Products
Propiverine was approved in many countries in 2020 in the form of modified-release hard capsules (Mictonorm). Later, coated tablets were also registered (Mictonet). This is an older active ingredient that was available earlier in Germany, for example.
Structure and properties
Propiverine (C23H29NO3, Mr = 367.5 g/mol) is present in drugs as propiverine hydrochloride. Active metabolites are involved in the effects. The parent compound is atropine.
Effects
Propiverine (ATC G04BD06) has spasmolytic and anticholinergic (antimuscarinic) properties. On the one hand, the effects are due to inhibition of calcium influx into urinary bladder smooth muscle cells by inhibition of L-type voltage-gated calcium channels. On the other hand, propiverine is also an antagonist at muscarinic acetylcholine receptors.
Indications
For the symptomatic treatment of hyperactive bladder (irritable bladder). This includes urinary incontinence, increased micturition frequency, and an imperative urge to urinate.
Dosage
According to the professional information leaflet.
Contraindications
- Hypersensitivity
- Intestinal obstruction
- Pronounced obstructive voiding dysfunction with predictable urinary retention.
- Myasthenia gravis
- Intestinal atony
- Severe ulcerative colitis
- Toxic megacolon
- Untreated narrow-angle glaucoma
- Moderate or severe liver dysfunction
- Tachyarrhythmias
For complete precautions, see the drug label.
Interactions
Propiverine is a substrate of CYP3A4, FMO1, and 3. Drug-drug interactions have been described with the following agents:
- Tricyclic antidepressants
- Sedatives such as benzodiazepines
- Anticholinergics
- Amantadine
- Neuroleptics
- Sympathomimetics
- Parasympathomimetics
- Isoniazid
Adverse effects
The most common possible adverse effects include dry mouth, headache, impaired accommodation, visual disturbances, constipation, abdominal pain, dyspepsia, fatigue, and exhaustion.
