In this article you can read the instructions for use of the drug Papaverine. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Papaverine in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Papaverine analogues in the presence of existing structural analogues. Use for the treatment of spasms in adults, children, as well as during pregnancy and breastfeeding.
Papaverine- myotropic antispasmodic. Reduces the tone of smooth muscles of internal organs (gastrointestinal tract, respiratory, urinary, reproductive systems) and blood vessels. Causes dilation of arteries, increases blood flow, incl. cerebral. Has a hypotensive effect.
In high doses, it reduces the excitability of the heart muscle and slows down intracardiac conduction.
When used in average therapeutic doses, the effect on the central nervous system is weak.
Pharmacokinetics
Bioavailability is 54%. It is well distributed in the body and penetrates histohematic barriers. Metabolized in the liver. Excreted by the kidneys in the form of metabolites. It is completely removed from the blood during dialysis.
Indications
- spasms of smooth muscles of the abdominal organs, bronchi, peripheral vessels, cerebral vessels, kidneys;
- angina pectoris (as part of combination therapy).
As an adjuvant for premedication.
Release forms
Tablets 40 mg.
Suppositories for rectal use 40 mg.
Solution for injection (injections in ampoules) 20 mg/ml.
Instructions for use and dosage
Orally - 40-60 mg 3-5 times a day. Rectally - 20-40 mg 2-3 times a day.
When administered intramuscularly, subcutaneously or intravenously, a single dose for adults is 10-20 mg; the interval between injections is at least 4 hours. For elderly patients, the initial single dose is no more than 10 mg. For children aged 1 to 12 years, the maximum single dose is 200-300 mg/kg.
Side effect
- nausea;
- constipation;
- drowsiness;
- increased sweating;
- arterial hypotension;
- development of AV blockade, heart rhythm disturbances (with rapid administration).
Contraindications
- AV block;
- glaucoma;
- severe liver failure;
- old age (risk of developing hyperthermia);
- children up to 6 months;
- hypersensitivity to papaverine.
Use during pregnancy and breastfeeding
During pregnancy and lactation (breastfeeding), the safety and effectiveness of papaverine has not been established.
Special instructions
Use with caution in conditions after traumatic brain injury, chronic renal failure, adrenal insufficiency, hypothyroidism, prostatic hyperplasia, supraventricular tachycardia, shock conditions.
Intravenously should be administered slowly and under the supervision of a physician.
During the treatment period, alcohol consumption should be avoided.
Drug interactions
When used simultaneously with anticholinergic drugs, the anticholinergic effects may be enhanced.
It is believed that when used concomitantly with alprostadil for intracavernosal administration, there is a risk of developing priapism.
There are reports of a decrease in the effectiveness of levodopa when used simultaneously.
Reduces the hypotensive effect of methyldopa.
Analogues of the drug Papaverine
Structural analogues of the active substance:
- Papaverine bufus;
- Papaverine hydrochloride;
- Papaverine hydrochloride MS;
- Papaverine hydrochloride solution for injection 2%;
- Papaverine hydrochloride tablets for children 0.01 g;
- Suppositories with papaverine hydrochloride 0.02.
If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.
Papaverine is a combined antihypertensive and antispasmodic drug with an analgesic effect.
Pharmacological action
The active substance Papaverine has antihypertensive, analgesic and anticonvulsant effects.
The use of Papaverine helps to reduce the tone of the smooth muscles of the internal organs of the urinary, respiratory, reproductive systems and blood vessels, dilate the arteries and increase blood flow.
In addition, according to the instructions, Papaverine has a hypotensive effect. In high doses, the active component of the drug has a sedative effect, slows down intracardiac conduction, and also helps reduce the excitability of the heart muscle. In average therapeutic doses, the drug has a mild effect on the central nervous system.
The safety and effectiveness of Papaverine during pregnancy and lactation have not been studied.
Release form
Papaverine is available in several dosage forms:
- Solution for injection, in 2 ml ampoules containing 20 mg of active substance;
- Rectal suppositories containing 20 mg of active substance;
- Tablets containing 40 mg of active substance;
- Tablets for children containing 10 mg of active substance.
Indications for use of Papaverine
According to the instructions, Papaverine is used for smooth muscle spasms:
- Peripheral vessels - with endarteritis;
- Bronchi - for bronchospasm;
- Brain vessels;
- Abdominal organs - for renal colic, pylorospasm, cholecystitis, spastic colitis;
- Heart – with angina pectoris;
As an adjuvant, the use of Papaverine is indicated for premedication.
Contraindications
According to the instructions, Papaverine is contraindicated for use in the elderly, children under 6 months, and also for:
- AV block;
- Severe liver failure;
- Glaucoma;
- Hypersensitivity to the components of Papaverine.
According to indications, Papaverine is used with caution:
- For chronic renal failure;
- For hypothyroidism;
- With supraventricular tachycardia;
- After a traumatic brain injury;
- In case of insufficiency of adrenal gland function;
- In states of shock;
- For prostatic hyperplasia.
The use of Papaverine during pregnancy is possible only as prescribed by a doctor.
During treatment with Papaverine, alcohol consumption should be avoided.
How to use Papaverine
According to indications, Papaverine is taken orally in tablet form up to four times a day.. An adult single dose is 40-60 mg of the drug. A single dose for children depends on age:
- From 6 months to 2 years – 5 mg;
- 3-4 years – from 5 to 10 mg;
- 5-6 years – 10 mg;
- 7-9 years – from 10 to 15 mg;
- 10-14 years – from 15 to 20 mg.
The injection solution is administered subcutaneously and intramuscularly no more than 4 times a day, 1-2 ml. Intravenous administration is possible only slowly and under medical supervision, while 20 mg of Papaverine is pre-diluted in 10-20 ml of 0.9% NaCl solution.
Rectally, according to indications, Papaverine can be used only by adults, 20-40 mg up to three times a day.
The dosage and duration of use of Papaverine during pregnancy is determined individually by the doctor.
In case of overdose, Papaverine according to the instructions can cause drowsiness, decreased blood pressure, weakness and diplopia.
It is possible to enhance anticholinergic effects with simultaneous use of Papaverine with anticholinergic drugs.
Side effects
When using Papaverine, the following may develop:
- Nausea;
- Drowsiness;
- Eosinophilia;
- Arterial hypotension;
- Allergic reactions;
- Ventricular extrasystole;
- Constipation;
- Increased sweating;
- Increased activity of liver transaminases;
- AV blockade.
According to the instructions Papaverine with rapid intravenous administration or when used in high doses may lead to the development of heart rhythm disturbances.
Storage conditions
Papaverine is a prescription antispasmodic drug. The shelf life of tablets is 5 years, solution for injection is 24 months.
Sincerely,
Papaverine (lat. Papaverinum) is a drug from the group of myotropic antispasmodics. Currently, it is used only in the form of hydrochloric acid salt (papaverine hydrochloride).
Reduces the tone and contractile activity of smooth muscles of blood vessels and internal organs.
Prescribed for spastic conditions of the gastrointestinal tract, urinary tract, bronchi, cerebral and peripheral circulation disorders.
Thanks to long experience of use, it is one of the most studied drugs. Produced by various pharmaceutical manufacturers.
Papaverine was discovered by chemistry student Heinrich Merck in 1848. The German isolated the new substance from opium - the milky juice of the sleeping pill poppy (lat. Papaver Somniferum).
According to its chemical structure, the drug was classified as an alkaloid.
In 1910, A. Pictet was the first to synthesize papaverine artificially from veratraldehyde and hypuric acid. Around the same time, the alkaloid was discovered to have antispasmodic and vasodilating properties.
In 1913, the German physician J. Pahl introduced the drug into clinical practice, beginning to use it in patients with angina pectoris and bronchial asthma. Later, papaverine began to be used for spasms of the intestines, ureters and as an antihypertensive agent.
In 1930, the Hungarian corporation Chinon was the first in the world to begin producing the drug on an industrial scale. By the middle of the 20th century. the total number of papaverine manufacturing companies has grown to several dozen.
In the 50s the drug has a competitor - drotaverine (No-Shpa). In terms of antispasmodic properties, it turned out to be several times more active than its predecessor, so it has found wider use. However, in many countries, papaverine still remains a fairly popular medicine, both due to established traditions and due to its low cost.
Properties
International nonproprietary name: papaverine (English: papaverine).
Chemical name according to IUPAC: 1-(3,4-dimethoxybenzyl)-6,7-dimethoxyisoquinoline hydrochloride.
Gross formula: C20H21NO4 *HCl
Molar mass: 375,85.
Papaverine hydrochloride is a white crystalline powder with a slightly bitter taste and odorless. Melting point - 225ºС. It dissolves well in water, poorly in ethyl alcohol, chloroform, and diethyl ether. The drug is isolated from opium or obtained synthetically.
Research results
The first studies devoted to the study of the pharmacological activity of papaverine were carried out by J. Pahl in the 1910s. The scientist found that the drug has a toxic effect on lower organisms (amoebas, trypanosomes) comparable to morphine.
In higher animals, papaverine, on the contrary, exhibits significantly lower toxicity than morphine. For example, in rabbits, mild symptoms of poisoning occur only when the drug is administered subcutaneously at a dose of 0.25-0.30 mg per 1 kg of weight.
When treating patients with angina pectoris, Pahl noted that papaverine has virtually no narcotic properties. In rare cases, the medication caused drowsiness, usually on the second day after use. Overdose phenomena occurred only after oral administration of the alkaloid in an amount of more than 400 mg.
In placebo-controlled clinical studies conducted in the second half of the 20th century, papaverine showed good effectiveness in the treatment of three groups of diseases:
- renal colic,
- gastrointestinal spasms,
- pathologies of the biliary tract.
According to test data, the pronounced antispasmodic properties of the drug were noted on average by about 60% of patients. 23% described its effect as moderate or weak. In 17% no improvement was observed.
In separate clinical trials, the rationality of using papaverine in patients with gastrointestinal ulcers was studied. It was found that taking the drug at a dose of 80 mg 3 times a day leads to a noticeable reduction in pain in 78% of patients.
Double-blind, placebo-controlled trials in the 1990s. confirmed the effectiveness of papaverine for intestinal disorders.
One Russian study involved 62 patients with irritable bowel syndrome. Volunteers in the experimental group took the drug 80 mg 3 times a day for 2 months.
The control group received a placebo. At the end of therapy, all subjects from the first population noted a decrease in the strength and frequency of pain. Whereas in the control group, patients complained of increased pain.
According to the results of the entire volume of clinical studies, papaverine showed the greatest antispasmodic activity in the treatment of renal colic, gastrointestinal pain, cholelithiasis, and dysmenorrhea. The use of the drug was least effective in patients with cerebrovascular disorders.
In all trials, the drug was well tolerated. Side effects occurred in no more than 0.5-3% of patients.
Application in different countries
Papaverine is approved for use in more than 50 countries, including Russia, Germany, France, Great Britain, USA and Japan. Various factories produce the drug under the trade names “Papaverine”, “Papaverine hydrochloride” or under their own brand names (for example, Paparin is produced in Taiwan, Atroveran in Venezuela, Mesotin in Argentina).
- to eliminate spasms of the digestive tract, biliary and urinary tracts,
- in complex therapy of cerebral and coronary circulatory disorders.
In the USA and Canada, papaverine was also approved in 1986 as a treatment for erectile dysfunction in men*. However, after the invention of phosphodiesterase-5 inhibitors (Viagra, Cialis, etc.), the drug is practically not used for this purpose.
In Russia, papaverine is included in the List of vital and essential medicines, approved by Order of the Government of the Russian Federation No. 2135-r dated December 30, 2009.
*In case of erectile dysfunction, papaverine solution is injected intracavernosally (into the cavernous body of the penis). The positive effect is associated with relaxation of the trabeculae of the cavernous bodies and increased blood flow.
Composition and release forms
In Russia, the drug is available in the form:
- 2% (20 mg/ml) injection solution in ampoules of 2 ml,
- suppositories containing papaverine hydrochloride 20 mg,
- tablets containing papaverine hydrochloride 40 mg (for adults) and 10 mg (for children).
In some European countries (Switzerland, Great Britain), you can also find papaverine powders packaged in 150 mg sachets and 3% injection solutions in pharmacies.
Mechanism of action
Papaverine acts directly on the smooth muscles of internal organs and blood vessels, causing it to relax. Vasodilation leads to improved blood flow, including cerebral blood flow, and a decrease in blood pressure.
According to modern concepts, the antispasmodic effects of the drug are due to the blockade of the phosphodiesterase enzyme in the muscles, due to which cyclic 3,5-adenosine monophosphate (cAMP) begins to accumulate in the cells. This leads to the release of calcium ions from the cells and a decrease in muscle contractile activity.
The relaxing properties of papaverine in relation to different organs are expressed differently. The colon undergoes the greatest relaxation, then in order of decreasing effect:
- duodenum,
- stomach, uterus,
- biliary and urinary tract, sphincter of Oddi,
- bronchi,
- vessels.
In high doses, papaverine reduces myocardial excitability and slows intracardiac conduction.
The drug has virtually no effect on the central nervous system. The sedative effect occurs only when papaverine is consumed in doses above average therapeutic ones.
The effectiveness of the drug decreases due to smoking.
Metabolism and excretion
When administered orally and rectally, papaverine is quickly absorbed from the digestive tract. On average, up to 54% of the dose taken enters the bloodstream. In plasma, the drug is 90% protein bound.
The product is well distributed throughout the body. Passes through the blood-brain barrier. Biotransformed in the liver to inactive metabolites, which are excreted by renal filtration. The half-life is 0.5-2 hours (with kidney pathologies, this time can increase to 24 hours).
Indications for use
The reasons for prescribing papaverine are:
- spastic conditions of the abdominal organs (spastic colitis, cholecystitis, pylorospasm),
- renal colic,
- bronchospasm,
- spasm of peripheral (endarteritis) or cerebral vessels.
As an adjuvant, papaverine is used to prepare patients for surgical interventions.
Previously, the drug was widely used to prevent angina attacks, but today more modern antianginal drugs are recommended for this purpose.
Contraindications
Papaverine is contraindicated in the following conditions:
- atrioventricular conduction disorders,
- comatose states,
- depression of respiratory functions,
- glaucoma,
- age up to 6 months. (for injection forms - up to 1 year),
- bronchial obstruction,
- severe liver dysfunction,
- inflammatory processes of the rectum (the limitation applies only to suppositories).
Due to the high risk of developing hyperthermia, it is not recommended to use the drug in old age.
Pregnancy and lactation
In Russia and Europe, no special studies have been conducted to prove the safety of papaverine during pregnancy or lactation.
Impact on the ability to drive vehicles and operate complex machinery
After parenteral (especially intravenous) administration of the drug, driving and engaging in hazardous activities should be avoided for 1 hour.
Directions for use and doses
Papaverine is prescribed orally, rectally, subcutaneously, intramuscularly and intravenously.
Pills .
- children from 6 months. up to 2 years of age, 5 mg per dose is prescribed,
- from 3 to 4 years - 5-10 mg,
- from 5 to 6 years - 10 mg,
- from 7 to 9 years - 10-15 mg,
- from 10 to 14 years - 15-20 mg.
Dosage regimen: 1 dose 3-4 times a day.
Maximum permissible daily doses:
- for adults - 600 mg,
- for children from 6 months. up to one year - 10 mg, from 3 to 4 years - 20 mg, from 5 to 6 years - 40 mg, from 7 to 9 years - 60 mg, from 10 to 14 years - 200 mg.
Suppositories.
Adults: administer 1-2 soups. 2-3 times a day after spontaneous bowel movement or enema.
Injections .
Adults are administered subcutaneously and intramuscularly with 1-2 ml of ampoule solution (in terms of the active substance - 20-40 mg of papaverine hydrochloride).
Adults are administered intravenously 1 ml of the drug (or 20 mg of papaverine hydrochloride), which is pre-diluted with 10-20 ml of saline. The introduction is carried out slowly and under the supervision of a physician.
For elderly patients, the initial dose should not exceed 10 mg.
For children aged 1 to 12 years, the amount of the drug is calculated based on body weight: 0.3 mg of papaverine per 1 kg of weight.
The maximum daily dose for adults when administered parenterally should not exceed 300 mg. 
Side effects
With papaverine therapy the following are possible:
- lowering blood pressure,
- dizziness,
- headache,
- weakness,
- drowsiness,
- atrioventricular block or ventricular extrasystole (risks increase with rapid intravenous administration of the drug),
- dyspeptic disorders (constipation, nausea),
- increased sweating,
- allergic reactions,
- eosinophilia,
- increased levels of liver transaminases.
When using suppositories, local negative reactions may be observed: a burning sensation or itching in the anal passage.
Special instructions
During treatment you must stop drinking alcohol.
Papaverine should be used with caution in the elderly, in patients with hyperthyroidism, renal or hepatic failure, prostate adenoma, supraventricular tachycardia, severe heart disease, shock and traumatic brain injury.
Overdose
Papaverine poisoning manifests itself:
- general malaise,
- diplopia (double vision),
- increased sweating,
- headache,
- arrhythmia.
The condition is treated by gastric lavage and taking enterosorbents. If necessary, carry out symptomatic therapy (adjust blood pressure).
Interaction with other drugs
The drug inhibits the effects of levodopa and dopegit.
Combination with barbiturates leads to a weakening of the antispasmodic properties of papaverine.
The effect of the alkaloid can be enhanced by:
- narcotic drugs,
- tranquilizers,
- analgesics,
- sedatives.
The hypotensive effect of the drug is potentiated by various antihypertensive drugs, tricyclic antidepressants, reserpine, quinidine, procainamide.
The activity of papaverine inhibits nicotine.
Vacation conditions
Injections are available by prescription. Tablets and suppositories - without a prescription.
Storage
In a dry place, protected from light. Away from children. Tablets are stored at a temperature of 8 to 25ºС, solution for injection - at a temperature of 17-25ºС, suppositories - at a temperature of 8-15ºС.
In pharmacies and medical institutions, ampoules are stored according to the conditions of List B.
Best before date
Pills. 4 years.
Solution for injection. 2 years.
Suppositories. 2-3 years (depending on the manufacturer).
Review of manufacturers
Products based on papaverine are produced by a number of Russian and foreign enterprises. Each company uses its own production technologies, so even identical dosage forms manufactured at different factories may differ from each other in the amount of impurities, composition of auxiliary components and physicochemical characteristics. These differences may account for slight differences in the clinical effectiveness of the products.
In Russia, papaverine preparations from the following companies are registered and approved for sale:
- JSC Pharmstandard (Russia),
- JSC Veropharm (Russia),
- OJSC Irbit Chemical and Pharmaceutical Plant (Russia),
- JSC Biokhimik (Russia),
- RUE Borisov Pharmaceutical Plant (Republic of Belarus),
- OJSC Novosibkhimpharm (Russia),
- JSC Biosintez (Russia),
- OJSC Nizhpharm (Russia),
- OJSC PFK Obnovleniya (Russia),
- NPO FSUE Microgen (Russia),
- JSC Dalkhimfarm (Russia),
- JSC Moskhimfarmpreparaty im. Semashko (Russia),
- Federal State Unitary Enterprise Armavir Biofactory (Russia),
- CJSC Medisorb (Russia).
The main production is concentrated in the Central, Siberian and Volga districts. Russian drugs are marketed under the trade names “Papaverine” and “Papaverine hydrochloride”.
Some foreign producers of papaverine:
| Trade name | Manufacturer | Countries in which the drugs are registered |
| Papaverine Spofa | Spofa (Slovakia) | Slovakia, Czech Republic |
| Papaverine | Galen (Türkiye) | Türkiye, Taiwan |
| Papaverine hydrochloride Biosano | Biosano (Chile) | Chile |
| Papaverol | Cifsa (Ecuador) | Ecuador, Colombia |
| Para-Time | Time-Cap (USA) | USA, Canada |
| Papaverine Sopharma | Sofarma (Bulgaria) | Bulgaria |
| Papaverine hydrochloride | American Regent (USA) Bedford (USA) Eon (USA) United Research (USA) Hospira (New Zealand) Teva (Israel), etc. | Different countries |
Analogs
Other synthetic drugs and alkaloids have a similar antispasmodic effect to papaverine:
- drotaverine,
- mebeverine,
- dibazole,
- hyoscine butyl bromide,
- bencyclane,
- theophylline.
Drotaverine and mebeverine are closest to papaverine in chemical structure and mechanism of action. They similarly change the calcium content inside muscle cells, which leads to relaxation of internal organs. However, in comparison with their predecessor, drotaverine and mebeverine exhibit stronger pharmacological activity. In addition, the drugs differ in their range of side effects and contraindications.
Comparative characteristics of the drugs papaverine, drotaverine and mebeverine:
| Active ingredient | Some trade names and manufacturers | Release forms | Main indications for use | Adverse reactions | Contraindications |
| Papaverine hydrochloride | Papaverine hydrochloride and Papaverine (more than 100 different manufacturers | Tablets 10 and 40 mgSuppositories 20 mg2% solution for injection | Spastic conditions of the digestive tract, renal colic, vascular spasms, bronchospasms. | Rarely: hypotension, drowsiness, constipation, allergic reactions, heart rhythm disturbances. | Liver failure, glaucoma, age up to 6 months, atrioventricular block, allergic reaction to the components of the drug. |
| Drotaverine hydrochloride | No-Shpa (Chinoin Pharmaceutical and Chemical Works Co., Hungary) Vero-Drotaverin (Veropharm, Russia) Drotaverin-Teva (Teva, Israel) Drotaverin (Alsi Pharma, Biokhimik, Moskhimfarmpreparaty, etc., Russia) | Tablets and capsules of 40 and 80 mg 2% solution for injection | Spasms of smooth muscles of the urinary and biliary tract. As an auxiliary therapy - for gastrointestinal spasms and gynecological diseases. | Rarely or very rarely: nausea, vomiting, dizziness, headache, tachycardia, hypotension, allergic reactions. | Hypersensitivity, renal, hepatic or heart failure. |
| Mebeverine hydrochloride | Duspatalin (Solvay Pharmaceuticals, Netherlands), Niaspam (SUN Pharmaceutikal Industries Ltd, India), Sparex (Canonpharma, Russia) | Capsules 200 mg | Spasms of the digestive tract, including those associated with organic diseases. | Very rare: allergic reactions. | Age under 18 years, pregnancy, allergy to the components of the drug. |
Best doctors:
Dear visitors of the Farmamir website. This article does not constitute medical advice and should not serve as a substitute for consultation with a physician.
Gross formula
C 20 H 21 NO 4Pharmacological group of the substance Papaverine
Nosological classification (ICD-10)
CAS Code
58-74-2Characteristics of the substance Papaverine
Papaverine hydrochloride is an odorless white crystalline powder with a slightly bitter taste. Slowly soluble in water (1:40), slightly soluble in ethanol, soluble in chloroform, practically insoluble in ether. Molecular weight 375.85.
Pharmacology
Pharmacological action- antispasmodic, hypotensive.Inhibits phosphodiesterase and causes the accumulation of cyclic 3,5"-AMP in the cell and a decrease in Ca 2+ levels. Reduces tone and relaxes smooth muscles of internal organs (gastrointestinal tract, respiratory, genitourinary system) and blood vessels. In large doses, it reduces the excitability of the heart muscle and slows down intracardiac conduction.
Quickly and completely absorbed by any route of administration. In plasma it binds to proteins. Easily passes through histohematic barriers and undergoes biotransformation in the liver. T1/2 - 0.5-2 hours. Excreted by the kidneys mainly in the form of metabolites.
Application of the substance Papaverine
Spasm of smooth muscles: abdominal organs (cholecystitis, pylorospasm, spastic colitis, renal colic), peripheral vessels (endarteritis), cerebral vessels, heart - angina pectoris (as part of complex therapy), bronchospasm; as an auxiliary drug for premedication.
Contraindications
Hypersensitivity, AV block, glaucoma, severe liver failure, old age (risk of developing hyperthermia), children (up to 6 months).
Restrictions on use
Condition after TBI, shock conditions, chronic renal failure, adrenal insufficiency, hypothyroidism, prostatic hyperplasia, supraventricular tachycardia.
Use during pregnancy and breastfeeding
Safety of use during pregnancy and breastfeeding has not been established.
Side effects of the substance Papaverine
From the cardiovascular system and blood (hematopoiesis, hemostasis): AV blockade, ventricular extrasystole, decreased blood pressure.
From the gastrointestinal tract: constipation, increased activity of liver transaminases.
Others: drowsiness, eosinophilia, allergic reactions.
Interaction
In combination with barbiturates, the antispasmodic effect of papaverine is enhanced. When used together with tricyclic antidepressants, procainamide, reserpine, quinidine, the hypotensive effect of papaverine may be enhanced.
Overdose
Symptoms: blurred vision (double vision), weakness, drowsiness, decreased blood pressure.
Treatment: gastric lavage (milk, activated carbon), maintaining blood pressure.
Routes of administration
Inside, subcutaneously, intramuscularly, rectally.
Precautions for the substance Papaverine
It should be kept in mind that effectiveness decreases when smoking.
Interactions with other active ingredients
Trade names
| Name | The value of the Vyshkowski Index ® |
1. Pharmacological action
The active substance of the drug has a relaxing effect on the smooth muscles of blood vessels and internal organs. The analgesic effect of Papaverine is due to the relief of spasm. In addition, the drug lowers blood pressure and significantly improves blood flow in the vessels. Papaverine is absorbed quite quickly and almost completely binds to plasma proteins, ensuring its distribution throughout all organs and tissues. Penetrates well through all protective barriers of the body. The drug is neutralized in the liver, and excreted through the kidneys in the form of decay products.
2. indications for use
- Spasms of smooth muscles of internal organs;
- Spasms of vascular smooth muscles;
- Pain in the heart area;
- Auxiliary use in drug preparation.
3. Method of application
Papaverine in tablet form: The dosage of the drug is 40-60 mg up to 5 times a day. The frequency of use and dosage can be changed by the attending physician depending on the patient's condition. Papaverine in the form of rectal suppositories: The dosage of the drug is 20-40 mg up to 3 times a day. The frequency of use and dosage can be changed by the doctor depending on the patient's condition. Papaverine in injection form: The drug can be used in the form of intravenous infusions, intramuscular injections and intravenous drips. The single dosage depends on the patient’s age:
- Age 1-12 years - 200-300 mg per kg of body weight;
- Middle-aged patients - 10-20 mg with an interval between doses of at least 4 hours;
- Elderly patients - no more than 10 mg with an interval between doses of at least 4 hours.
- The drug in the form of intravenous infusions should be administered slowly enough under the supervision of a physician;
- Papaverine is well removed by mechanical blood purification (dialysis), which should be taken into account in the event of severe conditions associated with side effects;
- During the entire course of treatment, it is unacceptable to take alcohol in any form;
- Suffered traumatic brain injury;
- Heart rhythm disturbances;
- Functional kidney failure in chronic form;
- Functional adrenal insufficiency;
- Prostate enlargement.
4. Side effects
- Digestive system disorders (nausea, vomiting, stool disorders, increased activity of liver enzymes);
- Metabolic disorders (sweating);
- Cardiovascular system disorders (heart rhythm disturbances, low blood pressure, blockade of cardiac pathways).
5. Contraindications
6. During pregnancy and lactation
To date, there is no data on undesirable effects on the body of mother and child. The use of the drug during pregnancy and lactation is undesirable and is possible only in cases of urgent need according to the indications of the attending physician, with the obligatory refusal of breastfeeding throughout the entire course of treatment.
7. Interaction with other drugs
- Simultaneous use with drugs that have a blocking effect on acetylcholine receptors leads to a significant increase in the therapeutic effect of the latter;
- Simultaneous use with Levodopa drugs leads to a decrease in the therapeutic effect of the latter;
- Simultaneous use with Methyldopa leads to a decrease in the therapeutic effect of the latter associated with a decrease in blood pressure;
- Simultaneous use with Alprostadil in men leads to a long-lasting, persistent erection.
8. Overdose
No data on overdose of Papaverine has been provided. Increased side effects are expected.
9. Release form
Tablets, 40 mg - 10, 20, 30 or 6000 pcs. Solution for injection, 40 mg/2 ml - amp. 10 or 20 pcs; 20 mg/1 ml - amp. 2 ml 10 pcs; 2% (40 mg/2 ml) - amp. 10 pcs; 40 mg/2 ml - amp. 5, 10 or 20 pcs; 20 mg/1 ml - 2 ml amp. 10 pcs. Rectal suppositories, 20 mg - 10 pcs.
10. Storage conditions
Papaverine should be stored in a dry place at a temperature of about 25 degrees.
11. Composition
1 ml solution:
- papaverine hydrochloride - 20 mg.
1 suppository:
- papaverine hydrochloride - 20 mg.
1 tablet:
- papaverine hydrochloride - 40 mg.
12. Conditions for dispensing from pharmacies
The drug is dispensed according to the prescription of the attending physician.How many times a day can you place Papaverine suppositories?
Instructions for use of the drug Papaverine provide only recommendations for taking the drug; the exact amount is prescribed by the doctor.
One Papaverine suppository contains 20 mg of the main active ingredient. Adults are allowed to insert 20-40 mg rectally up to 2-3 times a day. In this case, equal intervals of time should be observed. The maximum daily dosage is 120 mg.
It is not advisable to use suppositories more than 3 times a day, otherwise you can provoke an overdose of the drug. After all, it should be remembered that the most active absorption of medicinal substances usually occurs in the intestines.
Dibazol with Papaverine for blood pressure
Often, with high blood pressure, the use of Dibazol is combined with Papaverine. In this case, the drugs enhance each other’s actions, and the effect occurs much faster. This combination is administered intramuscularly. As a result, pain, spasm are eliminated, blood vessels dilate, and, accordingly, pressure decreases and a hypertensive crisis is prevented.
The advantage of this combination is the minimal risk of side effects. In this case, the exact dosage is prescribed by the doctor depending on the value of blood and pulse pressure, age and individual characteristics of the person. On average, a combination of 4 ml of Dibazol and 2 ml of Papaverine is prescribed, but this dosage is only approximate. In critical conditions, analgin can be added to this combination, which enhances the analgesic effect.
How long does it take for Papaverine to work?
When using a medicine, it is important for a person to know how long it will take for the therapeutic effect to occur.
A drug called Papaverine has an antispasmodic and vasodilating effect on the body. As a result, spasm is eliminated and blood pressure decreases.
Regardless of the route of administration, the drug is absorbed quickly and almost completely. Therefore, the onset of the therapeutic effect occurs within a few minutes. On average, relief occurs after 20-30 minutes. After this, the effect of the drug continues for another 4-6 hours.
Papaverine and Diphenhydramine
To ensure a high therapeutic effect, papaverine is combined with other drugs, for example Diphenhydramine. When Analgin is added to this combination, a lytic mixture is obtained.
The combination of these 3 drugs when administered intramuscularly provides the following effect:
- Reduces high temperature
- Relieves cramps that appear against the background of high temperature;
- Relieves pain and eliminates spasms.
Papaverine eliminates muscle spasm, relaxing and dilating blood vessels. Diphenhydramine has an antihistamine effect, relieving allergy symptoms, and also has a calming effect. Adding Analgin to this combination provides an analgesic and antipyretic effect.
This mixture is often used for some surgical, gynecological, urological pathologies and is used in emergency cases to effectively reduce temperature. This combination can also be used to eliminate a hypertensive crisis.
Papaverine for headaches
Papaverine is used for a variety of diseases, but will it help eliminate severe headaches?
To answer this question, you should find out what causes headaches. Often this disease appears as a result of circulatory problems in the brain, caused by vasospasm and increased blood pressure.
If the headache was provoked by these reasons, then Papaverine will help. After all, looking at the instructions for Papaverine, you can see that the drug has a vasodilator and antispasmodic effect. In addition, the medicine helps you relax and fall asleep peacefully.
The dosage is calculated individually. On average, for spasm of cerebral vessels, 40-60 mg of the tablet form of Papaverine is prescribed up to 3-4 times a day. Also, to eliminate headaches, the doctor may prescribe the drug in the form of injections.
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* Instructions for medical use of the drug Papaverine are published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, YOU MUST CONSULT WITH A SPECIALIST
