Medicines containing dextropropoxyphene will be withdrawn from the market, Medsafe has ruled, after a review found the dangers of the medicine outweigh its benefits. Dextropropoxyphene, an opioid analgesic used in combination with paracetamol to treat chronic moderate pain, is sold in New Zealand as Paradex (tablets) and Capadex (capsules). The Medicines Adverse Reactions Committee (MARC) review concluded these medicines: 

• were no better at treating pain than full dose paracetamol 
• could cause additional side effects to those caused by paracetamol used at recommended doses 
• were dangerous in overdose, or if taken with alcohol.

Medsafe Group Manager Dr Stewart Jessamine says the withdrawal will not be immediate to allow time for patients to transfer to alternative treatments. Any patient currently using Paradex or Capadex should continue with their medicines, he says. Regular users of these medicines should see their GP to discuss alternatives. A 2009 report by Medsafe describes dextropropoxyphene as a morphine-like opioid with adverse effects on the central nervous system including sedation, respiratory depression, reduced bowel motility, euphoria and rashes. A 2005 report in the Journal of the New Zealand Medical Association says, "Dextropropoxyphene has previously been associated with a disproportionate rate of poisoning deaths in relation to prescription volume." In New Zealand between there were 16 deaths involving dextropropoxyphene (Jan 2001 - Dec 2002), of which six were unintentional. Medicines containing dextropropoxyphene have been withdrawn in several other countries including the UK.