Papaverine HCl
| (pap-PAV-uhr-een HIGH-droe-KLOR-ide) |
| Pavabid Plateau Caps, Pavagen TD |
| Class: Peripheral vasodilator |
Action Directly relaxes tone of all smooth muscle, especially when spasmodically contracted. Causes vasodilatation of blood vessels of the coronary, cerebral, pulmonary and peripheral arteries; relaxes musculature of bronchi, GI tract, ureters and biliary system.
IndicationsOral form: Relief of cerebral and peripheral ischemia associated with arterial spasm and myocardial ischemia complicated by arrhythmias. Parenteral form: Vascular spasm associated with acute MI (coronary occlusion), angina pectoris, peripheral and pulmonary embolism, peripheral vascular disease in which there is a vasospastic element, certain cerebral angiospastic states, visceral spasm (eg, ureteral, biliary, and GI colic). Unlabeled use(s): Intracavernous injection for impotence.
Contraindications Complete atrioventricular (AV) heart block; intracorporeal injection for impotence.
Route/DosageIschemia
ADULTS: PO 100 to 300 mg 3 to 5 times daily (immediate-release tablets) or 150 mg q 8 to 12 hr or 300 mg q 12 hr (sustained-release capsules).
Vascular Occlusion
ADULTS: IV/IM Initial dose: 30 mg. Repeat doses: 30 to 120 mg q 3 hr prn.
Impotence
ADULTS: IV 2.5 to 60 mg as intracavernous injection (usually combined with phentolamine mesylate).
InteractionsCNS depressants: Effects may be additive. Levodopa: May reduce effectiveness of levodopa. INCOMPATIBILITIES: Lactated Ringer’s solution incompatible with parenteral formulation; do not mix.
Lab Test Interferences None well documented.
Adverse ReactionsCV: Increase in heart rate; slight increase in BP. CNS: Depression; dizziness; vertigo; headache; drowsiness; sedation; lassitude; malaise; lethargy. DERM: Flushing of face; sweating; pruritus. GI: Constipation; nausea; diarrhea; abdominal distress; dry mouth; anorexia. HEPA: Jaundice; hepatitis. HEMA: Eosinophilia. RESP: Increased depth of respiration.
PrecautionsPregnancy: Category C. Lactation: Unknown. Children: Safety and efficacy not established. Glaucoma: Use drug with caution. Hepatic hypersensitivity: Has been reported.
| PATIENT CARE CONSIDERATIONS |
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Administration/Storage- Give at evenly spaced intervals throughout day.
- Do not crush or allow patient to chew sustained-release capsules.
- Do not administer in Lactated Ringer’s solution because precipitate will develop.
- Administer parenteral form slowly over 1 to 2 min to minimize adverse effects.
- Store at room temperature.
Assessment/Interventions- Obtain patient history, including drug history and any known allergies.
- Assess mental status before and during therapy (eg, lassitude, sedation, malaise, headache, depression).
- Assess bowel status and bowel sounds before administering drug and periodically during treatment.
- Monitor patient’s BP, both lying and standing.
- Monitor liver function tests.
- Monitor ECG. If cardiac changes occur on ECG, notify physician immediately.
- If AV block, flushing, headache, jaundice, abdominal distress, constipation, or diarrhea develop, notify physician.
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Patient/Family Education- Instruct patient to take medication at evenly-spaced intervals throughout day.
- Advise patient with glaucoma to undergo regular eye examinations.
- Instruct patient to report the following symptoms to physician: Flushing, sweating, headache, tiredness, jaundice, skin rash, nausea, anorexia, abdominal distress, constipation, or diarrhea.
- Advise patient to avoid smoking and intake of alcoholic beverages or other CNS depressants.
- Caution patient to avoid sudden position changes to prevent orthostatic hypotension.
- Advise patient that drug may cause dizziness, vertigo, and drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.
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