Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 30mg/mL
Arterial Spasm
Sustained release oral formulation: 150 mg PO q8-12hr OR 300 mg PO q12hr
Injection solution: 30-65 mg (up to 120 mg if needed) IV/IM; may repeat q3hr
Cardiac extrasystoles: Administer 2 doses 10 minutes apart
Admin IV by slow push (1-2 minutes)
Mesenteric Ischemia (Orphan)
Orphan designation for treatment of mesenteric ischemia
Sponsor
- Nir Barak, MD; CO Noa Avtalion; 161 Jefferson Avenue; Tenafly, New Jersey 07670
Safety & efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- calcium/magnesium/potassium/sodium oxybates
papaverine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- lofexidine
lofexidine, papaverine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- sodium oxybate
papaverine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (142)
- albuterol
papaverine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and papaverine both increase sedation. Use Caution/Monitor.
- alprazolam
alprazolam and papaverine both increase sedation. Use Caution/Monitor.
- amitriptyline
amitriptyline and papaverine both increase sedation. Use Caution/Monitor.
- amobarbital
amobarbital and papaverine both increase sedation. Use Caution/Monitor.
- amoxapine
amoxapine and papaverine both increase sedation. Use Caution/Monitor.
- apomorphine
apomorphine and papaverine both increase sedation. Use Caution/Monitor.
- arformoterol
papaverine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
aripiprazole and papaverine both increase sedation. Use Caution/Monitor.
- azelastine
azelastine and papaverine both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and papaverine both increase sedation. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and papaverine both increase sedation. Use Caution/Monitor.
- benperidol
benperidol and papaverine both increase sedation. Use Caution/Monitor.
- benzphetamine
papaverine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bretylium
papaverine, bretylium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Each drug may cause hypotension.
- brompheniramine
brompheniramine and papaverine both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and papaverine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and papaverine both increase sedation. Use Caution/Monitor.
- butabarbital
butabarbital and papaverine both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and papaverine both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and papaverine both increase sedation. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and papaverine both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and papaverine both increase sedation. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and papaverine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and papaverine both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and papaverine both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and papaverine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
chlorzoxazone and papaverine both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and papaverine both increase sedation. Use Caution/Monitor.
- clemastine
clemastine and papaverine both increase sedation. Use Caution/Monitor.
- clomipramine
clomipramine and papaverine both increase sedation. Use Caution/Monitor.
- clonazepam
clonazepam and papaverine both increase sedation. Use Caution/Monitor.
- clorazepate
clorazepate and papaverine both increase sedation. Use Caution/Monitor.
- clozapine
clozapine and papaverine both increase sedation. Use Caution/Monitor.
- codeine
codeine and papaverine both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and papaverine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and papaverine both increase sedation. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and papaverine both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and papaverine both increase sedation. Use Caution/Monitor.
- desflurane
desflurane and papaverine both increase sedation. Use Caution/Monitor.
- desipramine
desipramine and papaverine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
dexchlorpheniramine and papaverine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
papaverine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and papaverine both increase sedation. Use Caution/Monitor.
- dextromoramide
dextromoramide and papaverine both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and papaverine both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and papaverine both increase sedation. Use Caution/Monitor.
- diethylpropion
papaverine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and papaverine both increase sedation. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate and papaverine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and papaverine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
diphenoxylate hcl and papaverine both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and papaverine both increase sedation. Use Caution/Monitor.
- dopexamine
papaverine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
doxepin and papaverine both increase sedation. Use Caution/Monitor.
- doxylamine
doxylamine and papaverine both increase sedation. Use Caution/Monitor.
- droperidol
droperidol and papaverine both increase sedation. Use Caution/Monitor.
- estazolam
estazolam and papaverine both increase sedation. Use Caution/Monitor.
- ethanol
ethanol and papaverine both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and papaverine both increase sedation. Use Caution/Monitor.
- fenfluramine
papaverine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluphenazine
fluphenazine and papaverine both increase sedation. Use Caution/Monitor.
- flurazepam
flurazepam and papaverine both increase sedation. Use Caution/Monitor.
- haloperidol
haloperidol and papaverine both increase sedation. Use Caution/Monitor.
- hydromorphone
hydromorphone and papaverine both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and papaverine both increase sedation. Use Caution/Monitor.
- iloperidone
iloperidone and papaverine both increase sedation. Use Caution/Monitor.
- imipramine
imipramine and papaverine both increase sedation. Use Caution/Monitor.
- ketamine
ketamine and papaverine both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
ketotifen, ophthalmic and papaverine both increase sedation. Use Caution/Monitor.
- levodopa
papaverine decreases effects of levodopa by unknown mechanism. Use Caution/Monitor.
- levorphanol
levorphanol and papaverine both increase sedation. Use Caution/Monitor.
- lofepramine
lofepramine and papaverine both increase sedation. Use Caution/Monitor.
- lofexidine
lofexidine and papaverine both increase sedation. Use Caution/Monitor.
- loprazolam
loprazolam and papaverine both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and papaverine both increase sedation. Use Caution/Monitor.
- lormetazepam
lormetazepam and papaverine both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and papaverine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled and papaverine both increase sedation. Use Caution/Monitor.
- maprotiline
maprotiline and papaverine both increase sedation. Use Caution/Monitor.
- marijuana
marijuana and papaverine both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and papaverine both increase sedation. Use Caution/Monitor.
- meprobamate
meprobamate and papaverine both increase sedation. Use Caution/Monitor.
- metaxalone
metaxalone and papaverine both increase sedation. Use Caution/Monitor.
- methadone
methadone and papaverine both increase sedation. Use Caution/Monitor.
- methocarbamol
methocarbamol and papaverine both increase sedation. Use Caution/Monitor.
- methylenedioxymethamphetamine
papaverine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
midazolam and papaverine both increase sedation. Use Caution/Monitor.
- mirtazapine
mirtazapine and papaverine both increase sedation. Use Caution/Monitor.
- morphine
morphine and papaverine both increase sedation. Use Caution/Monitor.
- motherwort
motherwort and papaverine both increase sedation. Use Caution/Monitor.
- moxonidine
moxonidine and papaverine both increase sedation. Use Caution/Monitor.
- nabilone
nabilone and papaverine both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and papaverine both increase sedation. Use Caution/Monitor.
- nitroglycerin rectal
nitroglycerin rectal, papaverine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Observe for possible additive hypotensive effects during concomitant use. .
- nortriptyline
nortriptyline and papaverine both increase sedation. Use Caution/Monitor.
- olanzapine
olanzapine and papaverine both increase sedation. Use Caution/Monitor.
- opium tincture
opium tincture and papaverine both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and papaverine both increase sedation. Use Caution/Monitor.
- oxazepam
oxazepam and papaverine both increase sedation. Use Caution/Monitor.
- oxycodone
oxycodone and papaverine both increase sedation. Use Caution/Monitor.
- oxymorphone
oxymorphone and papaverine both increase sedation. Use Caution/Monitor.
- paliperidone
paliperidone and papaverine both increase sedation. Use Caution/Monitor.
- papaveretum
papaveretum and papaverine both increase sedation. Use Caution/Monitor.
- pentazocine
pentazocine and papaverine both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital and papaverine both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine and papaverine both increase sedation. Use Caution/Monitor.
- phenobarbital
phenobarbital and papaverine both increase sedation. Use Caution/Monitor.
- phenylephrine PO
papaverine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
papaverine and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
pimozide and papaverine both increase sedation. Use Caution/Monitor.
- primidone
primidone and papaverine both increase sedation. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and papaverine both increase sedation. Use Caution/Monitor.
- promethazine
promethazine and papaverine both increase sedation. Use Caution/Monitor.
- propofol
propofol and papaverine both increase sedation. Use Caution/Monitor.
- propylhexedrine
papaverine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
protriptyline and papaverine both increase sedation. Use Caution/Monitor.
- quazepam
quazepam and papaverine both increase sedation. Use Caution/Monitor.
- quetiapine
quetiapine and papaverine both increase sedation. Use Caution/Monitor.
- ramelteon
papaverine and ramelteon both increase sedation. Use Caution/Monitor.
- risperidone
risperidone and papaverine both increase sedation. Use Caution/Monitor.
- scullcap
papaverine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and papaverine both increase sedation. Use Caution/Monitor.
- sevoflurane
sevoflurane and papaverine both increase sedation. Use Caution/Monitor.
- shepherd's purse
papaverine and shepherd's purse both increase sedation. Use Caution/Monitor.
- sufentanil
sufentanil and papaverine both increase sedation. Use Caution/Monitor.
- tapentadol
tapentadol and papaverine both increase sedation. Use Caution/Monitor.
- temazepam
temazepam and papaverine both increase sedation. Use Caution/Monitor.
- thioridazine
thioridazine and papaverine both increase sedation. Use Caution/Monitor.
- thiothixene
thiothixene and papaverine both increase sedation. Use Caution/Monitor.
- topiramate
papaverine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and papaverine both increase sedation. Use Caution/Monitor.
- trazodone
trazodone and papaverine both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and papaverine both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and papaverine both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and papaverine both increase sedation. Use Caution/Monitor.
- trimipramine
trimipramine and papaverine both increase sedation. Use Caution/Monitor.
- triprolidine
triprolidine and papaverine both increase sedation. Use Caution/Monitor.
- xylometazoline
papaverine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
papaverine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
papaverine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
ziprasidone and papaverine both increase sedation. Use Caution/Monitor.
Minor (2)
- eucalyptus
eucalyptus and papaverine both increase sedation. Minor/Significance Unknown.
- sage
papaverine and sage both increase sedation. Minor/Significance Unknown.
Adverse Effects
Frequency not defined
BP changes
Flushing
Tachycardia
Abdominal distress
Depression
Dizziness
HA
Drowsiness
Malaise
Raised intracranial pressure
Pruritus
Diaphoresis
Rash
Anorexia
Diarrhea
Dry mouth
Constipation
Apnea
Nausea
Vomiting
Hepatitis (rare)
Cirrhosis (rare)
Priapism (with intracavernosal inj)
Sweating
Warnings
Contraindications
Hypersensitivity
Complete AV block
Cautions
Rapid injection may cause fatal apnea
Use caution in glaucoma, cardiac conduction disorder
Intracavernosal injection may lead to priapism
Discontinue use if GI symptoms, eosinophilia, jaundice, or abnormal liver function tests
Chronic use may lead to dependence due to CNS depressant effect
Discontinue if signs or symptoms of hepatic hypersensitivity
Pregnancy & Lactation
Pregnancy Category: C
Lactation: unknown; use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Synthetic derivative of opium
Smooth muscle spasmolytic via inhibition of oxidative phosphorylation & interference with Ca++ during muscle contraction as well as increase in cAMP from inhibition of cyclic nucleotide phosphodiesterase; most pronounced effect on blood vessels, including coronary, cerebral, pulmonary, gastrointestinal sphincter relaxation & peripheral arteries
Depresses cardiac muscle excitability
Pharmacokinetics
Onset: Rapid
Duration: 12 hr (PO)
Protein binding: 90%
Half-life elimination: 0.5-1.5hr
Metabolism: Liver, via glucuronidation
Excretion: Urine
Administration
IV Incompatibilities
Solution: LR
Additive: aminophylline with trimecaine
Syringe: diatrizoate meglumine/diatrizoate sodium, ioxaglate meglumine/ioxaglate sodium
IV Compatibilities
Solution: dextrose solutions, fructose solutions, saline, dextrose-saline, Ringer's, Na-lactate 1/6M
Additive: theophylline
Syringe: iohexol, iopamidol, phentolamine
IV/IM Administration
IM or slow IV over 1-2 min
Storage
Store vial at room temp, do not freeze
Protect from light
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| papaverine injection - | 30 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
papaverine injection
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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