pinaverium
General
Canada-Approved Medicine
This monograph describes a medication approved for use in Canada by the Therapeutic Products Directorate, a division of Health Canada’s Health Products and Food Branch. The medication is not approved by the United States Food and Drug Administration; however, a similar formulation carrying a different generic or brand name might be available in the US.
Pronunciation:
pin-ah-veer-ee-um
Trade Name(s)
- Dicetel
Ther. Class.
anti irritable bowel syndrome agents
Pharm. Class.
Indications
- 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 Effect(s):
Decreased symptoms of IBS.
Pharmacokinetics
Absorption: Poorly absorbed (1–10%).
Distribution: Distributes selectively to digestive tract.
Protein Binding: 97%.
Metabolism and 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 |
Contraindication/Precautions
Contraindicated in:
- Known hypersensitivity;
- Galactose intolerance/Lapp lactase deficiency/glucose-galactose malabsorption (tablets contain lactose);
- Lactation: Avoid use if breast feeding;
- Pedi: Safety and effectiveness not established, use is not recommended.
Use Cautiously in:
- Pre-existing eosphageal 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.
Adverse 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
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
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.
Potential Diagnoses
- Acute pain
- Diarrhea
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.
- Advise female patient to inform health care professional if pregnancy is planned or suspected or if breast feeding.
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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