Included in the formulation
АТХ:G.04.B.E.52 Papaverine in combination with other drugs
Pharmacodynamics:Combined drug.
Platyphylline
M-holinoblokator. It has a direct myotropic antispasmodic effect on the blood vessels and smooth muscles of the internal organs. Mydriasis and causes paralysis of accommodation, increases intraocular pressure reduces salivary secretory activity, sweat, bronchial glands.
Papaverine
Inhibits phosphodiesterase, resulting in cAMP accumulation and reducing the concentration of calcium ions within the cells, thereby reducing the smooth muscle tone of the vascular walls and internal organs: respiratory, gastrointestinal, genital, urinary system.
Pharmacokinetics:Platyphylline
When administered orally, it lasts for 4-6 hours. Connection with blood plasma proteins - up to 18%. Penetrates through the blood-brain barrier.
The elimination half-life is 2 hours. Metabolism in the liver. Elimination by the kidneys, about 60% unchanged.
Papaverine
After oral ingestion, up to 54% is absorbed in the gastrointestinal tract. The connection with plasma proteins is 90%. Penetrates through the histohematological barriers.
Metabolism in the liver.
The half-life is 0.5-2 hours. Elimination by the kidneys in the form of metabolites. Removed during hemodialysis.
Indications:It is used for the prophylaxis and treatment of functional disorders and pains associated with spasms of smooth musculature of vessels, abdominal cavity organs, bronchi, kidneys, stomach ulcer and duodenal ulcer.
XI.K20-K31.K26 Duodenal ulcer
XI.K20-K31.K25 Stomach ulcer
XI.K55-K63.K58 Irritable Bowel Syndrome
XI.K80-K87.K80 Gallstone disease [cholelithiasis]
XI.K80-K87.K80.2 Stones of the gallbladder without cholecystitis
XI.K80-K87.K80.5 Stones of the bile duct without cholangitis or cholecystitis
XI.K80-K87.K80.8 Other forms of cholelithiasis
XIV.N20-N23.N23 Renal colic, unspecified
XVIII.R10-R19.R10.4 Other and unspecified abdominal pain
XVIII.R25-R29.R25.2 Cramp and spasm
Contraindications:Atrioventricular blockade, severe hepatic insufficiency, glaucoma, age under 1 year, elderly age, individual intolerance.
Carefully:Chronic hepatic insufficiency, conditions after head trauma, hypothyroidism, adrenal insufficiency, supraventricular tachycardia, shock state. Age over 40 years is the danger of undiagnosed glaucoma.
Cardiovascular diseases with a tendency to atrial fibrillation (ischemic heart disease, arterial hypertension, stenosis of the mitral valve).
Reflux esophagitis, achalasia of the esophagus, intestinal atony.
Children's cerebral palsy, Down's disease.
Pregnancy and lactation:Recommendations for the FDA - Category C. It is used in cases where the risk of application is lower than the expected complications. Penetrates into breast milk, with prolonged use suppresses lactation.
Dosing and Administration:Inside, 1 tablet 2-3 times a day.
The highest daily dose: 3 tablets.
The highest single dose: 1 tablet (2 mg of papaverine hydrochloride and 5 μg of platifillin hydrotartrate).
Side effects:Central and peripheral nervous system: dizziness, drowsiness, hyperthermia in elderly patients, hallucinations, impaired tactile perception.
Hemopoietic system: eosinophilia.
The cardiovascular system: arterial hypotension, tachycardia.
Gastrointestinal system: dry mouth, constipation.
Sense organs: mydriasis, photophobia.
urinary system: retention of urine.
Dermatological reactions: Hyperhidrosis.
Allergic reactions.
Overdose:Visual impairment, unsteadiness of gait, difficulty breathing, drowsiness, hallucinations, hyperthermia, muscle weakness.
Treatment: administration of physostigmine (intravenously from 0.5 to 2 mg at a speed of up to 1 mg / min, not more than 5 mg per day) or neostigmine methyl sulfate (intramuscularly 1 mg every 2-3 hours, intravenously up to 2 mg).
Interaction:Platyphylline
Reduce absorption of platyphylline in the gastrointestinal tract antacids containing aluminum or calcium carbonate. It is recommended to maintain an interval of at least 1 hour.
With simultaneous use with phenylephrine, the development of hypertension is possible.
Procainamide potentiates the action of platyphylline.
Platifillin lowers the concentration of levodopa in the blood plasma.
Papaverine
With simultaneous use with levodopa, the antiparkinsonian effect decreases.
Simultaneous use with barbiturates increases the spasmolytic effect.
Tricyclic antidepressants, reserpine, quinidine sulfate increase the hypotensive effect.
Special instructions:Monitoring of liver function, intraocular pressure.
During treatment should refrain from drinking alcohol, driving a car and working with moving mechanisms.