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Fatal overdosage with nefopam (Acupan)
A Tracqui1, L Berthelon, B Ludes
1Institut de Médecine Légale, Faculté de Médecine de Strasbourg, France. atracqui@mageos.com
Journal of Analytical Toxicology
|June 11, 2002
Summary
This study reports a rare fatality from a massive intravenous overdose of nefopam (Acupan), a non-opiate pain reliever. Postmortem analysis revealed extremely high nefopam levels, highlighting the drug
Area of Science:
- Forensic Toxicology
- Clinical Pharmacology
Background:
- Nefopam (Acupan) is a non-opiate central analgesic used for pain management.
- Overdose cases are rare, with limited documented fatalities.
Observation:
- A 37-year-old female died following massive intravenous self-administration of nefopam.
- Postmortem analysis was conducted using high-pressure liquid chromatography coupled to mass spectrometry.
Findings:
- Heart blood nefopam concentration was 4.38 microg/mL.
- This concentration was approximately 30 times higher than typical therapeutic levels.
- This represents the third reported case of nefopam overdose fatality in the literature.
Implications:
- This case underscores the potential toxicity of nefopam at supra-therapeutic doses.
- It highlights the importance of careful monitoring and dose control in nefopam administration.
- Further research into nefopam's toxicokinetics and postmortem redistribution is warranted.