IN-VITRO EVALUATION OF PAPAVERINE HYDROCHLORIDE INCOMPATIBILITIES - ASIMULATION OF INTRAARTERIAL INFUSION FOR CEREBRAL VASOSPASM

PURPOSE: To elucidate, in light of reports of complications associated with intraarterial infusion of papaverine hydrochloride, the known pr opensity of papaverine hydrochloride to form precipitate in combinatio n with other solutions or pharmaceuticals. METHODS: Initially simulati ng 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 contr ast material. RESULTS: Papaverine in concentrations of 0.3% (300 mg/10 0 mt of normal saline) or greater formed a precipitate when mixed with human serum (blood). The precipitate crystals were 50 to 100 mu m in size and could be returned to solution simply by the addition of more serum. CONCLUSION: Crystal emboli are a possible transient cause of co mplications experienced during treatment of vasospasm with its attenda nt altered flow dynamics.