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 GI (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 ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1 hr	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Galactose intolerance/Lapp lactase deficiency/glucose-galactose malabsorption;
Lactation: Lactation.

Use Cautiously in:

Pre-existing esophageal lesions/hiatal hernia;
OB: Safety and effectiveness not established in pregnancy;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

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

Derm: rash

Neuro: drowsiness, headache, vertigo

Interactions ⬆ ⬇

Drug-drug:

Anticholinergic medications may ↑ spasmolytic effects.

Route/Dosage ⬆ ⬇

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

Availability ⬆ ⬇

Tablets (contain lactose): 50 mg; 100 mg

Assessment ⬆ ⬇

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

Implementation ⬆ ⬇

PO: Administer tablet with 8 ounces of water and food. DNC: Swallow tablet whole; do not crush, chew, or suck. If >3 tablets/day prescribed, take additional tablets with 8 ounces 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 ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Advise patient to take as directed. Take missed doses as soon as remembered unless almost time for next dose; do not double doses.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Advise patient to notify health care provider 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 women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇