In vitro evaluation of papaverine hydrochloride incompatibilities: a simulation of intraarterial infusion for cerebral vasospasm.
OBJECTIVE
To elucidate, in light of reports of complications associated with intraarterial infusion of papaverine hydrochloride, the known propensity of papaverine hydrochloride to form precipitate in combination with other solutions or pharmaceuticals.


METHODS
Initially simulating a situation experienced during an intraarterial papaverine infusion for cerebral vasospasm, we mixed various concentrations of papaverine with serum, nonheparinized and heparinized saline, and nonionic contrast material.


RESULTS
Papaverine in concentrations of 0.3% (300 mg/100 mL of normal saline) or greater formed a precipitate when mixed with human serum (blood). The precipitate crystals were 50 to 100 microns in size and could be returned to solution simply by the addition of more serum.


CONCLUSIONS
Crystal emboli are a possible transient cause of complications experienced during treatment of vasospasm with its attendant altered flow dynamics.
Mathis
J M
JM
Division of Neuroradiology, University of Virginia Health Sciences Center, Charlottesville 22908.
DeNardo
A J
AJ
Thibault
L
L
Jensen
M E
ME
Savory
J
J
Dion
J E
JE
D002533:Cerebral Angiography; D011232:Chemical Precipitation; D003460:Crystallization; D004305:Dose-Response Relationship, Drug; D004344:Drug Incompatibility; D006801:Humans; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000009:adverse effects / Q000493:pharmacokinetics; D002546:Ischemic Attack, Transient / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008955:Models, Cardiovascular; D010208:Papaverine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D013053:Spectrophotometry
D007472:Iohexol; D010208:Papaverine