Of the antispasmodic drugs "Papaverine" is one of the safest drugs used for various pathologies. Under what diseases and why "Papaverine" is prescribed, it will become clear if you understand the mechanism of its action. Like all medicines, this medicine should only be prescribed by a doctor.
What is papaverine
Papaverine hydrochloride is a medicinal substance that has a vasodilating and antispasmodic effect. Found in poppy plants. What is papaverine, people learned in the middle of the 19th century, although ancient Roman sources talk about mixing a substance with a similar name into food. At the beginning of the 20th century, papaverine was synthesized, and now it is a drug widely used in medicine.
Action of papaverine
The action of papaverine on smooth muscle cells is associated with enzymatic processes, which ultimately reducethe amount of calcium inside the cell, due to which smooth muscles relax. This ability extends to the gastrointestinal tract, biliary tract, cells lining the bronchi, urinary system, cells of the vascular wall, heart muscle, and the muscular layer of the uterus. Describes a mild sedative effect when influencing the brain of patients.
Absorption and excretion
The medicinal substance can be absorbed by 54%. The drug binds well to plasma proteins (90%). In the body, it quickly passes between blood and tissue fluid, penetrating into all cells of the body, including the brain. Papaverine conversion reactions occur in liver cells. It is excreted from the body quite quickly: the half-life is from thirty minutes to two hours, but with liver diseases, a much longer elimination of the substance is possible. The drug is eliminated by the kidneys, so it is important to know that dialysis patients may have accelerated excretion of papaverine (what you already know) in the urine.
Indications for use
What helps papaverine, it becomes clear, based on its mechanism of action. The drug has an antispasmodic effect and is used:
- To relieve stomach cramps caused by intoxication, inflammation (gastritis), peptic ulcer and functional disorders of the nervous system.
- Elimination of spasms of the biliary tract in cholecystitis, cholangitis, dysfunction due to imbalanceregulation of the nervous system, cholelithiasis.
- In the treatment of spastic processes in the intestines associated with inflammatory diseases of the small and large intestine, functional spasms.
- To reduce bronchospasm in acute and chronic bronchitis, bronchial asthma, pneumonia.
- When eliminating the causes of spasm of the walls of the urinary tract and vessels of the kidneys due to infectious processes, dysfunction of relaxation as a result of the pathology of the peripheral nervous system.
- To relieve spasms of blood vessels in inflammatory processes in the arteries, functional spasms of the brain that cause headaches, arterial hypertension.
- In combination with other angina medicines.
- "Papaverine" during early pregnancy is used to relieve increased uterine tone.
- To relieve spasms of the muscles of the uterus and relieve pain during menstruation in women.
- In preparation for surgery to provide a mild hypnotic effect in conjunction with other sedatives.
Dosage "Papaverine"
The drug is used in 40 mg tablets, 20 mg suppositories and 40 mg injections.
The dosage of "Papaverine" for adults is two tablets (candles) or one ampoule intramuscularly three times a day. The maximum dose is possible up to 240 mg per day with severe pain spasmodic sensations. The introduction of the drug by any route should be carried out no more than fourhours.
Medication does not depend on food. The action develops quickly enough, the drug begins to relieve spasmodic pain within thirty minutes after use.
The duration of taking "Papaverine" is individual and can be long in case of chronic pain.
Use in childhood
Infants under six months of the drug is contraindicated. Starting from six months of age and up to two years, you can give 5 mg three times a day. Children 3-4 years old are given 5-10 mg three times a day. At the age of five and six - 10 mg, that is, 1/4 tablet three times a day. From seven to nine years old, 10-15 mg three times a day is given. Children 10-14 years old - 15 to 20 mg three times a day. From the age of 15, the dosage corresponds to that in adults, which is 40 mg three times a day.
Use during pregnancy
In the first trimester of pregnancy, women often experience increased uterine tone, that is, muscle spasm. This can lead to early miscarriage. Pathology is often accompanied by pain in the abdomen and in the sacrum, sometimes there may even be discharge, as during menstruation. Such patients are hospitalized in the department of pathology of pregnancy and "Papaverine" is prescribed for use in injections. In this case, the drug perfectly relaxes the smooth muscles of the uterus, improves blood circulation, without adversely affecting the developing child.
Candles "Papaverine" in the early stages have the same positive effect. Apply them 3-4 times a day, depending on the condition. Such treatment should be carried out under the mandatory supervision of a physician in order to avoid severe relaxation of the muscles of the uterus.
Hypertension use
Arterial hypertension, which is accompanied by a spasm of cerebral vessels and an increase in blood pressure, can be stopped with the help of "Papaverine" with "Dibazol" administered together. "Dibazol" is an antispasmodic that eliminates spasm of peripheral vessels and muscles of internal organs. The combination of these two antispasmodics allows you to increase the chances of lowering blood pressure and improve the patient's condition faster. One ampoule of "Dibazol" in 2 ml contains 10 mg of active ingredient.
In a hypertensive crisis, 1-2 ampoules of each substance are administered intramuscularly or slowly intravenously in one syringe. "Papaverine" and "Dibazol" tend to mutually reinforce each other. It is undesirable to use such a combination for elderly people with heart problems. "Dibazol" is contraindicated in epilepsy and convulsive seizures of another etiology, as well as hypersensitivity to this drug.
Contraindications
Studying what "Papaverine" is, you should figure out who should not take this drug:
- Babies up to six months of age.
- Elderly people over 70,having a diseased heart, which is less able to pump blood around the body.
- For survivors of myocardial infarction.
- For patients with atrioventricular block, which slows down the conduction of the impulse between the ventricle and the atrium, which leads to a slowing of the pulse and a decrease in the ejection of blood into the aorta.
- With increased eye pressure.
- Severe liver failure.
- With respiratory disorders, obstructive pulmonary processes.
- In patients with impaired consciousness (in a coma and soporous state).
- In case of increased individual sensitivity.
Special Instructions
"Papaverine" is generally well tolerated, but should be used with caution in the following cases:
- Tendency to low blood pressure and bradycardia.
- Decreased thyroid function.
- Insufficient production of adrenal hormones.
- Chronic kidney disease with failure.
- Dishormonal prostatic hyperplasia in men.
- Brain injury.
- Shock conditions.
- ECG signs of supraventricular tachycardia.
- When driving vehicles and working at height, the effect of "Papaverine" on the body should be taken into account.
Side effects
What "Papaverine" is used for, we described above, but it does not always bring only positive results. Sometimes undesirable consequences are possible:
- Nausea, stomach discomfort, dry mouth, constipation, diarrhea, bloating, appetite instability.
- Decrease in blood pressure up to collapse, extrasystoles, arrhythmias, tachycardia, bradycardia, blockade, dizziness.
- Drowsiness, lethargy, blurred vision, headache, sensitivity to light.
- Increased eosinophils in peripheral blood.
- Increase in body temperature above 37 degrees (more often in young children and the elderly).
- Increased perspiration.
- Yellow skin and sclera.
- Allergic rashes, angioedema.
- Burning sensation at the injection site.
- Vein thrombosis with a tendency to thrombosis.
Overdose
Exceeding the dose of "Papaverine" can lead to a general deterioration in the condition. The patient will complain of double vision, painful sensitivity to light, fatigue, drowsiness, discomfort in the heart area, decreased heart rate, dizziness. Possible development of respiratory arrest.
Help must be provided immediately. When breathing stops, cardiopulmonary resuscitation is indicated. In milder cases, when taking tablets, gastric lavage is performed, sorbents (activated charcoal) are taken. With an intravenous overdose, dialysis may be used to quickly cleanse the body.
Drug Interactions
It should be clarified whether "Papaverine" can be used with other medicinal substances.
Contraindicatedthe use of alcoholic beverages during treatment with this drug due to increased toxic effects on liver cells. Nicotine reduces the effect of "Papaverine", so smoking should be stopped or reduced so as not to reduce the effectiveness of treatment.
Anticholinergic drugs ("Atropine", "Cyclodol", "Ipratropium bromide"), when taken together with "Papaverine", may act with greater force, so their dosage should be adjusted.
Reducing the effect of Levodopa (a drug for parkinsonism), Methyldopa and Dopegyt.
May be more likely to cause cardiac arrest when used concomitantly with 3-adrenergics (Reserpine, Octadine).
The sedative effect is enhanced when taken together with sleeping pills, narcotic, anti-anxiety, antidepressant, antipsychotic and pain medications.
When taking drugs to lower blood pressure, their dose should be adjusted due to the high likelihood of developing hypotension.
Format and trade names
In tablet form, the drug is produced in the following names only by domestic manufacturers:
- Papaverine is a drug produced by Pharmstandard-Tomskhimfarm OJSC.
- "Papaverine" in tablets of 40 mg, produced by OJSC "Irbitsky CPP".
- "Papaverine" of PJSC "Biosintez".
- "Papaverine hydrochloride MS", manufactured at the enterprise CJSCMedisorb.
In the form of rectal suppositories, the drug in Russia is represented by domestic medicines:
- "Papaverine" suppositories of 20 mg, produced by OJSC "Biochemist".
- "Papaverine" rectal suppositories made by JSC "Nizhpharm".
- "Papaverine" rectal suppositories produced by the Tula Pharmaceutical Factory.
- "Papaverine hydrochloride" candles PJSC "Biosintez".
- "Papaverine hydrochloride" suppositories JSC "Dalchimpharm".
The drug for injections of 2 ml is produced at Russian enterprises under the names:
- Papaverine, manufacturers: Novosibkhimfarm OJSC, Grotex LLC, Veropharm JSC, Biochemist OJSC, Biosynthesis PJSC, Ellara LLC.
- "Papaverine Bufus", produced by CJSC "PFC Renewal".
- "Papaverine hydrochloride" enterprises: OJSC "Moskhimfarmpreparaty im. N. A. Semashko, Atoll LLC, Slavyanskaya Apteka LLC, Dalkhimpharm OJSC, FKP Armavir Biofactory.
And also imported "Papaverine" in solution from the Republic of Belarus, made at JSC "Borisov Plant of Medical Preparations".
