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All about: Papaverine HCl

Big Image Pronouncation: (pap-PAV-uhr-een HIGH-droe-KLOR-ide)
Class: Peripheral vasodilator

Trade Names:
Pavagen TD
- Capsules, timed-release 150 mg

Mechanism of 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.



Readily absorbed from GI tract. Oral bioavailability is approximately 54%. T max is 1 to 2 hr after a dose.


Drug localizes in fat depots and in the liver; remainder is distributed throughout the body. Protein binding is 90%.




Urine (inactive form). T 1/ 2 is 0.5 to 2 hr. T 1/ 2 varies widely; constant levels can be maintained by giving drug at 6-hr intervals.

Indications and Usage

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 Uses

Intracavernous injection for impotence.


Complete atrioventricular (AV) heart block; intracorporeal injection for impotence.

Dosage and Administration


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

IV / IM Initial dose is 30 mg. Repeat doses are 30 to 120 mg q 3 hr prn.


IV 2.5 to 60 mg as intracavernous injection (usually combined with phentolamine mesylate).

General Advice

Do not crush or allow patient to chew sustained-release capsules.


Store at room temperature.

Drug Interactions

CNS depressants

Effects may be additive.


May reduce effectiveness of levodopa.


Lactated Ringer's solution incompatible with parenteral formulation; do not mix.

Laboratory Test Interactions

None well documented.

Adverse Reactions


Increase in heart rate; slight increase in BP.


Depression; dizziness; vertigo; headache; drowsiness; sedation; lassitude; malaise; lethargy.


Flushing of face; sweating; pruritus.


Constipation; nausea; diarrhea; abdominal distress; dry mouth; anorexia.




Jaundice; hepatitis.


Increased depth of respiration.



Category C .




Safety and efficacy not established.


Use drug with caution.

Hepatic hypersensitivity

Hepatic hypersensitivity reported.



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 Information

  • 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 health care provider: 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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