Papaverine

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Papaverine
File:Papaverin - Papaverine.svg
Clinical data
Pregnancy
category
Routes of
administration		Oral, intravenous, intramuscular, rectal,Template:Ref label intracavernosal
ATC code
Pharmacokinetic data
Bioavailability80%Template:Ref label
Protein binding~90%
MetabolismHepaticTemplate:Ref label
Elimination half-life1.5–2 hoursTemplate:Ref label
ExcretionRenalTemplate:Ref label
Identifiers
CAS Number
PubChem CID
DrugBank
E number{{#property:P628}}
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Chemical and physical data
FormulaC20H21NO4
Molar mass339.385 g/molTemplate:Ref label

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Papaverine is an opium alkaloid used primarily in the treatment of visceral spasm, vasospasm (especially those involving the heart and the brain), and occasionally in the treatment of erectile dysfunction.Template:Ref label While it is found in the opium poppy, papaverine differs in both structure and pharmacological action from the other opium alkaloids (opiates).

Uses

Papaverine is approved to treat spasms of the gastointestinal tract, bile ducts and ureter and for use as a cerebral and coronary vasodilatorTemplate:Ref label in subarachnoid hemorrhage (combined with balloon angioplasty)Template:Ref label and coronary artery bypass surgery.Template:Ref label Papaverine may also be used as a smooth muscle relaxant in microsurgery where it is applied directly to blood vessels.

The in vivo mechanism of action is not entirely clear, but an inhibition of the enzyme phosphodiesterase causing elevation of cyclic AMP levels is significant. It may also alter mitochondrial respiration.

It is also commonly used in cryopreservation of blood vessels along with other glycosaminoglycans and protein suspensions.[1][2] Functions as a vasodilator during cryopreservation when used in conjunction with verapamil, phentolamine, nifedipine, tolazolines, or nitroprusside.[3][4]

Papaverine is also being investigated as a topical growth factor in tissue expansion with some success.[5]

Side effects

Frequent side effects of papaverine treatment include polymorphic ventricular tachycardia, constipation, interference with sulphobromophthaleinTemplate:Ref label retention test (used to determine hepatic function), increased transaminase levels, increased alkaline phosphatase levels, somnolence, and vertigo.Template:Ref label

Rare side effects include flushing of the face, hyperhidrosis (excessive sweating), cutaneous eruption, arterial hypotension, tachycardia, lack of appetite, jaundice, eosinophilia, thrombopenia, mixed hepatitis, headache, allergic reaction, chronic active hepatitis,Template:Ref label and paradoxical aggravation of cerebral vasospasm.Template:Ref label

Formulations and trade names

Papaverine is available as a conjugate of hydrochloride, codecarboxylate, adenylate, and teprosylate.Template:Ref label It was also once available as a salt of hydrobromide, camsylate, cromesilate, nicotinate, and phenylglycolate. The hydrochloride salt is available for intramuscular, intravenous, rectal and oral administration.Template:Ref label The teprosylate is available in intravenous, intramuscular, and orally administered formulations.Template:Ref label The codecarboxylate is available in oral form, only,Template:Ref label as is the adenylate.Template:Ref label

The codecarboxylate is sold under the name Albatran®,Template:Ref label the adenylate as Dicertan®,Template:Ref label and the hydrochloride salt is sold variously as Artegodan® (Germany), Cardioverina® (countries outside Europe and the United States), Dispamil® (countries outside Europe and the United States), Opdensit® (Germany), Panergon® (Germany), Paverina Houde® (Italy, Belgium), Pavacap (United States), Pavadyl® (United States), Papaverin-Hamelin® (Germany), Paveron® (Germany), Spasmo-Nit® (Germany),Template:Ref label Cardiospan®, Papaversan®, Cepaverin®, Cerespan®, Drapavel®, Forpaven®, Papalease®, Pavatest®, Paverolan®, Therapav® (FranceTemplate:Ref label), Vasospan®, Cerebid®, Delapav®, Dilaves®, Durapav®, Dynovas®, Optenyl®, Pameion®, Papacon®, Pavabid®, Pavacen®, Pavakey®, Pavased®, Pavnell®, Alapav®, Myobid®, Vasal®, Pamelon®, Pavadel®, Pavagen®, Ro-Papav®, Vaso-Pav®, Papanerin-hcl®, Qua bid®, Papital T.R.®, Paptial T.R.®, Pap-Kaps-150®.Template:Ref label

References

  1. ↑ E. Müller-Schweinitzer and P. Ellis: "Sucrose promotes the functional activity of blood vessels after cryopreservation in DMSO-containing fetal calf serum". Naunyn-Schmiedeberg's Archives of Pharmacology, Volume 345, Number 5 / May, 1992
  2. ↑ Muller-Schweinitzer E, Hasse J, Swoboda L. : "Cryopreservation of human bronchi.". J Asthma. 1993;30(6):451-7. Links
  3. ↑ Brockbank KG.: "Effects of cryopreservation upon vein function in vivo". Cryobiology. 1994 Feb;31(1):71-81
  4. ↑ Joseph S. Giglia, Jeremy D. Ollerenshaw, Patti E. Dawson, Kirby S. Black, William M. Abbott : "Cryopreservation Prevents Arterial Allograft Dilation ". Annals of Vascular Surgery Volume 16, Number 6 / December, 2002
  5. ↑ Tang Y, Luan J, Zhang X (2004). "Accelerating tissue expansion by application of topical papaverine cream". Plast. Reconstr. Surg. 114 (5): 1166–9. PMID 15457029.
  1. Template:Note label Template:Note label Template:Note label "SID 544606 -- PubChem Substance Summary". Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) National Center for Biotechnology Information.
  2. Template:Note label "Papaverine Material Safety Data Sheet". Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help)
  3. Template:Note label Template:Note label Template:Note label Template:Note label Template:Note label Template:Note label Template:Note label Template:Note label Unknown (2000). "PAPAVERINE". Molécule(s) de base : PAPAVERINE. Biam. Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) (French)
  4. Template:Note label Unknown (2004). "Who should not take papaverine?". papaverine Consumer Drug Information. Cerner Multum, Inc. Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help)
  5. Template:Note label Template:Note label Template:Note label Unknown (1999). "PAPAVERINE CHLORHYDRATE". Molécule(s) de base : PAPAVERINE. Biam. Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) (French)
  6. Template:Note label Liu, James K.; Couldwell, William T (2005). "Intra-arterial papaverine infusions for the treatment of cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage". Neurocritical Care. 2 (2): 124–32. PMID 16159054. Fulltext options List of Library Holdings
  7. Template:Note label Takeuchi K, Sakamoto S, Nagayoshi Y, Nishizawa H, Matsubara J (2004). "Reactivity of the human internal thoracic artery to vasodilators in coronary artery bypass grafting". European Journal of Cardio-Thoracic Surgery. 26 (5): 956–9. PMID 15519189. Fulltext options List of Library Holdings
  8. Template:Note label "SID 149219 -- PubChem Substance Summary". Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) National Center for Biotechnology Information.
  9. Template:Note label Clyde BL, Firlik AD, Kaufmann AM, Spearman MP, Yonas H (1996). "Paradoxical aggravation of vasospasm with papaverine infusion following aneurysmal subarachnoid hemorrhage. Case report". Journal of Neurosurgery. 84 (4): 690–5. PMID 8613866
  10. Template:Note label "Molécule de base : PAPAVERINE". Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) Biam.
  11. Template:Note label Unknown (1999). "PAPAVERINE TEPROSILATE". Molécule(s) de base : PAPAVERINE. Biam. Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) (French)
  12. Template:Note label Unknown (1998). "PAPAVERINE CODECARBOXYLATE". Molécule(s) de base : PAPAVERINE. Biam. Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) (French)
  13. Template:Note label Unknown (1998). "PAPAVERINE ADENYLATE". Molécule(s) de base : PAPAVERINE. Biam. Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) (French)
  14. Template:Note label "SID 660773 PubChem Substance Summary". Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) National Center for Biotechnology Information.
  15. Template:Note label "SID 660767 -- PubChem Substance Summary". Retrieved 25 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) National Center for Biotechnology Information.
  16. Template:Note label "THERAPAV (PRODUIT PUR) - Détail". Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) CSST - Service du répertoire toxicologique. (French)
  17. Template:Note label "SID 660767 -- PubChem Substance Summary - Depositor-Supplied Synonyms: All". Retrieved 26 September. Unknown parameter |accessyear= ignored (|access-date= suggested) (help); Check date values in: |accessdate= (help) National Center for Biotechnology Information.

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