(pa PAV er een)
Various vascular spasms associated with smooth muscle spasms as in myocardial infarction, angina, peripheral and pulmonary embolism, peripheral vascular disease; cerebral angiospastic states; visceral spasms (ureteral, biliary, and GI colic). Note: Labeled uses have fallen out of favor; safer and more effective alternatives are available.
Patients with complete AV block
Note: Labeled uses have fallen out of favor; safer and more effective alternatives are available. The manufacturer 's labeling recommends the following dosing:
Arterial spasm: IM, IV: 30-120 mg; may repeat dose every 3 hours; if cardiac extrasystole occurs during use, may administer 2 doses 10 minutes apart
Refer to adult dosing.
No dosage adjustment provided in the manufacturer 's labeling.
No dosage adjustment provided in the manufacturer 's labeling.
Solutions should be clear to pale yellow. Precipitates with lactated Ringers.
Rapid IV administration may result in arrhythmias and fatal apnea; administer no faster than over 1-2 minutes.
May be taken with food.
Store at 20 ‚ °C to 25 ‚ °C (68 ‚ °F to 77 ‚ °F); excursions permitted to 15 ‚ °C to 30 ‚ °C (59 ‚ °F to 86 ‚ °F). Protect from light.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Injection, as hydrochloride:
Generic: 30 mg/mL (2 mL, 10 mL)
Stable in D5LR, D51/4NS, D51/2NS, D5NS, D5W, D10W, 1/2NS, NS; incompatible with LR.
Levodopa: Papaverine may enhance the hypotensive effect of Levodopa. Papaverine may diminish the therapeutic effect of Levodopa. Monitor therapy
Blood pressure, heart rate
Frequency not defined.
Cardiovascular: Arrhythmias (with rapid IV use), flushing, mild hypertension, tachycardia
Central nervous system: Headache, malaise, sedation, vertigo
Dermatologic: Rash
Gastrointestinal: Abdominal distress, anorexia, constipation, diarrhea, nausea
Hepatic: Cirrhosis, hepatic hypersensitivity, hepatitis (rare)
Respiratory: Apnea (with rapid IV use)
Miscellaneous: Diaphoresis
Concerns related to adverse effects:
- Arrhythmias: May (in large doses or with rapid infusion) depress AV and intraventricular cardiac conduction leading to serious arrhythmias (eg, premature beats, paroxysmal tachycardia).
- Hepatitis: May cause hepatic hypersensitivity; discontinue use if GI symptoms, jaundice, eosinophilia, or abnormal LFTs occur.
Disease-related concerns:
- Glaucoma: Use with caution in patients with glaucoma.
Other warnings/precautions:
- Appropriate use: Not indicated for treatment of impotence by intracorporeal injection; persistent priapism may occur.
C
Teratogenic effects have not been observed in animal reproduction studies.
Smooth muscle spasmolytic producing a generalized smooth muscle relaxation including: vasodilatation, gastrointestinal sphincter relaxation, bronchiolar muscle relaxation, and potentially a depressed myocardium (with large doses); muscle relaxation may occur due to inhibition or cyclic nucleotide phosphodiesterase, increasing cyclic AMP; muscle relaxation is unrelated to nerve innervation; papaverine increases cerebral blood flow in normal subjects; oxygen uptake is unaltered
Rapidly hepatic
Primarily urine (as metabolites)
Oral: Rapid
30 to 120 minutes
~90%
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Patient may experience constipation, diarrhea, dizziness, lack of appetite, or sweating a lot. Have patient report immediately to prescriber tachycardia, severe headache, fatigue, arrhythmia, severe nausea, severe vomiting, or jaundice (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.