Opioid. Considered safe in two references. Compare the other phenylpiperidine derivative, pethidine: South African list: use, French list use.

(To be edited, initial data ST OCT 04) Phenylpiperidine opioid analgesic used in severe pain. Clinical use mainly limited to Scandinavian countries. Metabolized by hydroxylation and demethylation. Anderson KE: Effects of antihypertensive drugs on hepatic heme biosynthesis, .... Biochem Biophys Acta 543:313, 1978: safe. Moore MR, Hift RJ: Drugs in the acute porphyrias. Cell Mol Biol 43:89, 1997: probably safe. Andersson; patient inquiry: used without illeffects (n=1)

Uneventful use reported in 7 patients with acute porphyria.