# Nefopam in Nigeria

Nefopam has 1 active NAFDAC registration in our October 2026 copy of the register, from 1 registration holder.

- Source: https://ogbogwu.com/drugs/nefopam/
- Drug class: Centrally acting non-opioid analgesic (benzoxazocine) (Pain & Fever)
- Also known as: Nefopam hydrochloride, Acupan, Non-opioid analgesic
- Prescription required: yes
- Last updated: October 2026

## Price in Nigeria

Our sampled online pharmacies hold no nefopam listing, so we quote no price. The one registered product is a hospital injection, bought by facilities and private clinics rather than by patients, and usually billed as part of post-operative or ward care. Nefopam tablets, common in Europe and West Africa's francophone markets, have no registration in our copy of the NAFDAC register, so a tablet offered for sale in Nigeria has no number to check.

## What is Nefopam?

Nefopam is a painkiller that belongs to neither of the two families most Nigerians know. It is not an NSAID like diclofenac or ibuprofen, so it does not irritate the stomach, strain the kidneys or thin the blood; and it is not an opioid like tramadol or pentazocine, so it does not slow breathing or cause the same dependence. It works in the brain and spinal cord on the pathways that carry pain, and it is roughly as strong as a moderate opioid dose for post-operative pain.

In Nigeria it is a hospital medicine. Our copy of the NAFDAC register holds one product: Acupan Injection 20 mg/2 mL, the French originator, registered to Merit Healthcare with an Active registration. The 30 mg tablets sold in Europe and in neighbouring francophone countries have no registration in our copy, which is worth knowing if someone offers you nefopam tablets across a counter — there is no NAFDAC number to check them against.

Nefopam has a particular side-effect profile that limits where it is used: it can cause convulsions, so it is avoided in anyone with epilepsy, and it has mild stimulant and anticholinergic effects — sweating, a fast pulse, a dry mouth, difficulty passing urine — that older people tolerate poorly. These are the reasons it is given by clinicians who can watch for them rather than sold for home use.

## What is Nefopam used for?

- Moderate acute pain, particularly after surgery, as part of multimodal pain relief alongside paracetamol
- Pain where NSAIDs are contraindicated — peptic ulcer, kidney impairment, aspirin-sensitive asthma, bleeding risk
- Reducing the amount of opioid needed after an operation
- Shivering after anaesthesia, an unlicensed but common hospital use

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: By injection only in Nigeria: 20 mg into a muscle, or 20 mg by slow intravenous infusion over at least 15 minutes with the patient lying down, repeated every six hours if needed, to a usual maximum of 120 mg in 24 hours. Rapid intravenous injection causes nausea, sweating and a racing heart, which is why it is given slowly. Where tablets are available elsewhere, the dose is 30 to 90 mg three times a day; no tablet is registered in Nigeria.
- Children: Not recommended under 12 years; safety and dosing are not established.
- Elderly: Start at the lower end and watch closely: older adults are more likely to become confused, to retain urine and to develop a fast heartbeat on nefopam, and the dose should be reduced.

Nefopam can turn urine pink — harmless and temporary, but alarming if nobody has warned you. It should not be combined with other medicines that lower the seizure threshold (tramadol, tricyclic antidepressants) without a clinician weighing the risk, and it is not given with or within two weeks of a monoamine oxidase inhibitor.

## Side effects

Common: Nausea and vomiting, especially after fast injection; Sweating, dry mouth, light-headedness, feeling nervous or jittery; A fast heartbeat (palpitations); Difficulty passing urine; pink-coloured urine; Drowsiness in some people, insomnia in others.

Serious (seek medical help immediately): Convulsions — the main reason it is avoided in epilepsy and in anyone taking other seizure-threshold-lowering drugs; Hallucinations, confusion or agitation, more often in older adults; Acute urinary retention, or an attack of angle-closure glaucoma, from its anticholinergic effect; Dependence and misuse have been reported with long-term use; it is a short-course medicine.

When to see a doctor: In hospital, tell the nurse at once about chest tightness, a racing heart, inability to pass urine, confusion or any twitching or fit. After discharge, nefopam should not normally be continued; if you have been given it to take home, ask what for and for how long, and report confusion, hallucinations or a seizure as an emergency.

## Warnings

Do not take if: Epilepsy or any history of convulsions; A heart attack in the recent past, or serious heart rhythm problems; Treatment with a monoamine oxidase inhibitor (MAOI) now or in the last 14 days; Angle-closure glaucoma; difficulty passing urine from an enlarged prostate; Known allergy to nefopam.

Interactions: Monoamine oxidase inhibitors — a dangerous rise in blood pressure and agitation; never combined; Tricyclic antidepressants (amitriptyline), tramadol, some antipsychotics and antimalarials such as mefloquine — additive lowering of the seizure threshold; Anticholinergic medicines (hyoscine, oxybutynin, chlorpheniramine) — more dry mouth, retention and confusion; Sympathomimetics and stimulants (pseudoephedrine, caffeine in large amounts) — more palpitations and nervousness; Sedatives and alcohol add to drowsiness.

Pregnancy & breastfeeding: Not recommended in pregnancy: there is too little safety data, and paracetamol is the usual first choice. It passes into breast milk in small amounts; a single hospital dose is unlikely to matter, but regular use while breastfeeding should be avoided or discussed with the doctor.

## Brands in Nigeria

Well-known NAFDAC-registered brands: Acupan Injection (Merit Healthcare Limited, made in France).
Full searchable brand list: https://ogbogwu.com/drugs/nefopam/brands/

## How to verify it is genuine

1. Check the ampoule box for its NAFDAC registration number — Acupan Injection 20 mg/2 mL carries A4-5504, recorded Active in our copy of the register, held by Merit Healthcare Limited
2. No nefopam tablet has a registration in our copy of the register; a tablet pack bearing a NAFDAC number should be looked up carefully, and one with no number at all should be refused
3. Enter the number in our free NAFDAC checker and confirm the product name, strength and holder match the carton
4. This is a hospital product. If you are being charged for it on a bill, the pharmacy or clinic should be able to show you the carton it came from

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### Is nefopam registered with NAFDAC in Nigeria?

One product is. Our copy of the NAFDAC register lists Acupan Injection 20 mg/2 mL under A4-5504, held by Merit Healthcare Limited, with status Active. No nefopam tablet appears in our copy, so tablets sold as Acupan or nefopam in Nigeria have no registration we can confirm. Check any number you are given in our NAFDAC checker.

### Is nefopam an opioid or an NSAID?

Neither. It is a centrally acting painkiller with its own mechanism — it does not depress breathing like an opioid and does not damage the stomach or kidneys like an NSAID. That makes it useful after surgery in people who cannot have diclofenac, but it brings its own risks: convulsions in susceptible people, and anticholinergic effects such as a racing heart and difficulty passing urine.

### Can nefopam cause seizures?

Yes, it can lower the seizure threshold, which is why it is contraindicated in anyone with epilepsy or a history of fits and used cautiously with other medicines that do the same, such as tramadol and amitriptyline. This is one of the main reasons it stays a hospital medicine in Nigeria rather than a take-home painkiller.

### Why is my urine pink after nefopam?

Nefopam and its breakdown products can colour the urine pink or red for a day or so. It is harmless and clears on its own. Blood in the urine looks similar, though, so if the colour persists after the medicine has stopped, or comes with pain or fever, have it checked.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)