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Dextromoramide

Dextromoramide
Dextromoramide2DACS.svg
Clinical data
Trade names Palfium
AHFS/Drugs.com International Drug Names
Pregnancy
category
  • AU: C
Routes of
administration
Oral, Rectal, Intravenous, Insufflation
ATC code N02AC01 (WHO)
Legal status
Legal status
Pharmacokinetic data
Bioavailability >75%
Protein binding High
Metabolism Liver, partly mediated by CYP3A4
Biological half-life 3.5 hours
Excretion Urine, faeces
Identifiers
CAS Number 357-56-2 N
PubChem (CID) 92943
DrugBank DB01529 YesY
ChemSpider 83901 YesY
UNII 9S4S6CIY83 YesY
KEGG D07287 YesY
ChEBI CHEBI:74274 N
ChEMBL CHEMBL431928 N
ECHA InfoCard 100.006.013
Chemical and physical data
Formula C25H32N2O2
Molar mass 392.534
3D model (Jmol) Interactive image
 NYesY (what is this?)  

Dextromoramide (Palfium, Palphium, Jetrium, Dimorlin) is a powerful opioid analgesic approximately three times more potent than morphine but shorter acting. It is subject to drug prohibition regimes, both internationally through UN treaties and by the criminal law of individual states. It is still marketed solely in the Netherlands.

Dextromoramide was discovered and patented in 1956 by Dr Paul Janssen at Janssen Pharmaceutica, who also discovered fentanyl, another important synthetic opioid, widely used to treat pain and in combination with other drugs as an anaesthetic, as well as haloperidol, piritramide, the loperamide-diphenoxylate series and other important drugs

Dextromoramide was singled out along with ketobemidone and several other synthetics by the United Nations and European Union as being "extra-dangerous" in the early 1960s, with dextromoramide being alleged to be three times more euphoric than heroin at equianalgesic doses, though this did little to stem production in the first half of the decade. The development of the moramides and the coming to fruition of work on piritramide were two of the events that precipitated the 1961 update to the Single Convention On Narcotic Drugs, as cited by Dr Shulgin in Controlled Substances and various monographs.

Dextromoramide was much favoured by drug users in Australia in the 1970s and the United Kingdom. It has the main proprietary name of Palfium amongst others, though as of mid-2004 the drug was discontinued in the UK due to limited supplies of precursor chemicals. Although this is true, it is believed there was an approximate one year shortage of Dextromoramide and the real reason that Palfium was not put back into production for the UK market is because of how addictive and potent it is as an oral painkiller. Dependence liability is similar to morphine, but with a less severe withdrawal syndrome.


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