Drotaverine (Drotin) Intramuscular Dosing
For adults, the standard intramuscular dose of drotaverine is 40-80 mg per injection, which can be repeated if necessary, with a maximum daily dose of 240 mg. 1, 2
Adult IM Dosing
- Standard dose: 40-80 mg IM per injection 1, 2
- Repeat dosing: Can be repeated once after 40 minutes if pain persists 2
- Maximum daily dose: 240 mg per day (typically divided into 2-3 injections) 1, 2
- Onset of action: IM administration has an onset time of 20-30 minutes, with duration of action approximately 30-60 minutes 3
Pediatric IM Dosing
Intramuscular drotaverine is not well-established in pediatric populations. The available evidence only supports oral administration in children:
- Ages 4-6 years: 20 mg orally three times daily 4
- Ages >6 years: 40 mg orally three times daily 4
- No established IM dosing guidelines exist for pediatric patients 4
Clinical Considerations
Efficacy
- Renal colic: Drotaverine 80 mg IV was effective in 79% of patients versus 46% with placebo (P < 0.001) 2
- Post-operative urinary retention: 40 mg IM significantly reduced time to micturition (441 vs 563 minutes) and decreased catheterization rates in male orthopedic patients (RR 0.29,95% CI: 0.1-0.87) 1
Safety Profile
- Common side effects: Transitory hypotension, vertigo, nausea, or vomiting 2
- Serious adverse events: None reported in clinical trials 4, 2
- Cardiac monitoring: Patients with cardiac conditions should be monitored for heart rate, particularly to avoid exacerbating tachyarrhythmias 3
Contraindications and Precautions
- Avoid in: Patients with tachyarrhythmias or significant cardiac disease without careful monitoring 3
- Hepatic/renal impairment: No specific dose adjustments are established in the literature, but caution is warranted given the drug's metabolism and clearance patterns 5
- Hypersensitivity: Discontinue if allergic reactions occur 2