Flupirtine is a novel non-
opiate centrally acting
analgesic agent with muscle relaxant properties, advocated for use in a number of
pain states. Preliminary evidence suggests that
flupirtine 100 to 200mg orally or 150mg rectally 3 to 4 times daily (maximum daily dose 600mg) is more effective than placebo in relieving moderate
acute pain of various types. For the relief of
pain due to surgery, traumatic injury, dental procedures,
headache/migraine and abdominal
spasms,
flupirtine has proved at least as effective as the
opiate analgesics codeine,
dihydrocodeine and
pentazocine, the
nonsteroidal anti-inflammatory agents suprofen,
diclofenac and
ketoprofen, as well as
dipyrone and
paracetamol (
acetaminophen). Although evidence to support a role in the treatment of
chronic pain is limited,
flupirtine has been found as effective as
pentazocine in short term trials of patients with muscular or neuralgiform
pain, dysmenorrhoea, soft tissue
rheumatism or
cancer pain. The safety profile of
flupirtine has not yet been fully established, although initial evidence suggests that adverse reactions, while frequent, are usually minor in nature. The most common reactions are drowsiness,
dizziness, dry mouth and various gastrointestinal complaints. In comparison with
opiate drugs,
flupirtine appears to produce fewer central nervous system effects, no respiratory or cardiovascular depression, and no overt tolerance or physical dependence on prolonged administration. If these initially favourable results are confirmed in larger long term trials, then
flupirtine would appear to represent an effective
analgesic for the relief of moderate
pain, particularly that of musculoskeletal origin.