pinaverium

Therapeutic Classification: anti irritable bowel syndrome agents

Pharmacologic Classification: calcium channel blockers

Indications ⬆ ⬇

REMS

Management of symptoms of irritable bowel syndrome, (IBS) including abdominal pain, bowel disturbances and discomfort.
Treatment of symptoms related to biliary tract disorders.

Action ⬆ ⬇

Acts as a calcium channel blocker with specific selectivity for intestinal smooth muscle.
Relaxes gastrointestinal (mainly colon) and biliary tracts, inhibits colonic motor response to food/pharmacologic stimulation.

Therapeutic effects:

Decreased symptoms of IBS.

Pharmacokinetics ⬆ ⬇

Absorption: Poorly absorbed (1–10%).

Distribution: Distributes selectively to digestive tract.

Protein Binding: 97%.

Metabolism/Excretion: Minimal enterohepatic cycling, eliminated almost entirely in feces. Some metabolism.

Half-Life: 1.5 hr.

Time/Action Profile ⬆ ⬇

(blood levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1 hr	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Known hypersensitivity;
Galactose intolerance/Lapp lactase deficiency/glucose-galactose malabsorption (tablets contain lactose);
Lactation: Avoid use if breastfeeding;
Pedi: Safety and effectiveness not established, use is not recommended.

Use Cautiously in:

Pre-existing esophageal lesions/hiatal hernia (glass of water and snack should be taken with each dose);
OB: Should be used only if essential to welfare of patient.

Adv. Reactions/Side Effects ⬆ ⬇

All less than 1%

CNS: drowsiness, headache, vertigo

GI: constipation, diarrhea, distention, dry mouth, epigastric pain/fullness, esophageal irritation, nausea

Derm: rash

Interactions ⬆ ⬇

Drug-drug:

Concurrent use of anticholinergics may ↑ spasmolytic effects.

Route/Dosage ⬆ ⬇

PO (Adults ): 50 mg 3 times daily; may be ↑ as needed/tolerated up to 100 mg 3 times daily.

Availability ⬆ ⬇

Tablets (contain lactose): 50 mg; 100 mg

Assessment ⬆ ⬇

Assess for symptoms of IBS (abdominal pain or discomfort, bloating, constipation).
Assess for lactose intolerance; product contains lactose.

Implementation ⬆ ⬇

PO: Administer tablet with a glass of water and food. Swallow tablet whole, do not crush, chew, or suck. If >3 tablets/day prescribed, take additional tablets with glass of water and a snack. May be irritating to esophagus. Do not take the tablet while lying down or just before bedtime.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take pinaverium as directed. Take missed doses as soon as remembered unless almost time for next dose; do not double doses.
Caution patient to inform health care professional if the following side effects persist or worsen: stomach pain or fullness, nausea, constipation or diarrhea, heartburn, headache, dry mouth, dizziness, skin rash.
Instruct patient to avoid alcohol intake while taking this medication.
Rep: Advise females of reproductive potential to inform health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes ⬆ ⬇

A decrease in symptoms of irritable bowel syndrome. The length of treatment depends on the condition being treated.

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Pronunciation ⬇

Classifications ⬆ ⬇