PROPOXYPHENEOVERDOSEDEATHSINCREASE 'We are observing an alarming increase in North Carolina in the number of deaths attributable to propoxyphene. We doubt that the phenomenon is peculiar to this state'- report Drs. McBay and Hudson of the Office of the Chief Medical Examiner, Chapel Hill, NC. The state's Medical Examiner System detected 21 deaths per annum attributable to propoxyphene in both 1972 and 1973. In 1974, there were 30 deaths. During just the first 3 months of 1975 there were 16 deaths. By comparison, barbiturate deaths remained about 39 per year for 1971-1974, and there were only 3 deaths in the first 3 months of this year.

The increased number of propoxyphene deaths may be related to: • a decrease in availability of rapid-acting barbiturates after rescheduling of these agents • stricter controls on the less lethal analgesic, codeine • the misconception among physicians that propoxyphene is quite harmless • payment for propoxyphene prescriptions but not for aspirin by the Medicare. Death may be caused by ingestion of 15-20 of the 65mg capsules or of the lOOmg napsylate tablets. Propoxyphene blood levels of 0,2mg/100ml can be lethal. Lesser amounts may be fatal when combined with alcohol or other central nervous system depressants. McBay, A.J. and Hudson, P.: Journal of the American Medical Association 233: 1257 (22 Sep 1975)

INPHARMA 4th October, 1975 p.2