Pronunciation: dih-PIP-uh-nohn

Chemical Abstracts Service Registry Number: 467-83-4 Formal Names: Diconal, Piperidyl-Methadone, Wellconal Type: Depressant (opioid class). See page 24 Federal Schedule Listing: Schedule I (DEA no. 9622) USA Availability: Illegal to possess Pregnancy Category: None

Uses. Actions of this drug are similar to those of morphine. Dipipanone has no officially approved medical usage in the United States, but elsewhere it is used as a powerful pain reliever for conditions such as surgery and cancer. Some cancer patients prefer this drug for pain control. The compound can control coughs.

Drawbacks. Persons are supposed to avoid the drug if they suffer from low thyroid activity or enlarged prostate. Dipipanone can make people sleepy, and users are supposed to be cautioned about operating dangerous machinery. Volunteers in one experiment experienced lower alertness after taking dipi-panone, but other experiments found the substance to lack sedative action. Study does show that sedation can occur when dipipanone is given together with the antihistamine triprolidine. Dipipanone can cause headache, tremors, nausea, and vomiting, impair vision, interfere with breathing, make urination difficult, lower blood pressure, and reduce production of saliva. Seizures have been reported. Euphoria may occur. A case study notes delusions and hallucinations caused by the drug. Paranoia has occurred occasionally. A case report tells of serious colon difficulty occurring after someone injected three dissolved oral Diconal tablets, a combination product containing dipipanone and the antivomiting drug cyclizine, accompanied by drinking three liters of beer. Even in ordinary medical use, however, dipipanone can cause constipation and is supposed to be used cautiously if a person has bowel obstruction.

Abuse factors. Dipipanone is related to methadone and can be substituted for assorted opioids. That property gave dipipanone a role in addiction treatment programs seeking to switch addicts to dipipanone. Tolerance and dependence can occur. Reportedly drug abusers find dipipanone more potent than heroin, and in combination with cyclizine, dipipanone reportedly can create a rush of enjoyment that some persons prefer over heroin. In the 1980s some British observers considered dipipanone abuse to be as much a problem as abuse of methadone and methylphenidate, with some addicts getting their supplies legally from doctors. Rather little has been heard about the substance since then, however.

Drug interactions. Dipipanone may interact badly with monoamine oxidase inhibitors (MAOIs), which are substances found in some antidepressants and other medication.

Cancer. Potential for causing cancer is unknown.

Pregnancy. Potential for birth defects is unknown. Authorities are uncertain whether the drug passes into a nursing mother's milk, but they believe the level would be so low as to cause no harm to the infant. An infant can be born dependent on the drug if the mother has been using it during the final trimester of pregnancy.

Additional scientific information may be found in:

Bound, D., and S. Greer. "Psychotic Symptoms after Dipipanone." Lancet 2 (1978): 480. Faull, C., et al. "Experience with Dipipanone Elixir in the Management of Cancer Related Pain—Case Study." Palliative Medicine 8 (1994): 63-65. Posner, J., et al. "Effects of an Opiate on Cold-Induced Pain and the CNS in Healthy

Volunteers." Pain 23 (1985): 73-82. Stewart, M.J., et al. "Forensic Toxicology in Urban South Africa." Journal of Toxicology:

Clinical Toxicology 38 (2000): 415-19. Telekes, A., et al. "Effects of Triprolidine and Dipipanone in the Cold Induced Pain Test, and the Central Nervous System of Healthy Volunteers." British Journal of Clinical Pharmacology 24 (1987): 43-50. Turnbull, A.R., and P. Isaacson. "Ischemic Colitis and Drug Abuse." British Medical Journal 2 (1977): 1000.

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