An Antidote for Propoxyphene HCl

To the Editor:— The oral administration of activated charcoal may be an effective means for treating acute ingestions of propoxyphene hydrochloride (Darvon). While investigating the adsorption by activated charcoal of drugs and household poisons, we found that 5 gm of activated charcoal (Norit A) will adsorb in vitro a significant amount of propoxyphene hydrochloride, 99% of a 10 capsule dose (320 mg) and 70% of a 30 capsule dose (960 mg). Since there is no known specific treatment for propoxyphene poisoning and many fatalities have resulted from the accidental or purposeful ingestion of this drug, we feel that this mode of therapy may prove useful and possibly lifesaving. We suggest that physicians treating suspected propoxyphene ingestion administer a slurry of 10 gm of activated charcoal by mouth when the patient is first seen, before induction of emesis or gastric lavage. Following stomach emptying, another 10 gm dose should be given