papaverine (Rx)

Brand and Other Names:ParaTime SR
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and papaverine

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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             activity indicator 

            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.

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              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

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              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

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              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.

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              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

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              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

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              papaverine injection
              -
              30 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              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) 2021 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.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.