Papaverine

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Papaverine
Clinical data
Pronunciation/pəˈpævəriːn/
Trade namesPavabid, others
AHFS/Drugs.comMonograph
MedlinePlusa682707
Pregnancy
category
  • AU: A
intracavernosal
ATC code
Legal status
Legal status
Renal
Identifiers
  • 1-[(3,4-dimethoxyphenyl)methyl]-6,7-dimethoxyisoquinoline
JSmol)
  • COc1ccc(cc1OC)Cc2c3cc(c(cc3ccn2)OC)OC
  • InChI=1S/C20H21NO4/c1-22-17-6-5-13(10-18(17)23-2)9-16-15-12-20(25-4)19(24-3)11-14(15)7-8-21-16/h5-8,10-12H,9H2,1-4H3 checkY
  • Key:XQYZDYMELSJDRZ-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Papaverine (

acute mesenteric ischemia. While it is found in the opium poppy, papaverine differs in both structure and pharmacological action from the analgesic morphine and its derivatives (such as codeine
).

In addition to opium, papaverine is purported to be present in high concentrations in

star gooseberry.[1]

History

Capsule of Papaver somniferum showing latex (opium) exuding from incision. Papaverine occurs naturally in opium.

Papaverine was discovered in 1848 by Georg Merck (1825–1873).

Merck corporation, a major German chemical and pharmaceutical company.[3]

Uses

Papaverine is approved to treat spasms of the gastrointestinal tract,

balloon angioplasty)[4] and coronary artery bypass surgery.[5] Papaverine may also be used as a smooth muscle relaxant in microsurgery
where it is applied directly to blood vessels.

Papaverine is used as an erectile dysfunction drug, alone or sometimes in combination.[6][7] Papaverine, when injected in penile tissue, causes direct smooth muscle relaxation and consequent filling of the corpus cavernosum with blood resulting in erection. A topical gel is also available for ED treatment.[8]

It is also commonly used in

nitroprusside.[11][12]

Papaverine is also being investigated as a topical growth factor in tissue expansion with some success.[13]

Papaverine is used as an

angiotensin II receptor antagonists
, etc. fail in the prophylaxis of migraines, have intolerable side effects or are contraindicated.

Papaverine is also present in combinations of opium alkaloid salts such as

Omnopon, Pantopon) and others, along with morphine, codeine, and in some cases noscapine
and others in a percentage similar to that in opium, or modified for a given application.

Papaverine is found as a contaminant in some

diacetylmorphine.[19]

Mechanism

The in vivo mechanism of action is not entirely clear, but an inhibition of the

mitochondrial respiration
.

Papaverine has also been demonstrated to be a selective phosphodiesterase inhibitor for the PDE10A subtype found mainly in the striatum of the brain. When administered chronically to mice, it produced motor and cognitive deficits and increased anxiety, but conversely may produce an antipsychotic effect,[20][21] although not all studies support this view.[22]

Side effects

Frequent side effects of papaverine treatment include polymorphic

vertigo
.

Rare side effects include flushing of the face,

thrombopenia, mixed hepatitis, headache, allergic reaction, chronic active hepatitis, and paradoxical aggravation of cerebral vasospasm.[23]

Papaverine in the plant

Sauropus androgynus is linked to bronchiolitis obliterans.[24]

Formulations and trade names

Papaverine is available in its salt form as the

nicotinate, and phenylglycolate
. The hydrochloride salt is available for intramuscular, intravenous, rectal and oral administration. The teprosylate is available in intravenous, intramuscular, and orally administered formulations. The codecarboxylate is available in oral form, only, as is the adenylate.

The codecarboxylate is sold under the name Albatran,[citation needed] the adenylate as Dicertan,[citation needed] 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), Papaverine (Israel), Papaverin-Hamelin (Germany), Paveron (Germany), Spasmo-Nit (Germany), Cardiospan, Papaversan, Cepaverin, Cerespan, Drapavel, Forpaven, Papalease, Pavatest, Paverolan, Therapav (Canada[25]), 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.[citation needed] In Hungary, papaverine and homatropine methylbromide are used in mild drugs that help "flush" the bile.[26]

References

  1. S2CID 38378580
    .
  2. doi:10.1002/jlac.18480660121
    .
  3. ISBN 978-0-521-52473-5
    .
  4. S2CID 35400205
    .
  5. PMID 15519189
    .
  6. PMID 16158020
    .
  7. S2CID 13056029
    .
  8. PMID 7815584
    .
  9. S2CID 10441842
    .
  10. PMID 8244915
    .
  11. PMID 8156802
    .
  12. S2CID 24777062
    .
  13. PMID 15457029
    .
  14. S2CID 28817628
    .
  15. S2CID 36626189
    .
  16. PMID 4134173
    .
  17. PMID 16803666
    . In addition to morphine, street heroin contains various alkaloids extracted from the opium poppy, Papaversomniferum, including codeine, thebaine, noscapine, and papaverine
  18. PMID 23316026
    .
  19. S2CID 205958031
    .
  20. S2CID 13447370
    .
  21. S2CID 9621541
    .
  22. PMID 19066855
    .
  23. S2CID 1172874
    .
  24. PMID 26413127
    .
  25. ^ "THERAPAV (PRODUIT PUR) - Détail". Retrieved 26 September 2005. CSST - Service du répertoire toxicologique. (French)
  26. ^ "Országos Gyógyszerészeti és Élelmezés-egészségügyi Intézet". www.ogyi.hu. Archived from the original on 2015-01-23. Retrieved 2008-10-14.
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