Last reviewed 01/2018

This is dextropropoxythene and paracetamol (in a combination of 32.5 mg of dextroproxyphene with 325mg of paracetamol).

  • dextropropoxyphene is well absorbed and metabolised in the liver. It has a half-life of 12 hours
  • dextropropoxyphene does not commonly causes adverse effects in short courses of therapeutic doses. Note though that chronic usage may cause constipation and overdose may cause similar effects to morphine
  • there is no evidence that dextropopoxythene 62.5 mg or 100 mg in combination with paracetamol 650 mg, given as a single dose, is more effective than paracetamol 650 mg given alone in the relief of ACUTE pain e.g. after episiotomy, tooth extraction, orthopaedic surgery (2)
  • there is no robust evidence that co-proxamol is any more effective than full strength paracetamol in the management of chronic pain (3)
  • problems of coproxamol in overdose (2)
    • in 2004 it was reported that, in England and Wales, between 300 and 400 people die each year following deliberate or accidental overdose with co-proxamol (Distalgesic; Cosalgesic; Dolgesic), a fixed-dose combination of paracetamol (325mg) and dextropropoxyphene (32.5mg) indicated for the treatment of mild to moderate pain
    • combination with alcohol or CNS depressants particularly hazardous and may cause fatal apnoea or cardiac arrhythmia

Check the summary of product characteristics before prescribing this drug.


  1. Drug and Therapeutics Bulletin (1998); 36 (10): 80
  2. Current Problems in Pharmacovigilance (2004); 30:1-12.
  3. MeReC Bulletin (2006);16 (4):13-16.