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Darvocet A500 (acetaminophen-propoxyphene)

Side Effect Search
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Darvocet A500 may cause the following symptoms that are related to abnormal menstrual bleeding (in females):

Medical Source Information
Yellow highlights indicate symptoms related to abnormal menstrual bleeding.

Hematologic side effects including rare cases of thrombocytopenia associated with acetaminophen have been reported. Acute thrombocytopenia has also been reported as having been caused by sensitivity to acetaminophen glucuronide, the major metabolite of acetaminophen. Methemoglobinemia with resulting cyanosis has also been observed in the setting of acute overdose. Cases of hemolytic anemia, pancytopenia, and disseminated intravascular coagulation after administration (or abuse) of propoxyphene-containing compounds have been reported rarely.

Gastrointestinal side effects of acetaminophen are rare, except in alcoholics and after overdose. Cases of acute pancreatitis have been reported rarely with acetaminophen use. Nausea, vomiting, and constipation are relatively common effects of propoxyphene. Gastrointestinal bleeding and acute pancreatitis have also been reported with the use of propoxyphene.

Side Effects to Watch
Watch closely for the following side effects and notify your physician immediately should any of these develop:
  • Abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (signs of problems with blood clot formation)
Lab and Diagnostic Tests
If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
  • Blood tests to assess normal clotting - in people who develop signs of bleeding such as abnormal bruising or signs of bleeding including bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash
References
  1. Does hypothermia protect against the development of hepatitis in paracetamol overdose? Block R, Jankowski JA, Lacoux P, Pennington CR Anaesthesia 1992;47:789-91.
  2. Chronic liver disease and acetaminophen. Johnson GK, Tolman KG Ann Intern Med 1977;87:302-4.
  3. An integrated approach to the study of chemically reactive metabolites of acetaminophen. Gillette JR Arch Intern Med 1981;141:375-9.
  4. Hepatotoxicity of dextropropoxyphene. Lee TH, Rees PJ Br Med J 1977;2:296-7.
  5. Paracetamol and acute biliary pain with cholestasis. Wong V, Daly M, Boon A, Heatley V Lancet 1993;342:869.
  6. Influence of age-dependent pharmacokinetics and metabolism on acetaminophen hepatotoxicity. Rumore MM, Blaiklock RG J Pharm Sci 1992;81:203-7.
  7. Liver failure induced by paracetamol. Bray GP BMJ 1993;306:157-8.
  8. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Zimmerman HJ, Maddrey WC Hepatology 1995;22:767-73.
  9. Acute renal failure in an alcoholic during therapeutic acetaminophen ingestion. Keaton MR South Med J 1988;81:1163-6.
  10. Fatal massive hepatic necrosis following acetaminophen overdose. McJunkin B, Barwick KW, Little WC, Winfield JB JAMA 1976;236:1874-5.
  11. Acetaminophen induced pancreatitis. Mofenson HC, Caraccio TR, Nawaz H, Steckler G Clin Toxicol 1991;29:223-30.
  12. Fatal paracetamol poisoning in an epileptic. Minton NA, Henry JA, Frankel RJ Hum Toxicol 1988;7:33-4.
  13. Propoxyphene jaundice. Daikos GK, Kosmidis JC JAMA 1975;232:835.
  14. Acute hepatic and renal toxicity from low doses of acetaminophen in the absence of alcohol abuse or malnutrition - evidence for increased susceptibility to drug toxicity due to cardiopulmonary and renal insufficiency. Bonkovsky HL, Kane RE, Jones DP, Galinsky RE, Banner B Hepatology 1994;19:1141-8.
  15. Failure of physicians to recognize acetaminophen hepatotoxicity in chronic alcoholics. Kumar S, Rex DK Arch Intern Med 1991;151:1189-91.
  16. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial. Keays R, Harrison PM, Wendon JA, et al BMJ 1991;303:1026-9.
  17. Ischaemic colitis and drug abuse. Briggs RS, Barrand KG, Levene M Br Med J 1977;2:1478.
  18. Dextropropoxyphene induced hepatotoxicity mimicking biliary tract disease. Bassendine MF, Woodhouse KW, Bennett M, James OF Gut 1986;27:444-9.
  19. Liver failure induced by paracetamol. Block R BMJ 1993;306:457.
  20. Centrilobular hepatic fibrosis following acetaminophen-induced hepatic necrosis in an alcoholic. O'Dell JR, Zetterman RK, Burnett DA JAMA 1986;255:2636-7.
  21. Severe hepatotoxicity in a patient receiving both acetaminophen and zidovudine. Shriner K, Goetz MB Am J Med 1992;93:94-6.
  22. Hepatotoxicity from paracetamol self-poisoning in Western Sydney: a continuing challenge. Brotodihardjo AE, Batey RG, Farrell GC, Byth K Med J Aust 1992;157:382-5.
  23. Product Information. Darvocet N-100 (acetaminophen-propoxyphene). Anonymous Lilly, Eli and Company, Indianapolis, IN. PROD;
  24. Acute liver failure. Lee WM Am J Med 1994;96:3-9.
  25. Propoxyphene (Darvon) hepatotoxicity. Klein NC, Magida MG Am J Dig Dis 1971;16:467-9.
  26. Dextropropoxyphene and jaundice. Ford MJ, Kellett RJ, Busuttil A, Finlayson ND Br Med J 1977;2:674.
  27. Dextropropoxyphene. Anonymous Med J Aust 1979;2:494.
  28. Acetaminophen hepatotoxicity in alcoholics. Seeff LB, Cuccherini BA, Zimmerman HJ, Adler E, Benjamin SB Ann Intern Med 1986;104:399-404.
Multum version: 154.0 (Jun 16, 2010)
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