Severe toxicity can occur with small increments above the therapeutic dose including cardiotoxicity, and fatal overdoses. This is especially true when the drug is combined with alcohol.Hayes CJ, Hudson TJ, Phillips MM, Bursac Z, Williams JS, Austin MA, Edlund MJ, Martin BC. The influence of propoxyphene withdrawal on opioid use in veterans. Pharmacoepidemiol Drug Saf. 2015 Nov;24(11):1180-8. doi: 10.1002/pds.3851. Epub 2015 Aug 6. PMID: 26248742; PMCID: PMC5305002.
