Nicomorphine

Nicomorphine (Vilan, Subellan, Gevilan) is the 3,6-dinicotinate ester of morphine. It is a strong opioid agonist analgesic two to three times as potent as morphine with a side effect profile similar to that of dihydromorphine, morphine, and diamorphine. It is used, particularly in the German-speaking countries and elsewhere in Central Europe and some other countries in Europe and the former USSR in particular, for post-operative, cancer, chronic non-malignant and other neuropathic pain. It is commonly used in patient-controlled analgesia (PCA) units. The usual starting dose is 5-10 mg given every 3–5 hours.

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Nicomorphine was patented as Vilan by Lannacher Heilmittel Ges. m.b.H. of Austria in 1957 and is believed to have been first produced in the opening years of the 20th century either there or at another firm in what was then Austria-Hungary. The hydrochloride salt is available as ampoules of 10 mg/ml solution for injection, 5 mg tablets, and 10 mg suppositories. It is possible that other manufacturers distribute 10 mg tablets and other concentrations of injectable nicomorphine in ampoules and multi-dose phials.

Nicomorphine is regulated in much the same fashion as morphine world-wide but was never introduced in the United States, making it a Schedule I controlled substance there.

Nicomorphine is the parent chemical of nicocodeine, which is a cough suppressant also made by Lannacher Heilmittel Ges. m.b.H. as Tusscodin, and by another firm as Lyopect which is about the same strength as hydrocodone and regulated as such; it has also never been introduced in the United States.

Nicomorphine's side effects are similar to those of other opioids and include itching, nausea and respiratory depression. It is considered by doctors to be one of the better analgesics for the comprehensive mitigation of suffering, as opposed to purely clouding the noxious pain stimulus, in the alleviation of chronic pain conditions.^[1]

CAS number of hydrochloride: 35055-78-8

References

1. ^ Vadon P, Rehak P. Comparison of the analgesic effect of nicomorphine in two different solutions (German). Wiener Medizinische Wochenschrift. 1979 Apr 30;129(8):217-20.