U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C17H19NO.ClH
Molecular Weight 289.8
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of NEFOPAM HYDROCHLORIDE

SMILES

Cl.CN1CCOC(C2=CC=CC=C2)C3=CC=CC=C3C1

InChI

InChIKey=CNNVSINJDJNHQK-UHFFFAOYSA-N
InChI=1S/C17H19NO.ClH/c1-18-11-12-19-17(14-7-3-2-4-8-14)16-10-6-5-9-15(16)13-18;/h2-10,17H,11-13H2,1H3;1H

HIDE SMILES / InChI

Molecular Formula C17H19NO
Molecular Weight 253.3389
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 0
Optical Activity ( + / - )

Molecular Formula ClH
Molecular Weight 36.461
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Description
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/mesh/68009340

Nefopam (nefopam hydrochloride) is a potent, rapidly-acting non-narcotic analgesic. It is totally distinct from other centrally-acting analgesics such as morphine, codeine, pentazocine and propoxyphene. Unlike the narcotic agents, nefopam (nefopam hydrochloride) has been shown not to cause respiratory depression. It is indicated for the relief of acute and chronic pain, including post-operative pain, dental pain, musculo-skeletal pain, acute traumatic pain and cancer pain. Its mechanism of action is unclear.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
6.27 null [pKi]
7.53 null [pKi]
7.48 null [pKi]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Nefopam Hydrochloride

Approved Use

Nefopam is indicated for the relief of acute and chronic pain, including post-operative pain, dental pain, musculo-skeletal pain, acute traumatic pain and cancer pain.

Launch Date

2015
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
48.5 nM
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
47.4 nM
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
183.1 nM
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
31 nM
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
50.89 ng/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
41.45 ng/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
377 nM × h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
748 nM × h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
1029 nM × h
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
787 nM × h
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
410.45 ng × h/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
672.93 ng × h/mL
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
5.1 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
10.6 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
5.1 h
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
15 h
20 mg single, intravenous
dose: 20 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
8.08 h
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
10.25 h
75 mg single, oral
dose: 75 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
N-DESMETHYLNEFOPAM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
25%
NEFOPAM plasma
Homo sapiens
Doses

Doses

DosePopulationAdverse events​
120 mg single, oral
Higher than recommended
Dose: 120 mg
Route: oral
Route: single
Dose: 120 mg
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M+F
Food Status: FASTED
Sources:
0.4 mg/kg single, intramuscular
Highest studied dose
Dose: 0.4 mg/kg
Route: intramuscular
Route: single
Dose: 0.4 mg/kg
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M+F
Food Status: UNKNOWN
Sources:
1.8 g single, oral
Lethal dose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Disc. AE: Seizures, Cardiorespiratory arrest...
AEs leading to
discontinuation/dose reduction:
Seizures (grade 5)
Cardiorespiratory arrest (grade 5)
Sources:
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
Disc. AE: Sweating, Drowsiness...
AEs leading to
discontinuation/dose reduction:
Sweating
Drowsiness
Hyperreflexia
Tachycardia
Convulsions grand mal
Sources:
90 mg single, oral
Recommended
Dose: 90 mg
Route: oral
Route: single
Dose: 90 mg
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
AEs

AEs

AESignificanceDosePopulation
Cardiorespiratory arrest grade 5
Disc. AE
1.8 g single, oral
Lethal dose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Seizures grade 5
Disc. AE
1.8 g single, oral
Lethal dose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Convulsions grand mal Disc. AE
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
Drowsiness Disc. AE
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
Hyperreflexia Disc. AE
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
Sweating Disc. AE
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
Tachycardia Disc. AE
1.8 g single, oral
Overdose
Dose: 1.8 g
Route: oral
Route: single
Dose: 1.8 g
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: F
Food Status: UNKNOWN
Sources:
PubMed

PubMed

TitleDatePubMed
The effects of nefopam on the gain and maximum intensity of shivering in healthy volunteers.
2010-08
Prolonged withdrawal delirium in concomitant diphenhydramine and nefopam dependence: A case report.
2010-05-30
Fatal nefopam overdose.
2010-05
[Watch out for headaches at the end of a pregnancy! Do not miss an autoimmune hypositys].
2010-04
Evaluation of the enantioseparation capability of the novel chiral selector clindamycin phosphate towards basic drugs by micellar electrokinetic chromatography.
2010-03-12
Glycogen: a novel branched polysaccharide chiral selector in CE.
2010-03
Development and evaluation of nefopam transdermal matrix patch system in human volunteers.
2010-02-23
Nefopam but not physostigmine affects the thermoregulatory response in mice via alpha(2)-adrenoceptors.
2010-02
Predictive risk factors for pain during extracorporeal shockwave lithotripsy.
2009-12
Positive interference of the analgesic nefopam in the urine immunoassay for benzodiazepines in a secure setting.
2009-11
Managing severe cancer pain: the role of transdermal buprenorphine: a systematic review.
2009-10
High-yielding synthesis of Nefopam analogues (functionalized benzoxazocines) by sequential one-pot cascade operations.
2009-09-07
Investigation of enantiomeric separation of basic drugs by capillary electrophoresis using clindamycin phosphate as a novel chiral selector.
2009-08
Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties.
2009-08
Anaesthetic practices for scheduled caesarean delivery: a 2005 French national survey.
2009-08
Single dose oral nefopam for acute postoperative pain in adults.
2009-07-08
Enatiomeric determination of tramadol and O-desmethyltramadol in human urine by gas chromatography-mass spectrometry.
2009-07-01
Nefopam and alfentanil additively reduce the shivering threshold in humans whereas nefopam and clonidine do not.
2009-07
Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam.
2009-07
Perioperative ketamine does not prevent chronic pain after thoracotomy.
2009-05
Nefopam hydrochloride compatibility and stability with selected proton pump inhibitors in bionolyte G5 injection for intravenous infusion.
2009-02
Compatibility and stability of binary mixtures of acetaminophen, nefopam, ketoprofen and ketamine in infusion solutions.
2009-01
B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients.
2009
Modulation of paracetamol and nefopam antinociception by serotonin 5-HT(3) receptor antagonists in mice.
2009
Contribution of transient receptor potential vanilloid subtype 1 to the analgesic and antihyperalgesic activity of nefopam in rodents.
2009
Cross-reactivity of nefopam and its metabolites with benzodiazepine EMIT immunoassay.
2008-11-22
Nefopam for the prevention of postoperative pain: quantitative systematic review.
2008-11
[Physico-chemical stability and sterility of non-opioid analgesics in solution].
2008-10
[A national survey of postoperative pain management in France: influence of type of surgical centres].
2008-09
A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges.
2008-07-15
Nefopam and ketoprofen synergy in rodent models of antinociception.
2008-04-28
Genetic and chemical modifiers of a CUG toxicity model in Drosophila.
2008-02-13
Hiccup during weaning from mechanical ventilation: the use of nefopam.
2007-11
Effective dose of nefopam in 80% of patients (ED80): a study using the continual reassessment method.
2007-11
[Prevention and relief of pain induced by otolaryngological and cervicofacial surgery].
2007-10
A review of the literature on post-operative pain in older cancer patients.
2007-10
Overview of adverse reactions to nefopam: an analysis of the French Pharmacovigilance database.
2007-10
Analgesic efficacy of bilateral superficial cervical plexus block administered before thyroid surgery under general anaesthesia.
2007-10
The immunopotentiator effects of nefopam.
2007-02
Uterus, fallopian tube, ovary and vagina-sparing laparoscopic cystectomy: technical description and results.
2007-02
[Nefopam by continuous intravenous injection and adverse drug reactions: which causality assessment?].
2007-01
Recent advances in the pharmacological management of pain.
2007
Meperidine and skin surface warming additively reduce the shivering threshold: a volunteer study.
2007
Nefopam is more potent than carbamazepine for neuroprotection against veratridine in vitro and has anticonvulsant properties against both electrical and chemical stimulation.
2007
Specific and sensitive analysis of nefopam and its main metabolite desmethyl-nefopam in human plasma by liquid chromatography-ion trap tandem mass spectrometry.
2006-11-16
Cyclodextrin inclusion complexes of the central analgesic drug nefopam.
2006-11-09
[What are the cardiovascular complications of the analgesics and glucocorticoids?].
2006-09
Role of catecholamines and serotonin receptor subtypes in nefopam-induced antinociception.
2006-09
Preoperative peribulbar block in patients undergoing retinal detachment surgery under general anesthesia: a randomized double-blind study.
2006-04
Efficacy of low-dose intrathecal morphine for postoperative analgesia after abdominal aortic surgery: a double-blind randomized study.
2005-08-03
Patents

Sample Use Guides

Dosage may range from 1 to 3 tablets three times daily depending on response. The recommended starting dosage is 2 tablets three times daily.
Route of Administration: Oral
The effects of nefopam on human serotonin receptors (5-HT2A, 5-HT2B, 5-HT2C) were tested. Nefopam had Ki values for 5-HT2A, 5-HT2B, and 5-HT2C of 1,685, 329.5, and 56 nM, respectively.
Substance Class Chemical
Created
by admin
on Mon Mar 31 18:00:24 GMT 2025
Edited
by admin
on Mon Mar 31 18:00:24 GMT 2025
Record UNII
685J48E13W
Record Status Validated (UNII)
Record Version
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Name Type Language
ACUPAN
Preferred Name English
NEFOPAM HYDROCHLORIDE
MART.   MI   USAN   WHO-DD  
USAN  
Official Name English
NSC-757856
Code English
1H-2,5-BENZOXAZOCINE, 3,4,5,6-TETRAHYDRO-5-METHYL-1-PHENYL-, HYDROCHLORIDE
Systematic Name English
3,4,5,6-Tetrahydro-5-methyl-1-phenyl-1H-2,5-benzoxazocine hydrochloride
Systematic Name English
NEFOPAM HYDROCHLORIDE [MI]
Common Name English
Nefopam hydrochloride [WHO-DD]
Common Name English
NEFOPAM HYDROCHLORIDE [USAN]
Common Name English
NEFOPAM HYDROCHLORIDE [MART.]
Common Name English
NEFOPAM HCL
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C1012
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
Code System Code Type Description
NSC
757856
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
ECHA (EC/EINECS)
245-585-5
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
NCI_THESAURUS
C83995
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
SMS_ID
100000091067
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
FDA UNII
685J48E13W
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
DRUG BANK
DBSALT002173
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
RXCUI
4324
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY RxNorm
PUBCHEM
31872
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
EVMPD
SUB03400MIG
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
ChEMBL
CHEMBL465026
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
CAS
23327-57-3
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
CHEBI
88312
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
EPA CompTox
DTXSID7045441
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY
MERCK INDEX
m7795
Created by admin on Mon Mar 31 18:00:24 GMT 2025 , Edited by admin on Mon Mar 31 18:00:24 GMT 2025
PRIMARY Merck Index
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