Active Ingredients

Propiverine – Effect, Application & Risks


Propiverine belongs to the active substance groups of spasmolytics and muscle relaxants. Preferably, this drug is prescribed to children with urinary incontinence .

What is propiverine?

Propiverine is also known under the alternative name Propiverinum . This drug is assigned to the drug groups of spasmolytics and muscle relaxants. Propiverine is the drug of first choice in children with urinary incontinence when it is caused by increased tension in the urinary muscles. This medicine is also used in patients with an overactive bladder due to paraplegia , multiple sclerosis and spinal cord damage.

Propiverine has active metabolites that bind to the muscarinic receptors (anticholinergic system) and in this way cause relaxation of the bladder. In vitro, there is also a calcium antagonistic effect on the cells involved in the smooth muscle of the urinary bladder.

Pharmacological action

Propiverine is preferably used in children with urinary incontinence. This incontinence is due to overexcitability of the urinary muscle, which causes abnormal urinary behavior, such as nocturnal wetting , nocturnal urination ( nocturia ), sudden urine loss and small amounts of urine leaking out ( polkisuria ).

Uncontrolled urinary behavior due to an overactive bladder is common in patients with paraplegia, multiple sclerosis and spinal cord damage. In these cases, too, propiverine is the drug of first choice.

A third area of ​​application consists in the treatment of bladder damage after surgical interventions and radiation . As a spasmolytic, propiverine has a direct effect on the activity of muscles and nerves . In the muscles, the drug becomes active on the muscle fibers of the hollow organs, which also include the bladder.

In the area of ​​the parasympathetic nerve fibers, which belong to the autonomic nervous system , propiverine, with its anticholinergic effect, displaces the endogenous messenger substance acetylcholine docked to the nerve fibers and prevents excessive stimulation of these receptors , which leads to the unwanted reflex of excessive urination. The urge to urinate decreases noticeably and the urinary bladder has a greater filling capacity.

Medical Application & Use

Propiverine has a long half-life of 14 to 20 hours. Each film-coated tablet contains 15 mg propiverine hydrochloride. Taking one film-coated tablet twice a day is usually sufficient. Due to the favorable profile of effects, patients with minor symptoms can get by with just one tablet a day. In the case of nerve- related bladder emptying disorders , the daily dose can be increased to three tablets, which corresponds to a maximum daily dose of 45 mg propiverine hydrochloride.

Patients with renal impairment should not exceed a maximum daily dose of 30 mg. In children, treatment for overactive bladder should not begin before the age of five because organ development is not complete at this age. Even if propiverine is the drug of first choice for children and is also considered to be well tolerated, treatment should only take place as part of an overall therapeutic concept (urotherapy). Overall, a low body weight of less than 35 kg is not suitable for the administration of film-coated tablets with 15 mg of this active ingredient. In this case, film-coated tablets with a low propiverine content of 5 mg are prescribed.

Dry mouth is described as the most common accompanying symptom when taking anticholinergic drugs. However, in contrast to oxybutynin , another active substance used in drug therapy for incontinence, propiverine is better tolerated. Physicians believe that the rate of anticholinergic side effects is reduced due to the drug’s dual action.

Risks & side effects

Propiverine also lists risks and side effects that may constitute a contraindication. The drug must not be used if there is a known hypersensitivity to the active ingredient. Patients with intestinal obstruction , lack of bowel movement ( intestinal atony ), inflammatory bowel disease, enlarged colon due to bacterial colonization ( toxic megacolon ), and myasthenia gravis should not take propiverine. Other contraindications are liver dysfunction and glaucoma (narrow-angle glaucoma).

A careful risk-benefit analysis must be performed in patients with renal and neurological disorders. In patients with a narrowed chamber angle of the anterior chamber of the eye , the drug can trigger a glaucoma attack due to its pupil-dilating effect. Various heart problems, heartburn , esophagitis , and benign enlargement of the prostate can occur as side effects.

Many patients suffer from visual disturbances , abdominal pain , digestive problems , reduced visual acuity , exhaustion and tiredness . Occasionally, hypotension , tremors , dizziness , nausea , drowsiness , urinary retention , and taste disturbances are possible.

Nocturnal and frequent urge to urinate as a result of kidney disease , organic bladder diseases, bladder cancer and cardiac insufficiency are clinical pictures that are not suitable for treatment with propiverine. During pregnancy and lactation , this drug is prescribed only after a strict risk-benefit analysis. Since the active substance is suitable for children, there are no fundamental contraindications. However, it is important to adapt the dose to the body weight of the small patient.

If various psychotropic drugs are taken at the same time, such as tetracyclic antidepressants , benzodiazepines and neuroleptics , the effect is enhanced. This also applies to the simultaneous intake of muscle-relaxing drugs such as muscarinic receptor antagonists. Patients who are being treated for cardiac arrhythmia, Parkinson’s disease and asthma may only take propiverine after prior clarification by the doctor treating them.

The combination of propiverine and metoclopramide for gastrointestinal problems reduces the effect of both drugs. Isoniazid , used to treat tuberculosis , can cause a drop in blood pressure.

The intake of propiverine can also impair the ability to react , especially when simultaneously taking central depressant medication such as psychotropic drugs, to such an extent that operating machines and driving a car are not without risk. Sometimes medicines can cause allergic reactions.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.