Included in the formulation
АТХ:A.03.A.D Papaverine and its derivatives
A.03.A.D.01 Papaverine
Pharmacodynamics:Inhibits phosphodiesterase, resulting in the accumulation of cAMP and a decrease in the concentration of calcium ions inside cells, resulting in a decrease in the tone of the smooth muscles of the vascular walls and internal organs: the respiratory, gastrointestinal, genital, urinary system.
Pharmacokinetics: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.
IX.I70-I79.I73.0 Raynaud's syndrome
IX.I70-I79.I73.1 Obliterating thromboangitis [Berger's disease]
IX.I70-I79.I73.9 Peripheral vascular disease, unspecified
IX.I70-I79.I79.2 * Peripheral angiopathy in diseases classified elsewhere
X.J40-J47.J44 Other chronic obstructive pulmonary disease
XI.K80-K87.K80 Gallstone disease [cholelithiasis]
XIV.N20-N23.N23 Renal colic, unspecified
XVIII.R10-R19.R10.4 Other and unspecified abdominal pain
XXI.Z40-Z54.Z51.4 Preparatory procedures for subsequent treatment, not elsewhere classified
Contraindications:Atrioventricular blockade, severe hepatic insufficiency, glaucoma, 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 (IHD, 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:Pregnancy and lactation: recommendations for FDA - Category C. 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:Children
Inside - 6 months-2 years: 2.5-5 mg;
3-4 years: 5-10 mg;
5-6 years: 10 mg each;
7-9 years: 15 mg each;
10-14 years: 15-20 mg 3-4 times / day.
Adults
Rectal (suppositories) on 0,02-0,04 g 2-3 times / day.
Subcutaneously: 1-2 ml of 2% solution 2-4 times / day.
Intravenously slow: 1 ml 2% solution (20 mg) in 10-20 ml isotonic sodium chloride solution.
The highest daily dose: 160 mg with parenteral administration, 0.12 g - rectally.
The highest single dose: 40 mg with parenteral administration, 0.04 g - rectally.
Side effects:Central and peripheral nervous system: dizziness, drowsiness, hyperthermia in elderly patients, hallucinations, impaired tactile perception.
The system of hematopoiesis: 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:Symtomas: impaired vision, unsteady gait, difficulty breathing, drowsiness, hallucinations, hyperthermia, muscle weakness.
Treatment: injection of physostigmine intravenously from 0.5 to 2 mg at a speed of up to 1 mg / min, not more than 5 mg / day or neostigmine methylsulfate intramuscularly 1 mg every 2-3 hours, intravenously - up to 2 mg.
Interaction:With simultaneous application with levodopa reduces antiparkinsonian effect.
Simultaneous use with barbiturates increases the spasmolytic effect.
Tricyclic antidepressants - reserpine, quinidine sulfate, enhance 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.