Nefopam appears no more potent than NSAIDs, but is commonly associated with adverse drug reactions and toxic in overdose. It may sometimes be preferred because alternatives are contraindicated or ineffective, or used as add-on therapy when pain is inadequately controlled. Prescribers should consider carefully whether the potential benefits outweigh the risks of adverse effects in individual patients. Treatment should be reviewed regularly and stopped if benefits are not seen in the short term.