Understanding the '222' Imprint
The number '222' on a pill is not a universal identifier for a single drug. Pharmaceutical companies use imprints to distinguish their products, and this number has appeared on several different medications over the years. Some of these include:
- Tramadol Hydrochloride: An oval white pill with 'A 222' used to treat chronic pain.
- Lamotrigine: A round peach pill with 'U S 222 100' used for bipolar disorder and seizures.
- Ethinyl Estradiol and Levonorgestrel: A round peach pill used for birth control.
- Haloperidol: A white round pill with 'par 222' used to treat various psychiatric conditions.
However, one of the most searched-for pills with this imprint was Darvocet-N 100, a once-common pain medication that has since been removed from the market. The rest of this article will focus on this specific formulation.
What Was Darvocet-N (Pill 222)?
Darvocet-N 100 was a prescription medication indicated for mild to moderate pain. It combined two active ingredients to achieve greater pain relief than either could alone.
- Propoxyphene Napsylate: An opioid (narcotic) pain reliever that works by stimulating opioid receptors in the brain, which increases pain tolerance and decreases discomfort. It was classified as a Schedule IV controlled substance due to its potential for abuse and dependence.
- Acetaminophen: A non-opiate analgesic and fever reducer. It relieves pain by elevating the body's pain threshold. This ingredient is widely available today in products like Tylenol.
FDA-Mandated Withdrawal Due to Cardiac Risks
In November 2010, the U.S. Food and Drug Administration (FDA) recommended against the continued use of all propoxyphene-containing products, including Darvocet. The agency requested that manufacturers voluntarily withdraw the drug from the U.S. market.
The decision was based on new data showing that propoxyphene could cause serious and sometimes fatal heart rhythm abnormalities. Studies revealed that even when taken at therapeutic doses, the drug and its metabolite, norpropoxyphene, could interfere with the electrical activity of the heart, leading to potentially dangerous changes. The FDA concluded that the drug's limited pain relief benefits did not outweigh its serious cardiac risks.
Side Effects and Dangers of Propoxyphene
Aside from the significant heart risks, pill 222 (Darvocet-N) was associated with a range of side effects. Common adverse reactions included:
- Dizziness and lightheadedness
- Sedation or drowsiness
- Nausea and vomiting
- Constipation
More serious risks were also present:
- Overdose: Overdoses, often in combination with alcohol or other central nervous system depressants, were a major concern, with fatalities reported within the first hour. Symptoms include respiratory depression, extreme sleepiness, and cardiac arrest.
- Liver Toxicity: The acetaminophen component carried a risk of severe liver damage, especially at high concentrations, with prolonged use, or when combined with alcohol.
- Dependence and Abuse: As an opioid, propoxyphene could lead to physical and psychological dependence.
Comparison of Darvocet-N to Modern Alternatives
With Darvocet-N off the market, physicians transitioned patients to other analgesics. Here’s how it compares to some common alternatives:
| Feature | Pill 222 (Darvocet-N 100) | NSAIDs (e.g., Ibuprofen) | Acetaminophen (e.g., Tylenol) | Tramadol |
|---|---|---|---|---|
| Drug Class | Opioid + Analgesic | Nonsteroidal Anti-Inflammatory | Analgesic & Antipyretic | Opioid Analgesic |
| Primary Use | Mild to moderate pain | Pain, inflammation, fever | Pain, fever | Moderate to severe pain |
| Key Risk | Cardiac toxicity, overdose | GI bleeding, kidney issues | Liver damage (in high doses) | Seizures, addiction |
| Availability | Discontinued in U.S. | Over-the-counter & Rx | Over-the-counter & Rx | Prescription only |
| Addiction Risk | Moderate | None | None | Lower than many opioids, but present |
What Should You Do If You Find Old Pills?
If you find any old prescription pills, including those with a '222' imprint, do not take them. They are long-expired and, in the case of Darvocet-N, proven to be unsafe. The FDA provides clear guidelines for the safe disposal of unused medicines.
The best option is a drug take-back program. If a take-back location is not available, you can dispose of the medicine in your household trash by following these steps:
- Mix the pills (do not crush them) with an unappealing substance like dirt, cat litter, or used coffee grounds.
- Place the mixture in a sealed container, like a plastic bag.
- Throw the container into your household trash.
- Scratch out all personal information from the prescription bottle before recycling or discarding it.
Authoritative Link: FDA - Drug Disposal Information
Conclusion
The imprint '222' can refer to several different medications, making visual identification by itself unreliable. One of the most historically significant pills with this marking, Darvocet-N 100, was a combination opioid pain reliever used for mild to moderate pain. Due to conclusive evidence of potentially fatal cardiac toxicity, it was removed from the U.S. market in 2010. Today, safer and more effective alternatives are used for pain management, and any remaining stashes of this discontinued drug should be disposed of properly.
