Centrally-acting non-opioid analgesic

Nefopam hydrochloride

Brand names: Acupan

Nefopam hydrochloride is a non-opioid, non-steroidal centrally acting analgesic used for moderate pain that has not responded to other non-opioid analgesics.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It is thought to act centrally by inhibiting reuptake of serotonin, noradrenaline and dopamine, producing analgesia without the typical opioid or anti-inflammatory mechanisms.

Prescribing in practice

It has antimuscarinic and sympathomimetic effects, so avoid in convulsive disorders and use with caution in those with cardiovascular disease, urinary retention or angle-closure glaucoma risk.
Avoid concurrent use with monoamine oxidase inhibitors and use cautiously with other serotonergic or anticholinergic drugs.
It may colour the urine pink, which is harmless but can alarm patients.

Monitoring

Monitor analgesic response and for antimuscarinic and sympathomimetic adverse effects such as dry mouth, tachycardia, urinary difficulty and CNS stimulation.

Counselling the patient

Your urine may turn pink; this is harmless.
Report palpitations, difficulty passing urine, marked dizziness or a dry mouth that troubles you.

Evidence & guidelines

Use is informed by the product SPC; nefopam offers a non-opioid option for moderate pain in established analgesic practice.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways