Instructions for use of the drug Papaverine for pregnant women - composition, indications, release form and price

Is it possible during pregnancy?

Medicines taken by the expectant mother can negatively affect the fetus and the course of pregnancy. Some names can even cause birth defects. Therefore, they should be used carefully, only after consultation with a doctor, especially in the early stages, when the baby’s organs are forming.

The instructions indicate that the benefits and safety of papaverine during pregnancy in the early stages and 2nd and 3rd trimesters have not been proven. But the experience of many doctors and women suggests that with the right approach, the medicine is effective and does not lead to complications. It is necessary to follow the recommendations of the attending physician, take into account the general condition of the body and concomitant pathology, so that the therapy does not harm the woman and her baby.

Obstetrician-gynecologists prescribe therapy both in the early stages to prevent interruption, and in the later stages to reduce tone. The drug can be combined with other drugs to enhance the effect. Due to its antispasmodic effect, it is indicated for abdominal pain associated with disruption of the gastrointestinal tract, urinary system, and respiratory tract.

Basic admission rules

Medicines should not be taken at your own discretion, especially during pregnancy. In order not to harm either herself or the child, a woman must strictly follow the rules for taking the drug:

• "Papaverine" tablets can be prescribed in the last stages of pregnancy. They take the drug to relieve tone and the threat of premature birth. The appointment period is determined by the doctor.
• In the early stages of pregnancy, Papaverine suppositories are taken 2-3 pieces per day.
• At the end of the last trimester, the medicine is given by injection to relax the walls of the uterus.

To relieve spasms of the smooth muscle organ, the female body produces the hormone progesterone; if its content is reduced, then the uterus of the expectant mother is in tension.

Why is papaverine prescribed during pregnancy?

Indicated for uterine hypertonicity in the early stages. In the 2nd and 3rd trimesters, it also relieves tone. In addition, it softens the cervix, due to which dilation in the 1st stage of labor occurs without rupture. And when labor begins, the drug relieves pain that occurs during contractions.

There are other indications:

• abdominal pain due to pathology of the gastrointestinal tract - with functional intestinal disorder with diarrhea or constipation, bloating, loose stools, cholecystitis, intestinal infections;
• headaches - due to spasm of cerebral vessels;
• bronchospasm, which manifests itself as cough, shortness of breath;
• elevated temperature with vasospasm and pale skin color - this condition is called “white” fever;
• spasm of the urinary tract due to inflammation.

Papaverine during early pregnancy is a temporary measure. The drug does not eliminate the cause of the threat of interruption and does not treat other diseases. It only relieves symptoms and alleviates the patient’s condition. A thorough examination should be carried out and the provoking factor should be identified: hormonal imbalance, stress, concomitant pathology, inflammation, infection, and eliminate them. For example, toxicosis, Rh conflict, stress, overly active sexual intercourse, physical activity, diseases of the cardiovascular and nervous systems can lead to the threat of interruption.

Pregnant woman at 37 weeks

As the due date approaches, pregnant women begin to notice the appearance of their precursors, that is, certain signs and changes that occur under the influence of hormones. A woman’s body is preparing to give birth to a child, progesterone gives way to the dominant role of the birth hormone estrogen, and the pregnant woman’s well-being changes.

From the 37th week, expectant mothers may observe the following changes:

• slight loss of body weight;
• reduction in abdominal volume;
• the appearance of training or “false” contractions and an increase in their intensity;
• discharge of mucus from the cervix.

The nature of the stool changes, it becomes weaker, aching pain in the lower back of varying intensity may appear, and the fundus of the uterus descends. The woman notes some signs on her own, others are observed by the gynecologist during a routine examination.

Precursors do not appear in all women. Some expectant mothers notice only some of the symptoms listed above, while others observe signs of impending labor not two or three weeks before the due date, but just a few hours. Both the appearance of precursors at the 37th week and their absence are normal and depend on the individual characteristics of the woman’s body.

This week, the female body is intensively preparing for the birth of a child. If the fetus is positioned correctly, head down, it gradually lowers, goes to the lower part of the uterus, presses it to the body and bends its limbs, intuitively taking the most comfortable position for passing the birth canal. The consequence of fetal movement is prolapse of the uterine fundus. The abdomen lowers, the pressure on the diaphragm decreases significantly, the pregnant woman can breathe easily, and the shortness of breath that plagued her in the previous weeks disappears. The pressure on the stomach also decreases, heartburn, a feeling of heaviness after eating and other unpleasant sensations disappear. Moving your baby can put pressure on your bowels and bladder. A pregnant woman at this stage often experiences the urge to urinate and may suffer from frequent loose stools. The reason for frequent bowel movements is not only the mechanical effect of the uterus on it, but also an increase in the content of estrogen in the body, hormones that promote the excretion of fluid. At the 37th week, the expectant mother can have bowel movements up to 3-4 times a day and at the same time observe significant dilution of the stool.

How it works

The active ingredient is papaverine hydrochloride. There are receptors for it in smooth muscle muscles. These are the stomach, intestines, blood and lymphatic vessels, bronchi, lungs, urethra, as well as the cervix and uterus.

By changing the activity of enzymes involved in the contraction of muscle fibers, it leads to relaxation of smooth muscles. The effect extends to all organs whose walls contain smooth muscle muscles - this fact must be taken into account when prescribing. The drug affects the central nervous system and myocardium only in large doses.

Thus, the effect of papaverine during pregnancy is associated with its antispasmodic effect, relaxation of the muscles of the uterus, and a decrease in its tone. In the absence of a threat, it is used when it is necessary to relieve pain caused by spasms due to pathologies of the gastrointestinal tract, respiratory tract, and urinary system. After the spasms are eliminated, the pain goes away and the function of the organ is restored.

If blood vessels spasm, blood pressure increases. Papaverine tablets or injections help lower blood pressure, restore normal blood circulation, and prevent vascular accidents - stroke and heart attack.

Composition of the drug

Papaverine is an opium alkaloid of poppy. It has antispasmodic properties that block the contraction of smooth muscle tissue of all types.

The drug received its name in the 19th century. A derivative of the word papever means “poppy”. The medicine owes its name to its composition. It was originally produced from opium, contained in significant doses in poppy seeds. With the correct approach and application, it does not have a negative effect on the functioning of the central nervous system.

The main advantage of the medicine is its antispasmodic functions with a wide area of ​​​​action.

Contraindications

In the following cases, papaverine is contraindicated during pregnancy:

• allergic reaction to the components of the product;
• liver dysfunction - hepatitis, liver failure and other diseases. In these cases, the elimination of the drug is impaired, it accumulates in the body and has a toxic effect;
• glaucoma - increased intraocular pressure. Treatment with an antispasmodic can cause an even greater increase in pressure: the pupil dilates, which obstructs the outflow of intraocular fluid from the chambers of the eye;
• heart dysfunction, such as atrioventricular block.

In any case, the use of papaverine tablets during pregnancy is possible only after consultation with a doctor. Especially if there is a concomitant pathology - dysfunction of the kidneys, digestive and endocrine organs, cardiovascular system (low blood pressure).

When to use suppositories

Why are Papaverine suppositories prescribed during pregnancy? This excellent remedy relaxes muscles and reduces blood pressure. When taking the suppository systematically, the following occurs:

1. Reduced blood pressure.
2. Improved blood circulation.
3. Relaxation of the muscles of the uterus.
4. The threat of miscarriage is stopped.

According to the instructions for use, during pregnancy, Papaverine suppositories do not harm the baby. On the contrary, they have a positive effect on him.

Many children have already grown up whose mothers took this medicine, but everything ended well. Taking the prescribed drug, the woman noticed that irritability decreased, her heartbeat returned to normal, and the aching pain in the abdomen and lower back disappeared. This has a beneficial effect on the physical and emotional health of mother and baby. This is another reason why Papaverine suppositories are prescribed during pregnancy.

This treatment is prescribed to pregnant women if there is a slight threat of miscarriage. Suppositories are used for home treatment and are used as a storage substance to maintain the normal condition of the uterus. The patient's condition improves literally in a matter of minutes.

Side effects

Like all medications, papaverine has side effects during early pregnancy.

These include:

• allergic reactions - rash, sneezing, lacrimation, urticaria, swelling, bronchospasm;
• decreased blood pressure - which is especially dangerous when the patient initially has hypotension;
• constipation, which is manifested by stool retention, pain, and a feeling of fullness in the abdomen;
• extrasystoles - usually occurs when the dosage is exceeded;
• headache;
• nausea;
• increased sweating.

If the symptoms listed above appear, you need to interrupt therapy and immediately seek medical help: even a harmless allergic rash in a matter of minutes can develop into bronchospasm or Quincke's edema, which requires emergency measures. Further tactics are determined by a specialist.

An overdose if the instructions and doctor's recommendations are not followed is possible. It manifests itself as weakness, dizziness, nausea, double vision, drowsiness and low blood pressure. Tactics in case of overdose include gastric lavage (if the drug was taken in tablet form), prescribing sorbents that “collect” the substance and remove it from the body, and infusion therapy.

The principle of action of the drug

In some cases, in the early stages of pregnancy, a woman feels tightness in her lower abdomen, pain occurs like during menstruation or pain in the lumbar region - this is hypertonicity. The muscles that lock the cervix actively work against each other and are in constant tension, which can negatively affect the course of pregnancy.

The hormone progesterone is responsible for protecting the child from early birth and miscarriage. Sometimes the amount of hormones in the blood decreases, and the body needs help at this stage.

The medicine is an antispasmodic, and the mechanism of action of “Papaverine” is aimed at relaxing muscles. By having a relaxing effect on the uterus, the drug relieves spasms. The woman recovers from the threatening state of hypertonicity, and the child is safe again.

Uterine hypertonicity can occur for several reasons:

• nausea;
• dilatation of the cervix prematurely;
• thyroid diseases;
• Rh conflicts;
• sexual intercourse;
• conflict situations;
• nervous tension.

In such cases, the main task is to relieve hypertonicity.

How to take papaverine during pregnancy

One of the important points that affects the effectiveness of the drug is the regimen and dosage. Let’s look at how much papaverine you can have during pregnancy.

Suppositories

Papaverine rectal suppositories begin to act quickly, so they can be used when it is necessary to immediately relieve uterine hypertonicity. They are used at home. Thanks to the rich venous network of the rectum, the active substance begins to be absorbed into the bloodstream almost immediately. In this case, dissolution is slow, the drug enters the body gradually. Thus the effect lasts for a long time.

Papaverine suppositories are safe, overdose is excluded, but you should consult your doctor before use. The specialist will select the dosage based on the specific situation. Usually 2 or 3 suppositories are prescribed per day.

How to use papaverine suppositories during pregnancy? It is used rectally: after cleansing the intestines, suppositories are inserted into the rectum in a lying position. If difficulties arise, Vaseline can be used to facilitate insertion. After the manipulation you need to lie down for a few minutes.

Suppositories are not intended for vaginal administration. The active substance from the rectum enters the blood, from there it is distributed to all organs, including the myometrium of the uterus.

Suppositories should be stored in a dark place where children cannot reach, at a temperature not exceeding 25 degrees in a closed package.

Injections

Papaverine injections begin to act immediately after administration. For this reason, treatment is indicated when the situation does not allow delay. The solution can be administered subcutaneously, intramuscularly or intravenously.

When administering the drug intravenously, it is diluted with saline and administered slowly. A drip with papaverine is placed in a hospital: usually, if intravenous infusion of drugs is required, the condition of the woman and fetus causes concern among doctors. Obviously, in this case the pregnant woman is left under the supervision of doctors and monitored around the clock.

Subcutaneous or intramuscular injections can be done at home if there is a person nearby with medical education or someone who owns the equipment. After the injections, the woman should be monitored to watch for side effects and an allergic reaction.

Pills

Papaverine tablets during pregnancy are prescribed when the condition of the expectant mother and her baby is stable, there is no threat to their life and there is no threat of abortion. When administered orally, the drug begins to act only after a while, so when there is a risk of miscarriage, other forms of the drug are prescribed: injections or suppositories, which act quickly.

The goal of treatment is usually to eliminate intestinal spasms and headaches.

The tablets should be taken orally with water. They should not be divided, chewed, or crushed. Eating does not affect the rate of absorption. But if a woman has gastrointestinal spasms, it is recommended to take the tablets half an hour before meals so that they begin to act by the time the patient sits down at the table. Then she will be able to eat in peace, without suffering from cramps and pain.

And in this case, the drug can be used only after consultation with a doctor. For example, if the cause of spasms is an intestinal infection, it is necessary to undergo tests to identify the pathogen. The treatment regimen must contain antibiotics or bacteriophages that act specifically on this bacterium. In this case, the antispasmodic is used as symptomatic therapy.

Instructions for use

The active ingredient of the drug is papaverine hydrochloride, which is an opium alkaloid that acts on smooth muscle elements. It causes relaxation, therefore, according to the pharmacological classification, it belongs to myotropic antispasmodics. The component inhibits some enzymes, lowers the level of calcium ions, and reduces vascular and muscle tone.

In large doses, it eliminates cardiac excitability, slows intracardiac conduction, and has a hypotensive and sedative effect. In combination with barbiturates, it enhances the antispasmodic effect. When taken simultaneously with tricyclic antidepressants, procainamide, reserpine, quinidine, the drug enhances the hypotensive effect.

Suppositories with papaverine during pregnancy

To prevent the product from causing harm, the pregnant woman should follow the instructions for its use. Rectal suppositories should be inserted into the anus after bowel movements. It is better to do this lying on your side. The course of treatment begins with a concentration of the active substance in the suppository in the amount of 0.02 g, gradually increasing to 0.04 g. It is allowed to use no more than three suppositories per day.

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Injection

The active component of the pharmaceutical product is characterized by high bioavailability, which allows subcutaneous, intramuscular or intravenous injections. Subcutaneous injections are given in the shoulder or outer thigh, but not in the forearm, because the risk of hematoma increases. Intramuscular injections are administered into the upper lateral quadrant of the buttock. Before the injection, the contents of the ampoule are dissolved with 10-20 ml of physiological solution and injected very slowly. A single dosage is 0.1 g, the daily dosage does not exceed 0.3.

Alternatives

Let's consider other medications that can replace papaverine during pregnancy and have a similar effect.

No-shpa

No-spa (drotaverine) is also an antispasmodic agent. It is prescribed when you need to relax smooth muscles for pain in the stomach, intestines, headaches, and menstrual pain. It eliminates spasms, improves the condition and normalizes the functioning of organs.

It is also used for uterine hypertonicity in the early stages: it is safe during this period, begins to act faster than other antispasmodics, does not affect the development of the fetus, the condition of the placenta, and has fewer side effects. Available in the form of tablets and solution for injection.

A contraindication to the use of drotaverine is hypersensitivity. It is not prescribed when a pregnant woman has problems with the kidneys, liver, heart, or the function of these organs is impaired.

Analogues of no-shpa are spasmol and spasmonet, which have the same indications and contraindications.

Viburkol

This is a homeopathic remedy that contains extracts of chamomile, belladonna, plantain, meadow lumbago, dulcamara salina, as well as carbonated lime obtained from oyster shells, and hard fat. It has antispasmodic, analgesic and anti-inflammatory effects.

Available in the form of rectal suppositories. Prescribed for hypertonicity of the uterus in the early stages, abdominal pain associated with disruption of the intestines and stomach, inflammation of the urinary organs. The drug is effective for infectious and inflammatory diseases of the respiratory and ENT organs, increased nervous excitability, and stress.

Contraindicated if you are allergic to suppository components.

Second trimester

This period is good because the list of approved drugs becomes much wider. In case of uterine hypertonicity and the threat of miscarriage, doctors resort to prescribing more serious remedies. Thanks to them, the contractile activity of the organ is inhibited. For example:

• "Ginipral";
• “Bricanil;
• magnesium injections.

In the 2nd trimester of pregnancy, Papaverine is most often prescribed to relieve pain:

• for renal colic;
• ailments of the gastrointestinal tract;
• urinary system;
• to lower blood pressure.

During this period, not only this drug is used, but also other medications depending on the clinical situation.

pharmachologic effect

Papaverine hydrochloride is a myotropic antispasmodic agent. Reduces the tone and reduces the contractile activity of smooth muscles and therefore has a vasodilator and antispasmodic effect. Causes dilation of arteries, increases blood flow, incl. cerebral. When used in average therapeutic doses, papaverine hydrochloride has virtually no effect on the central nervous system. In large doses, it reduces the excitability of the heart muscle and slows down intracardiac conduction. It is an inhibitor of the phosphodiesterase enzyme and causes intracellular accumulation of cyclic 3,5-adenosine monophosphate, which leads to impaired contractility of smooth muscles and their relaxation during spastic conditions.

Pain relief without drugs

So, if a woman is in good health and there are no complications during labor, then you can try to avoid painful sensations using various physiological methods: massage, water procedures, gymnastics and special breathing. All processes in the body are interconnected: if a woman is afraid, then a muscle spasm occurs, causing oxygen deficiency in the blood vessels and acute pain. Tension of the facial muscles causes a response spasm of the uterine uterus and delayed dilation of the cervix. Based on these data, when contractions occur, you need to relax and calm down, feeling that the pain is going away every minute.

Of course, it is not easy to immediately master such a technique, so during pregnancy it is necessary to attend special courses for expectant mothers, which teach the correct breathing tactics at different stages of childbirth, show basic relaxation techniques and exercises to relieve pain. Such courses can and should be attended with a partner, since many exercises are based on teamwork.

For physical exercise, you don’t need any special devices, you just need to listen to yourself and change positions more often, since physical activity makes labor easier and reduces pain. If the doctor has not prescribed bed rest, you need to walk more, preferably lying only on your side. Sitting is undesirable, as this creates pressure on the perineum.

Many women benefit from water procedures, but they can only be carried out if the water has not broken, since the risk of infection is very high. A warm bath with hydromassage is a great way to relieve tension and help you relax, but either a partner or someone from the medical staff must be present during the procedure. You can also use a shower cabin, directing streams of water to your back and lower abdomen. The water should be at a temperature of about thirty-six degrees so as not to cause bleeding. Aromatherapy, self-hypnosis and other techniques, including massage, are also quite effective in relieving severe pain. If desired, you can resort to a variety of techniques to minimize pain, but before using them, you should definitely talk with the doctor leading the birth.

Third trimester

It is rational to use Papaverine suppositories in the later stages of pregnancy:

• If there is significant tension in the uterine muscles, and there is still a lot of time before the baby is born. In this case, the doctor additionally prescribes steroid hormones.
• Before childbirth, suppositories are used to understand whether these are “false” contractions or not. If, after using the medicine, the activity of uterine contraction has ended, then the time for childbirth has not yet come.
• Closer to the preliminary date of birth, the drug is administered in order to prepare for the successful opening of the cervical canal.
• At the beginning of labor, the drug helps reduce the intensity of pain during contractions.

Only the attending physician, after a thorough examination and accurate diagnosis, prescribes Papaverine during pregnancy. How many days to drink it, the dosage and duration of the course of treatment is also determined by the doctor.

Epidural anesthesia

Advantages

Epidural anesthesia is absolutely safe for the child; its use completely anesthetizes and relieves sensitivity, which is why it is often used during a cesarean section. The patient remains conscious, but feels absolutely nothing, however, with the introduction of small doses of anesthetics, some women feel uterine contractions.

An epidural anesthesia procedure is performed under local anesthesia in the lumbar region, then the doctor uses a thin long needle to insert a catheter into the spine, more precisely into its epidural space, through which a dose of anesthetic is administered, if necessary. After the procedure, you need to lie down for fifteen minutes, during which time the medicine will begin to act. The catheter is not removed until labor is over; patients are usually not recommended to get out of bed and lie down, but there is also a mobile version of epidural anesthesia.

According to reviews of patients who have undergone childbirth with this type of anesthesia, pain is practically not felt, especially if an additional dose of medication is administered in a timely manner. However, there are strict contraindications for this procedure:

• Various neurological diseases;
• placental bleeding or any other origin;
• use of anticoagulants or bleeding disorders.

And finally, refusal of such a procedure is also a categorical contraindication.

Side effects

Typically, when a woman thinks about the side effects of this type of pain relief, she thinks about paraplegia, spinal nerve damage, or respiratory arrest. However, these complications are rather exceptions. The main danger is the long-term consequences: headaches, severe back pain that can last for months. Drug therapy for such pain usually does not produce results and it only goes away over time. While the medication is in effect, the patient may experience chills, trembling, decreased blood pressure, and difficulty breathing. You must tell your doctor about all the symptoms so that, if necessary, he can prescribe symptomatic treatment. Difficulty breathing occurs quite often during epidural anesthesia. This is a consequence of too large a dose of the administered drug and requires the use of an oxygen mask.

Take the first step

make an appointment with a doctor!

According to the latest data from medical studies, the use of epidural anesthesia in almost half of the cases led to various difficulties during childbirth. Since the woman in labor cannot control the birth process and does not understand when to push. In forty percent of cases, this led to protracted labor, forceps on the baby's head and traumatic brain injuries to the child. The high probability of ruptures of the perineum and vagina during such childbirth also does not add advantages to such anesthesia.

Approximately forty-five percent of women who undergo it experience this reaction to epidural anesthesia. This is quite a lot and before agreeing to such a procedure, you need to carefully weigh and think it over.

Experts' opinion

For many years, gynecologists have trusted this drug with the health of expectant mothers. Doctors leave excellent reviews about Papaverine during pregnancy. For uterine tone, professionals consider it the most convenient to use and universal remedy.

But self-medication and dose adjustments should not be allowed without first consulting a doctor. Even a slight excess of the dosage will lead to problems, including necessary hospitalization.

The convenience of using the drug is that it can be prescribed at any stage of pregnancy. The product in any form will not have any negative effect on the child. One should take into account the fact that if the dosage is observed, the likelihood of side effects from the woman’s body decreases.

It is important not to forget that during such a crucial period you should not rely on chance and your own understanding, but completely follow the recommendations of a specialist.