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Is Nefopam Effective in Treating Acute Renal Colic? A narrative review

Document Type : Review Paper

Authors

1 Department of Clinical Pharmacy, College of Pharmacy, University of Mosul, Mosul, Iraq

2 College of Medicine, University of Mosul, Mosul, Nineveh, Iraq.

3 Faculty of Pharmacy, University of Jordan, Jordan

10.33899/iphr.2023.141132.1047

Abstract

Abstract

Background: Acute renal colic is a severe and sudden form of loin pain that usually radiates from the flank towards the groin. Acute renal colic is one of the common causes of emergency department admission worldwide. Nefopam has a unique analgesic effect, that differs pharmacologically from nonsteroidal anti-inflammatory drugs, opioids, or paracetamol and has a potential role in multimodal analgesia. Furthermore, studies have found that nefopam has opioid-sparing effects postoperatively following urological surgery, making it a suitable option for urologists and emergency physicians. Aim: This review aims to survey the literature regarding the efficacy of nefopam in treating acute renal colic. Conclusion: This review revealed that the efficacy of nefopam in treating acute renal colic has not been established in any clinical trial, nor has it been included in any international guidelines. Nonsteroidal anti-inflammatory drugs and intravenous paracetamol are first-line agents in the management of acute renal colic.

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References
  1. Heel RC, Brogden RN, Pakes GE, Speight TM, Avery GS. Nefopam: a review of its pharmacological properties and therapeutic efficacy. Drugs 1980; 19: 249-67.
  2. Tobin WE, Gold RH. Nefopam hydrochloride: a novel muscle relaxant. J Clin Pharmacol New Drugs 1972; 12: 230-8.
  3. Koe BK. Molecular geometry of inhibitors of the uptake of catecholamines and serotonin in synaptosomal preparations of rat brain. J Pharmacol Exp Ther 1976; 199: 649-61.
  4. Rosland JH, Hole K. The effect of nefopam and its enantiomers on the uptake of 5-hydroxytryptamine, noradrenaline and dopamine in crude rat brain synaptosomal preparations. J Pharm Pharmacol 1990; 42: 437-8.
  5. Kornhuber J, Parsons CG, Hartmann S, Retz W, Kamolz S, Thome J, Riederer P (1995) Orphenadrine is an uncompetitive N-methyl- D-aspartate (NMDA) receptor antagonist: binding and patch clamp studies. J Neural Transm 102: 237–246
  6. Mather, G. G., Labroo, R., Le Guern, M. E., Lepage, F., Gillardin, J. M., & Levy, R. H. (2000). Nefopam enantiomers: preclinical pharmacology/toxicology and pharmacokinetic characteristics in healthy subjects after intravenous administration. Chirality: The Pharmacological, Biological, and Chemical Consequences of Molecular Asymmetry, 12(3), 153-159.‏
  7. Girard P, Chauvin M, Verleye M. Nefopam analgesia and its role in multimodal analgesia: A review of preclinical and clinical studies. Clin Exp Pharmacol Physiol. 2016; 43: 3-12.
  8. Kim, E. M., Jeon, J. H., Chung, M. H., Choi, E. M., Baek, S. H., Jeon, P. H., & Lee, M. H. (2017). The effect of nefopam infusion during laparascopic cholecystectomy on postoperative pain. International journal of medical sciences, 14(6), 570.‏
  9. Sinescu, R. D., Niculae, A., Peride, I., Vasilescu, F., Bratu, O. G., Mischianu, D. L., ... & Checheriţă, I. A. (2015). Uterus neuroendocrine tumor-a severe prognostic factor in a female patient with alcoholic cirrhosis undergoing chronic hemodialysis. Rom J Morphol Embryol, 56(2), 601-605.‏
  10. Na, H. S., Oh, A. Y., Ryu, J. H., Koo, B. W., Nam, S. W., Jo, J., & Park, J. H. (2018). Intraoperative nefopam reduces acute postoperative pain after laparoscopic gastrectomy: a prospective, randomized study. Journal of Gastrointestinal Surgery, 22, 771-777.‏
  11. Gheorghisan-Galateanu, A., Terzea, D. C., Carsote, M., & Poiana, C. (2013). Immature ovarian teratoma with unusual gliomatosis. Journal of ovarian research, 6(1), 1-6.‏
  12. Poiană, C., Neamţu, M. C., Avramescu, E. T., Carşote, M., Trifănescu, R., Terzea, D., ... & Dănciulescu Miulescu, R. (2013). The poor prognosis factors in G2 neuroendocrine tumor. Rom J Morphol Embryol, 54(3 Suppl), 717-720.‏
  13. Na, H. S., Oh, A. Y., Koo, B. W., Lim, D. J., Ryu, J. H., & Han, J. W. (2016). Preventive analgesic efficacy of nefopam in acute and chronic pain after breast cancer surgery: a prospective, double-blind, and randomized trial. Medicine, 95(20).‏
  14. Neagu, T. P., Ţigliş, M., Cocoloş, I., & Jecan, C. R. (2016). The relationship between periosteum and fracture healing. Rom J Morphol Embryol, 57(4), 1215-1220.‏
  15. Neagu, T. P., Enache, V., Cocoloş, I., Ţigliş, M., Cobilinschi, C., & Ţincu, R. (2016). Experimental study in order to assess the effects of limited periosteum stripping on the fracture healing and to compare osteosynthesis using plates and screws with intramedullary Kirschner wire fixation. Rom J Morphol Embryol, 57(2), 437-443.‏
  16. McLintock, T. T. C., Kenny, G. N. C., Howie, J. C., McArdle, C. S., Lawrie, S., & Aitken, H. (1988). Assessment of the analgesic efficacy of nefopam hydrochloride after upper abdominal surgery: a study using patient controlled analgesia. Journal of British Surgery, 75(8), 779-781.‏
  17. Sunshine, A., & Laska, E. (1975). Nefopam and morphine in man. Clinical Pharmacology & Therapeutics, 18(5part1), 530-534.‏
  18. Tigerstedt, I., Sipponen, J., Tammisto, T., & Turunen, M. (1977). Comparison of nefopam and pethidine in postoperative pain. British Journal of Anaesthesia, 49(11), 1133-1138.‏
  19. Kerr, D. E., & Fletcher, A. K. (2010). Fatal nefopam overdose. Emergency Medicine Journal, 27(5), 407-408.‏
  20. Goucke, C. R., Keaveny, J. P., Kay, B., Healy, T. E. J., & Ryan, M. (1990). The effect of diclofenac and nefopam on postoperative dental pain. Anaesthesia, 45(4), 329-331.‏
  21. Argoff, C. (2011). Mechanisms of pain transmission and pharmacologic management. Current medical research and opinion, 27(10), 2019-2031.‏
  22. Schug SA, Zech D, Dorr U. Cancer pain management according to WHO analgesic guidelines. Journal of Pain and Symptom Management. 1990;5:27-32
  23. Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. The Journal of Pain. 2016;17:131-157
  24. Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis and Rheumatism. 2000;43:1905-1915.
  25. Van Elstraete, A. C., & Sitbon, P. (2013). Median effective dose (ED50) of paracetamol and nefopam for postoperative pain: isobolographic analysis of their antinociceptive interaction. Minerva Anestesiol, 79(3), 232-239.‏
  26. Al-Awwady AN. Comparison of Paracetamol vs. Paracetamol Nefopam Combination vs. Paracetamol Tramadol Combination Intravenous Infusion for Intraoperative and Immediate Postoperative Analgesia for Laparoscopic Cholecystectomy. La Prensa Medica Argentina. 2020; 106(S1).
  27. Remérand, F., Le Tendre, C., Rosset, P., Peru, R., Favard, L., Pourrat, X., ... & Fusciardi, J. (2013). Nefopam after total hip arthroplasty: role in multimodal analgesia. Orthopaedics & Traumatology: Surgery & Research, 99(2), 169-174.‏
  28. Evans, S., Lysakowski, C., & Tramèr, M. R. (2008). Nefopam for the prevention of postoperative pain: quantitative systematic review. British journal of anaesthesia, 101(5), 610-617.
  29. Kim, S. Y., Huh, K. H., Roh, Y. H., Oh, Y. J., Park, J., & Choi, Y. S. (2015). Nefopam as an adjunct to intravenous patient‐controlled analgesia after renal transplantation: a randomised trial. Acta Anaesthesiologica Scandinavica, 59(8), 1068-1075.
  30. Elia, N., Lysakowski, C., & Tramer, M. R. (2005). Does multimodal analgesia with acetaminophen, nonsteroidal antiinflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Meta-analyses of randomized trials. The Journal of the American Society of Anesthesiologists, 103(6), 1296-1304.‏
  31. Delage,, Maaliki, H., Beloeil, H., Benhamou, D., & Mazoit, J. X. (2005). Median effective dose (ED50) of nefopam and ketoprofen in postoperative patients: a study of interaction using sequential analysis and isobolographic analysis. The Journal of the American Society of Anesthesiologists, 102(6), 1211-1216.‏
  32. Heel, R. C., Brogden, R. N., Pakes, G. E., Speight, T. M., & Avery, G. S. (1980). Nefopam: a review of its pharmacological properties and therapeutic efficacy. Drugs, 19, 249-267.
  33. David, C., Peride, I., Niculae, A., Constantin, A. M., & Checherita, I. A. (2016). Very low protein diets supplemented with keto-analogues in ESRD predialysis patients and its effect on vascular stiffness and AVF Maturation. BMC nephrology, 17, 1-10.
  34. Djerada, Z., Fournet‐Fayard, A., Gozalo, C., Lelarge, C., Lamiable, D., Millart, H., & Malinovsky, J. M. (2014). Population pharmacokinetics of nefopam in elderly, with or without renal impairment, and its link to treatment response. British Journal of Clinical Pharmacology, 77(6), 1027-1038.
  35. Durrieu, G., Olivier, P., Bagheri, H., Montastruc, J. L., & French Network of Pharmacovigilance Centers. (2007). Overview of adverse reactions to nefopam: an analysis of the French Pharmacovigilance database. Fundamental & clinical pharmacology, 21(5), 555-558.‏
  36. Revol, B., Delorme, J., Jouanjus, E., Spadari, M., Djezzar, S., Lepelley, M., ... & Mallaret, M. (2021). Thirty years of nefopam abuse in France. Therapie, 76(6), 527-537.
  37. Mimoz, O., Chauvet, S., Grégoire, N., Marchand, S., Le Guern, M. E., Saleh, A., ... & Levy, R. H. (2010). Nefopam pharmacokinetics in patients with end-stage renal disease. Anesthesia & Analgesia, 111(5), 1146-1153.‏
  38. Summary of Product Characteristics. Nefopam Hydrochloride 30mg Film-coated Tablets, Galen Limited. Date of revision of the text 09/05/2019. Online. https://www.medicines.org.uk/emc/product/2357/smpc
  39. Nefopam. (2023). Online. https://www.mims.com/malaysia/drug/info/nefopam?mtype=generic
  40. Schulz, T., Lalande, L., Aubrun, F., & Dziadzko, M. (2022). Nefopam prescribing preferences in French hospitals: results of a survey. The Pan African Medical Journal, 41.‏
  41. Ostwal, S. P. (2019). Nefopam: another pragmatic analgesic in managing chronic neuropathic pain. Indian Journal of Palliative Care, 25(3), 482.‏
  42. Lv, M., Wang, X., Qu, W., Liu, M., & Wang, Y. (2015). Nefopam for the prevention of perioperative shivering: a meta-analysis of randomized controlled trials. BMC anesthesiology, 15(1), 1-10.‏
  43. Stewart, C. (1988). Nephrolithiasis. Emergency medicine clinics of North America, 6(3), 617-630.‏
  44. Drach, G. W. (1990). Urinary lithiasis, etiology, diagnosis and medical management. Campbell's urology.‏
  45. Alkhayal, A., Alfraidi, O., Almudlaj, T., Nazer, A., Albogami, N., Alrabeeah, K., & Alathel, A. (2021). Seasonal variation in the incidence of acute renal colic. Saudi Journal of Kidney Diseases and Transplantation, 32(2), 371-376.‏
  46. Moody, T. E., Vaughn Jr, E. D., & Gillenwater, J. Y. (1975). Relationship between renal blood flow and ureteral pressure during 18 hours of total unilateral uretheral occlusion. Implications for changing sites of increased renal resistance. Investigative urology, 13(3), 246-251.‏
  47. Klahr, S. (1991). New insights into the consequences and mechanisms of renal impairment in obstructive nephropathy. American journal of kidney diseases, 18(6), 689-699.‏
  48. Smith, R. C., Levine, J., Dalrymple, N. C., Barish, M., & Rosenfield, A. T. (1999, April). Acute flank pain: a modern approach to diagnosis and management. In Seminars in Ultrasound, CT and MRI (Vol. 20, No. 2, pp. 108-135). WB Saunders.‏
  49. Gourlay, K., Splinter, G., Hayward, J., & Innes, G. (2021). Does pain severity predict stone characteristics or outcomes in emergency department patients with acute renal colic?. The American Journal of Emergency Medicine, 45, 37-41.‏
  50. Ganti, S., & Sohil, P. (2018). Renal colic: a red herring for mucocele of the appendiceal stump. Case Reports in Emergency Medicine, 2018.‏
  51. Nadav, G., Eyal, K., Noam, T., & Yeruham, K. (2019). Evaluation of the clinical significance of sonographic perinephric fluid in patients with renal colic. The American Journal of Emergency Medicine, 37(10), 1823-1828.‏
  52. Patti, L., & Leslie, S. W. (2021). Acute Renal Colic. 2021 Aug 23. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.‏
  53. Pathan, S. A., Mitra, B., & Cameron, P. A. (2018). A systematic review and meta-analysis comparing the efficacy of nonsteroidal anti-inflammatory drugs, opioids, and paracetamol in the treatment of acute renal colic. European urology, 73(4), 583-595.‏
  54. Engeler, D. S., Schmid, S., & Schmid, H. P. (2008). The ideal analgesic treatment for acute renal colic–theory and practice. Scandinavian journal of urology and nephrology, 42(2), 137-142.‏
  55. Schriger, D. L. (2014). Pseudo-objectivity in the conduct and reporting of systematic reviews: an example. BMJ, 328, 1401.‏
  56. Hughes, T., Ho, H. C., Pietropaolo, A., & Somani, B. K. (2020). Guideline of guidelines for kidney and bladder stones. Turkish journal of urology, 46(Suppl 1), S104.‏
  57. Afshar, K., Jafari, S., Marks, A. J., Eftekhari, A., & MacNeily, A. E. (2015). Nonsteroidal anti‐inflammatory drugs (NSAIDs) and non‐opioids for acute renal colic. Cochrane database of systematic reviews, (6).‏
  58. García-Perdomo, H. A., Echeverría-García, F., López, H., Fernández, N., & Manzano-Nunez, R. (2017). Interventions pharmacologiques pour traiter la douleur colique rénale dans les épisodes aigus de la pierre: revue systématique et méta-analyse. Progres en Urologie, 27(12), 654-665.‏
  59. Pathan, S. A., Mitra, B., & Cameron, P. A. (2018). A systematic review and meta-analysis comparing the efficacy of nonsteroidal anti-inflammatory drugs, opioids, and paracetamol in the treatment of acute renal colic. European urology, 73(4), 583-595.‏
  60. Krughoff, K., & Pais Jr, V. M. (2020). Kidney stones and the opioid epidemic: recent developments and review of the literature. Current Opinion in Urology, 30(2), 159-165.
  61. ‏ Holdgate, A., & Pollock, T. (2004). Nonsteroidal anti‐inflammatory drugs (NSAIDs) versus opioids for acute renal colic. Cochrane Database of Systematic Reviews, (1).‏
  62. American Urological Association. (2019). AUA position statement: opioid use. Linthicum, Maryland: American Urological Association.‏
  63. Benyamin, R., Trescot, A. M., Datta, S., Buenaventura, R. M., Adlaka, R., Sehgal, N., ... & Vallejo, R. (2008). Opioid complications and side effects. Pain physician, 11(2S), S105.‏
  64. Innes, G., Murphy, M., Nijssen–Jordan, C., Ducharme, J., & Drummond, A. (1999). Procedural sedation and analgesia in the emergency department. Canadian Consensus Guidelines. The Journal of emergency medicine, 17(1), 145-156.‏
  65. Guichard, G., Fromajoux, C., Cellarier, D., Loock, P. Y., Chabannes, E., Bernardini, S., ... & Kleinclauss, F. (2008). Management of renal colic in pregnant women, based on a series of 48 cases. Progres en Urologie: Journal de L'association Francaise D'urologie et de la Societe Francaise D'urologie, 18(1), 29-34.‏
  66. Wolfe, M. M., Lichtenstein, D. R., & Singh, G. (1999). Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. New England Journal of Medicine, 340(24), 1888-1899.‏
  67. Duggan, S. T., & Scott, L. J. (2009). Intravenous paracetamol (acetaminophen). Drugs, 69, 101-113.‏
  68. Bektas, F., Eken, C., Karadenız, O., Goksu, E., Cubuk, M., & Cete, Y. (2009). Intravenous paracetamol or morphine for the treatment of renal colic: a randomized, placebo-controlled trial. Annals of emergency medicine, 54(4), 568-574.‏
  69. Serinken, M., Eken, C., Turkcuer, I., Elicabuk, H., Uyanik, E., & Schultz, C. H. (2012). Intravenous paracetamol versus morphine for renal colic in the emergency department: a randomised double-blind controlled trial. Emergency Medicine Journal, 29(11), 902-905.‏
  70. Masoumi, K., Forouzan, A., Asgari Darian, A., Feli, M., Barzegari, H., & Khavanin, A. (2014). Comparison of clinical efficacy of intravenous acetaminophen with intravenous morphine in acute renal colic: a randomized, double-blind, controlled trial. Emergency medicine international, 2014.‏
  71. Pathan, S. A., Mitra, B., Straney, L. D., Afzal, M. S., Anjum, S., Shukla, D., ... & Cameron, P. A. (2016). Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial. The Lancet, 387(10032), 1999-2007.‏
  72. Grissa, M. H., Claessens, Y. E., Bouida, W., Boubaker, H., Boudhib, L., Kerkeni, W., ... & Nouira, S. (2011). Paracetamol vs piroxicam to relieve pain in renal colic. Results of a randomized controlled trial. The American journal of emergency medicine, 29(2), 203-206.‏
  73. Morgan, S. (2011). Intravenous paracetamol in patients with renal colic. Emergency Nurse, 18(9).‏
  74. Pathan, S. A., Mitra, B., & Cameron, P. A. (2018). A systematic review and meta-analysis comparing the efficacy of nonsteroidal anti-inflammatory drugs, opioids, and paracetamol in the treatment of acute renal colic. European urology, 73(4), 583-595.‏
  75. Kehlet, H., & Dahl, J. B. (1993). The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesthesia & Analgesia, 77(5), 1048-1056.‏
  76. Atallah, F., Bastside-Heulin, T., Samii, K., & Plante, P. (2001). Nefopam analgesia as a substitute of neurolept analgesia for extracorporeal shock wave lithotripsy. Anesthesia & Analgesia, 92(2), 557.‏
  77. Cheon, Y. W., Kim, S. H., Paek, J. H., Kim, J. A., Lee, Y. K., Min, J. H., & Cho, H. R. (2018). Effects of nefopam on catheter-related bladder discomfort in patients undergoing ureteroscopic litholapaxy. Korean Journal of Anesthesiology, 71(3), 201-206.‏
  78. Vergnolles, M., Wallerand, H., Gadrat, F., Maurice-Tison, S., Deti, E., Ballanger, P., ... & Robert, G. (2009). Predictive risk factors for pain during extracorporeal shockwave lithotripsy. Journal of endourology, 23(12), 2021-2027.‏
  79. Dacero, J. P. (2004). The management of acute pain in ambulatory patients. The place of nefopam. Presse Medicale (Paris, France: 1983), 33(4), 277-280.‏
  80. Moustafa, F., Liotier, J., Mathevon, T., Pic, D., Perrier, C., & Schmidt, J. (2013). Usefulness of nefopam in treating pain of severe uncomplicated renal colics in adults admitted to emergency units: a randomised double-blind controlled trial. The ‘INCoNU’study. Emergency Medicine Journal, 30(2), 143-148.‏
Iraqi Journal of Pharmacy

Articles in Press, Accepted Manuscript
Available Online from 21 July 2023
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  • Receive Date: 18 June 2023
  • Revise Date: 19 July 2023
  • Accept Date: 21 July 2023
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