Nefopam

What is nefopam?

Nefopam is a prescription-only non-opioid painkiller used to treat moderate to severe pain. It’s often prescribed when standard painkillers like paracetamol or ibuprofen aren’t effective enough. Nefopam is available under the brand name Acupan[1]. 

What is nefopam used to treat?

Nefopam is used to relieve moderate to severe pain, including[1]: 

• Post-surgery pain 

• Musculoskeletal pain (e.g., muscle or joint pain) 

• Pain after injury 

• Chronic pain when other treatments aren’t suitable 

How does nefopam work?

Nefopam reduces pain by[1]: 

• Blocking the reuptake of serotonin, dopamine, and noradrenaline 

• Modifying nerve signals by blocking sodium and calcium channels 

This helps change how pain is felt by your brain. 

Who can take nefopam?

Most adults can take nefopam, but caution is needed if you[1]: 

• Are allergic to nefopam 

• Have epilepsy or a history of seizures 

• Have severe liver or kidney problems 

• Have a risk of urinary retention 

• Have a history of drug or alcohol misuse 

• Are taking MAOIs (a type of antidepressant) 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of nefopam?

Each tablet contains 30mg of nefopam. The dose varies depending on your doctor or pharmacist’s instructions[1]: 

• Usual dose: 30-60mg, three times a day 

• Maximum: 90mg, three times a day 

If you’re over 65 or have severe kidney failure, you may be prescribed a lower dose. 

How do you take nefopam?

Nefopam is taken as a tablet[1]: 

• Can be taken with or without food 

• Swallow whole with water 

• Take at regular times each day for best effect 

Can you stop taking nefopam?

Yes, but not suddenly if you've been on it for a while. Your doctor may help you reduce the dose gradually to avoid withdrawal symptoms[1]. 

What do you do if you take too much nefopam?

Overdosing on nefopam is dangerous. Seek emergency help (call 999 or go to A&E) if you or someone else has taken too much. Overdose symptoms include[1]: 

• Seizures 

• Hallucinations 

• Fast heartbeat 

• Agitation 

• Coma 

What do you do if you forget a dose of nefopam?

If you miss your dose of nefopam[1]: 

• Take it as soon as you remember 

• If it’s almost time for your next dose, skip the missed one 

• Don’t take a double dose 

Medicines you can and can’t take with nefopam

Avoid or use with caution[1]: 

• MAOIs (e.g. phenelzine, isocarboxazid) – risk of dangerously high blood pressure 

• Tricyclic antidepressants – increased side effects 

• SSRIs and other serotonergic drugs – risk of serotonin syndrome  (symptoms: agitation, fever, rapid heart rate). 

• Alcohol – worsens side effects like drowsiness and dizziness 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of nefopam?

The most common side effects include[1]: 

• Nausea or vomiting 

• Drowsiness 

• Sweating 

• Dry mouth 

• Dizziness 

The rarer, but more serious side effects include[1]: 

• Hallucinations 

• Confusion (especially in older adults) 

• Agitation, high fever, muscle rigidity, or rapid heart rate – signs of serotonin syndrome  

• Seizures 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include:

• Difficulty breathing

• Tightness in throat and chest

• Swelling of the tongue or throat

• Feeling faint or dizzy

• Blue/grey skin or lips

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about nefopam

Is nefopam addictive? 
Dependence is uncommon but may occur with long-term use. Always taper under medical supervision[1]. 

Can I drive or operate machinery while taking nefopam? 
Nefopam causes drowsiness. Do not drive, cycle, or use tools/machinery until the effects are known[1]. 

Can I drink alcohol on nefopam? 
Avoid it – alcohol can increase side effects[1]. 

Can I take nefopam during pregnancy or breastfeeding? 
Only if recommended by your doctor – it’s usually not advised unless essential[1]. 

For the official NHS guide for nefopam, visit their website.