Drug General Information (ID: DDIXVPB9GZ)
Drug Name			Papaverine		Drug Info		Nesiritide		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Vasodilator Agents				Recombinant Natriuretic Peptide
Structure

Mechanism of Papaverine-Nesiritide Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Papaverine				Nesiritide
Mechanism		Hypotensive effects Phosphodiesterase 4D/5A  Inhibitor				Antihypertensive agent Guanylate cyclase  Agonist
Key Mechanism Factor 1
		Factor Name		Phosphodiesterase				Structure Sequence
		Protein Family		Cyclic nucleotide phosphodiesterase family
		Protein Function		Hydrolyzes the second messenger cAMP, which is a key regulator of many important physiological processes.     Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions.     Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Papaverine and Nesiritide

Recommended Action
Management		Whether used alone or with other agents, nesiritide should be administered only in settings where blood pressure can be closely monitored. The dosage should be reduced or the drug discontinued in patients who develop hypotension.

References
1	Product Information. Natrecore (nesiritide) Scios Inc, Sunnyvale, CA.