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine for use during pregnancy has not been established. The manufacturer advises that it should be avoided during pregnancy unless there are no safer treatment options. Seek further medical advice from your doctor.
- It is not known if this medicine passes into breast milk. There is no information about the safety of this medicine for use during breastfeeding. Seek further medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Feeling sick.
- Dry mouth.
- Difficulty passing urine (urinary retention).
- Low blood pressure.
- Dizziness and fainting.
- Awareness of your heart beat (palpitations).
- Disturbances of the gut such as abdominal pain and diarrhoea.
- Sensation of pins and needles.
- Blurred vision.
- Increased heart rate (tachycardia).
- Difficulty sleeping (insomnia).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Likewise, always ask your doctor or pharmacist before taking any new medicines while taking this one, to check that the combination is safe.
Nefopam should not be taken at the same time as monoamine oxidase inhibitor medicines (MAOIs). These include monoamine-oxidase inhibitor antidepressants such as phenelzine, tranylcypromine, isocarboxazid and moclobemide, the antibiotic linezolid and the anti-Parkinson's medicines selegiline and rasagiline.
There may be an increased risk of side effects if nefopam is used in combination with tricyclic antidepressant medicines such as amitriptyline or imipramine.
There may be an increase in side effects such as dry mouth, difficulty passing urine and confusion if this medicine is taken with other medicines that have anticholinergic effects, including the following:
- anticholinergic medicines for Parkinson's symptoms, eg procyclidine
- antihistamines, eg brompheniramine, chlorphenamine
- antipsychotic medicines, eg chlorpromazine, fluclopentixol
- antisickness medicines, eg promethazine, meclozine, cyclizine
- antispasmodic medicines, eg hyoscine, atropine
- medicines for urinary incontinence, eg oxybutynin, flavoxate, tolterodine, propiverine, trospium
- MAOI antidepressants, eg phenelzine
- muscle relaxants, eg baclofen
- tricyclic antidepressants, eg amitriptyline.
Other medicines containing the same active ingredient
There are currently no other medicines available in the UK that contain nefopam as the active ingredient.