Candles with papaverine during pregnancy25.05.2022
Papaverine is a drug to eliminate spasms of internal organs and blood vessels. Such drugs are called antispasmodics . During pregnancy, a doctor may prescribe papaverine suppositories to relieve pain caused by spasms of the intestines or gallbladder. Also, the drug can be prescribed in the early stages of pregnancy with the so-called uterine hypertonicity.
Candles with papaverine are well tolerated by pregnant women. However, the necessity and safety of their use are questionable.
Under what conditions are suppositories with papaverine prescribed during pregnancy
Papaverine relaxes the smooth muscles of the walls of internal organs and blood vessels, so the doctor can prescribe candles with it for:
- cholecystitis (inflammation of the gallbladder) ;
- spastic colitis;
Spastic colitis occurs against the background of a violation of the motor function of the intestine. Violation of intestinal motility leads to involuntary painful contractions – spasms that occur in different departments.
- renal colic ;
Renal colic is an emergency pathological condition that occurs when there is a violation of the outflow of urine formed in the kidney through the ureters into the bladder.
Also, suppositories with papaverine are used as part of combination therapy for diseases of the heart and blood vessels, as well as a reserve drug for the relief of migraines .
Migraine is a disease characterized by recurring headaches of moderate to severe severity. Typically, episodes affect one side of the head, are pulsatile, and last from a few hours to three days. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell.
The appointment of Papaverine for diseases associated with pregnancy is limited to hypertonicity of the uterus / uterine wall (strictly speaking, such a diagnosis does not exist!).
The term “Hypertonic uterus” or “Hyperstimulation of the uterus” means a specific complication during artificial induction of labor.
Foreign obstetricians and gynecologists argue that pulling sensations in the uterus and periodic contraction of its walls, which can be felt by placing a palm on the pubis of a pregnant woman (pregnant women themselves characterize this as “stone” or “stone” of the uterus) is a normal physiological reaction in the first half pregnancy.
In Western Europe and the USA, Papaverine is approved for use and is known as a vasodilator , that is, a drug for the treatment of vasospasm .
Benefits for mother and fetus
Modern medicine does not consider papaverine suppositories to be a good remedy for spasms (regardless of the reason for use). Although the rectal (placing a suppository in the rectum) route of administration improves the bioavailability and effectiveness of Papaverine, initially it is a weak antispasmodic.
Papaverine is a substance of plant origin, but this does not mean its naturalness or safety. Firstly, it was isolated from the opium poppy and is a derivative of opium, and secondly, it has long been synthesized chemically.
Since the middle of the last century, Papaverine has been almost completely replaced by such effective drugs for relieving spasms of internal organs, such as:
- Drotaverine (used mainly in the countries of Central and Eastern Europe and Asia, best known under the commercial name No-shpa);
- Hyoscine (used in Western Europe and Canada, best known under the commercial name Buscopan);
- Dicyclomine (prescribed in the US, best known under the commercial name Bentyl).
Are papaverine suppositories safe during pregnancy?
There are very few modern and high-quality studies on the safety of Papaverine for a pregnant woman and fetus.
The manufacturer’s instructions say that for the use of suppositories with papaverine during pregnancy, efficacy and safety have not been established. This does not mean that Papaverine should not be taken by pregnant women. However, due to the lack of experimental studies, there is no guarantee that it is safe.
Early studies of fetal toxicity (negative effect on the development of the fetus) of papaverine in chick embryos showed that the use of high doses of the drug led to the development of serious defects in the nervous tissue.
In 2020, Israeli scientists published the results of a retrospective study of 498 pregnant women who were prescribed Papaverine in short courses.
When conducting retrospective research drug trials are not conducted. Information about the people who took it is collected and analyzed.
These studies showed that Papaverine did not increase the amount of :
- premature birth;
- caesarean sections;
- lower body weight of newborns;
- infant mortality.
In addition, the frequency of malformations in the case of exposure to Papaverine in the first trimester of pregnancy was the same as in the group of pregnant women who did not take this drug.
How to use papaverine suppositories
If papaverine suppositories are prescribed by a doctor, they are usually administered 2-3 times a day, preferably after defecation (stool).
Contraindications and side effects
The use of suppositories with papaverine during pregnancy is contraindicated in:
- heart rhythm disturbances;
- liver diseases;
- known hypersensitivity to the components of the drug.
When using the drug in the usual dosage, side effects such as:
- lowering blood pressure;
- increased sweating.
Sometimes allergic reactions may develop or signs of damage to liver cells may appear.
Manufacturers of candles with papaverine in Russia
Rectal suppositories with papaverine are produced by the following Russian pharmaceutical enterprises:
- Papaverine. Register of medicines of Russia, website .
- Palmer AC. Behavior of the Uterus in Early Pregnancy. \ Proc R Soc Med. 1950;43(2):99-103, NCBI .
- Papaverine website .
- Gueta I., Braun A., Gilan A., et al. Pregnancy outcomes following gestational exposure to papaverine: An observational comparative study. \ Br J Clin Pharmacol. 2021;87(10):3910-3915, PubMed .