Papaverine HCl

A to Z Drug Facts

Papaverine HCl

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(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.

Indications

Oral 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/Dosage

Ischemia

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).

Interactions

CNS 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 Reactions

CV: 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.

Precautions

Pregnancy: Category C. Lactation: Unknown. Children: Safety and efficacy not established. Glaucoma: Use drug with caution. Hepatic hypersensitivity: Has been reported.

PATIENT CARE CONSIDERATIONS

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.

OVERDOSAGE: SIGNS & SYMPTOMS
	Drowsiness, weakness, diplopia, lassitude, depression, nystagmus, incoordination, coma, cyanosis, respiratory depression, anxiety, ataxia, headache, pruritic skin rashes, nausea, CNS depression, blurred vision, GI upset, vomiting, diaphoresis, sinus tachycardia, metabolic acidosis, hyperventilation, hyperglycemia, hypokalemia

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.