Papaveretum

(BAN)
Synonyms: A mixture of 253 parts of morphine hydrochloride, 23 parts of papaverine hydrochloride, and 20 parts of codeine hydrochloride.
Cyrillic synonym: Папаверетум.

💊 Chemical information

CAS — 8002-76-4.
ATC — N02AA10.
ATC Vet — QN02AA10.

Pharmacopoeias.

In Br.

BP 2008

(Papaveretum). It contains 80.0 to 88.4% of anhydrous morphine hydrochloride, 8.3 to 9.2% of papaverine hydrochloride, and 6.6 to 7.4% of anhydrous codeine hydrochloride. A white or almost white crystalline powder. Soluble in water, sparingly soluble in alcohol. A 1.5% solution in water has a pH of 3.7 to 4.7. Protect from light.

💊 Profile

The opium alkaloids are the prototypical opioid analgesics. Mixtures of opium alkaloids such as papaveretum have the analgesic and sedative properties of morphine and are used in the treatment of moderate to severe pain including postoperative and severe chronic pain. They may also be used for pre-operative sedation and as an adjunct to anaesthesia. Papaveretum (BP 2008) 15.4 mg contains the equivalent of about 10 mg of the major component, anhydrous morphine.
In the UK, papaveretum formerly contained the hydrochlorides of morphine, codeine, noscapine, and papaverine. However, because of concern over the potential genotoxicity of noscapine UK preparations containing papaveretum were reformulated to exclude the noscapine component and the name papaveretum was redefined in the BP 1993 to reflect this change of formulation. It is possible that in other countries the term papaveretum is still being used to describe a mixture containing noscapine.
Doses. Papaveretum is generally given by subcutaneous or intramuscular injection in doses of 7.7 to 15.4 mg every 4 hours if necessary. The initial dose in the elderly or debilitated patients should not exceed 7.7 mg. In the treatment of pain and as an adjunct in anaesthesia, papaveretum may also be given intravenously in doses of one-quarter to one-half the corresponding subcutaneous or intramuscular dose. For pre-operative medication papaveretum is given intramuscularly or subcutaneously sometimes with hyoscine hydrobromide. For details of doses in children, see below. Oral preparations containing papaveretum with aspirin have been given for the management of moderate to severe pain.
1. Robinson LQ, Stephenson TP. Self injection treatment for impotence. BMJ 1989; 299: 1568.

Administration in children.

Papaveretum may be given to children in the treatment of moderate to severe pain including postoperative and severe chronic pain. It is also used for pre-operative sedation and as an adjunct to anaesthesia. Papaveretum is generally given by subcutaneous or intramuscular injection every 4 hours if necessary, according to age as follows:
neonates: 115 micrograms/kg
1 to 12 months: 154 micrograms/kg
1 to 6 years: 1.93 to 3.85 mg
6 to 12 years: 3.85 to 7.7 mg Older children may be given the usual adult dose (see above). In the treatment of pain and as an adjunct to anaesthesia papaveretum may also be given intravenously in doses of one-quarter to one-half the corresponding subcutaneous or intramuscular dose.

💊 Preparations

BP 2008: Papaveretum Injection.

Proprietary Preparations

S.Afr.: Omnopon. Multi-ingredient: UK: Aspav.
Published February 07, 2019.