In a survey conducted in hospitalized patients less than 1% of patients taking propoxyphene hydrochloride at recommended doses experienced side effects. The most frequently reported were dizziness, sedation, nausea and vomiting. Some of these adverse reactions may be alleviated if the patient lies down.

Other adverse reactions include constipation, abdominal pain, skin rashes, lightheadedness, headache, weakness, euphoria, dysphoria hallucinations, and minor visual disturbances.

Propoxyphene therapy has been associated with abnormal liver function tests and more rarely with instances of reversible jaundice (including cholestatic jaundice).

Renal papillary necrosis may result from chronic aspirin use, particularly when the dosage is greater than recommended and when combined with acetaminophen.

Subacute painful myopathy has occurred following chronic propoxyphene overdosage.

The CNS-depressant effect of propoxyphene is additive with that of other CNS depressants, including alcohol.

Salicylates may enhance the effect of anticoagulants and inhibit the uric-casework effect of uricosuric agents.

As is the case with many medicinal agents propoxyphene may slow the metabolism of a concomitantly administered drug. Should this occur the higher serum concentrations of that drug may result in increased pharmacologic or adverse effects of that drug. Such occurrences have been reported when propoxyphene was administered to patients on antidepressants, anticonvulsants, or warfarin-like drugs. Severe neurologic signs, including coma have occurred with concurrent use of carbamazepine.

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