Clinical Use
Opiate analgesia
(15.4 mg/mL) 1 mL contains 10 mg anhydrous
morphine, 1.2 mg papaverine HCl, and 1.04 mg codeine
HCl
Drug interactions
Potentially hazardous interactions with other drugs
Analgesics: possible opioid withdrawal with
buprenorphine and pentazocine.
Anti-arrhythmics: delayed absorption of mexiletine.
Antidepressants: possible CNS excitation or
depression with MAOIs – avoid; possible CNS
excitation or depression with moclobemide;
increased sedative effects with tricyclics.
Antihistamines: increased sedative effects with
sedating antihistamines.
Antipsychotics: enhanced hypotensive and sedative
effects.
Dopaminergics: avoid with selegiline.
Nalmefene: avoid concomitant use.
Sodium oxybate: enhanced effect of sodium oxybate
– avoid.
Metabolism
Papaverine: Mainly metabolised in the liver and excreted
in the urine, almost entirely as glucuronide-conjugated
phenolic metabolites.