Is Papaverine compatible with breastfeeding? Do we have alternatives for Papaverine?

Papaverine

July 31, 2018 (Low Risk)

An alkaloid derived from the opium of the Papaver somniferum plant or prepared synthetically. Not structurally related to the rest of opium alkaloids such as morphine or codeine.
It has a relaxant effect on the vascular system, bronchial musculature and the gastrointestinal, biliary and urinary tracts (American Regent 2017).
Indicated in coronary, pulmonary, peripheral or cerebral vascular spasms and gastrointestinal, ureteral or biliary colic. Oral, intramuscular or intravenous administration every 3 to 12 hours.

Since the last update we have not found published data on its excretion in breastmilk.

Its pharmacokinetic data (large volume of distribution, high percentage of protein binding, short half-life, pKa acid) make transfer to milk in significant quantities unlikely.

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Papaverine Hydrochloride

Writings

  • Παπαβερίνη (Greek)
  • Папаверин (Cyrillic)
  • パパベリン (Japanese)
  • C20 H21 NO4 (Molecular formula)
  • 6,7-Dimethoxy-1-(3,4-dimethoxybenzyl)isoquinoline (Chemical name)
  • A03AD01; G04BE02 (ATC Code/s)

References

  1. American Regent. Papaverine. Drug Summary. 2017 Full text (in our servers)
  2. AcoFarma. Papaverina. Ficha técnica. 2010 Full text (in our servers)
  3. Berg G, Jönsson KA, Hammar M, Norlander B. Variable bioavailability of papaverine. Pharmacol Toxicol. 1988Abstract
  4. Wilén G, Ylitalo P. Metabolism of [14C] papaverine in man. J Pharm Pharmacol. 1982Abstract Full text (link to original source)
  5. Garrett ER, Roseboom H, Green JR Jr, Schuermann W. Pharmacokinetics of papaverine hydrochloride and the biopharmaceutics of its oral dosage forms. Int J Clin Pharmacol Biopharm. 1978Abstract
  6. Ritschel WA, Hammer GV. Pharmacokinetics of papaverine in man. Int J Clin Pharmacol Biopharm. 1977Abstract