Drug General Information (ID: DDINMJ250K)
Drug Name			Papaverine		Drug Info		Amisulpride		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasodilator Agents				Antipsychotic Agents
Structure

Mechanism of Papaverine-Amisulpride Interaction (Severity Level: Major)
Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Drug Name		Papaverine				Amisulpride
Mechanism		Prolong QT interval				Prolong QT interval
Key Mechanism Factor 1
		Factor Name		QT interval
		Factor Description		Long QT syndrome is a heart signaling disorder that can cause a fast, chaotic heartbeat (arrhythmia). Many people may not exhibit symptoms, and usually the condition is detected during routine medical tests. In others, the most common symptoms include: sudden fainting, palpitations, dizziness, seizures, sudden death.
Mechanism Description		Increased risk of prolong QT interval by the combination of Papaverine and Amisulpride

Recommended Action
Management		Caution and close monitoring are advised during intracoronary administration of papaverine, particularly in patients receiving concomitant drugs that can prolong the QT interval or cause bradycardia and in patients with other risk factors described above.

References
1	Goto M, Sato M, Kitzazawa H, et.al "Papaverine-induced QT interval prolongation and ventricular fibrillation in a patient with a history of drug-induced QT prolongation." Intern Med 53 (2014): 1629-31. [PMID: 25088875]
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3	Jain A, Jenkins MG "Intracoronary electrocardiogram during torsade des pointes secondary to intracoronary papaverine." Cathet Cardiovasc Diagn 18 (1989): 255-7. [PMID: 2605630]
4	Kern MJ, Deligonul U, Serota H, Gudipati C, Buckingham T "Ventricular arrhythmia due to intracoronary papaverine: analysis of QT intervals and coronary vasodilatory reserve." Cathet Cardiovasc Diagn 19 (1990): 229-36. [PMID: 2334953]
5	Nakayama M, Saito A, Kitazawa H, et.al "Papaverine-induced polymorphic ventricular tachycardia in relation to QTU and giant T-U waves in four cases." Intern Med 51 (2012): 351-6. [PMID: 22333368]
6	Nakayama M, Tanaka N, Sakoda K, et.al "Papaverine-induced polymorphic ventricular tachycardia during coronary flow reserve study of patients with moderate coronary artery disease." Circ J 79 (2015): 530-6. [PMID: 25746536]
7	Talman CL, Winniford MD, Rossen JD, Simonetti I, Kienzle MG, Marcus ML "Polymorphous ventricular tachycardia: a side effect of intracoronary papaverine." J Am Coll Cardiol 15 (1990): 275-8. [PMID: 2299067]
8	Vrolix M, Piessens J, De Geest H "Torsades de pointes after intracoronary papaverine." Eur Heart J 12 (1991): 273-6. [PMID: 2044564]