Interactions between Go-Evac and Papaverine
1 drug interaction and 16 additional warnings found for the following 2 drugs:
- Go-Evac (polyethylene glycol 3350 with electrolytes)
- papaverine
Drug interactions
Moderate drug interactions
Moderate:
papaverine polyethylene glycol 3350 with electrolytes
Applies to: papaverine and Go-Evac (polyethylene glycol 3350 with electrolytes)
Monitor
The use of bowel cleansing preparations may increase the risk of ventricular arrhythmia, particularly torsade de pointes, in patients treated with drugs that prolong the QT interval. Severe and potentially fatal cases of electrolyte disorders and arrhythmias have been reported in elderly patients using bowel cleansing products. Electrolyte disturbances including hypokalemia and hypomagnesemia are known risk factors for torsade de pointes associated with QT interval prolongation.
Management
Caution is advised when bowel cleansing preparations are prescribed in patients treated with drugs that prolong the QT interval. Monitoring of baseline and posttreatment serum electrolyte levels is recommended, particularly in the elderly. Patients should be instructed to drink plenty of clear liquids before, during, and after the bowel preparation process. Consideration should be given to consumption of 36 to 48 fluid ounces of a carbohydrate-electrolyte solution in the six hours before the first dose. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.
References (7)
- Hill AG, Parry BR (1996) "Hypokalaemia following bowel cleansing with sodium phosphate." N Z Med J, 109, p. 347
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2007) "Product Information. Fleet Phospho Soda (sodium acid phosphate-sodium phosphate)." Fleet, CB
- (2007) "Product Information. Visicol (sodium acid phosphate-sodium phosphate)." Salix Pharmaceuticals
- Cerner Multum, Inc. "Australian Product Information."
- (2010) "Product Information. Suprep Bowel Prep Kit (magnesium/potassium/sodium sulfates)." Braintree Laboratories
- (2013) "Product Information. Suclear (polyethylene glycol 3350 with electrolytes)." Braintree Laboratories
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
papaverine Food/Lifestyle
Applies to: papaverine
Adjust dosing interval
Smoking before administration of an intracavernosal papaverine/phentolamine combination may reduce its erection-inducing effect.
Management
Smoking should be avoided for at least 1 hour before the intracavernosal papaverine/phentolamine combination is administered. The applicable manufacturer's labeling should be consulted for additional guidance.
References (1)
- (2023) "Product Information. Androskat (papaverine-phentolamine)." Imported (Netherlands)
Moderate:
polyethylene glycol 3350 with electrolytes Food/Lifestyle
Applies to: Go-Evac (polyethylene glycol 3350 with electrolytes)
Generally avoid
Using macrogol 3350 with electrolytes with starch-based food thickeners may counteract the thickening effect of the starch. According to some authorities, this may liquefy the preparations, potentially increasing the risk for aspiration in patients with swallowing problems. In addition, combining macrogol 3350 with electrolytes can increase the gastrointestinal transit rate. Oral medications administered within one hour of starting the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.
Management
Mixing of macrogol 3350-based solutions with starch-based food thickeners should generally be avoided to minimize aspiration risk; always consult individual product package labeling and relevant institutional protocols for guidance. Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment, so oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing whenever possible. If taking medications at these times cannot be avoided, monitoring for reduced therapeutic effects may be advisable.
References (3)
- (2024) "Product Information. GaviLyte-N With Flavor Packs (polyethylene glycol 3350 with electrolytes)." Gavis Pharmaceuticals
- (2021) Polyethylene glycol (PEG) laxatives and starch-based thickeners: potential interactive effect when mixed, leading to an increased risk of aspiration https://www.gov.uk/drug-safety-update/polyethylene-glycol-peg-laxatives-and-starch-based-thickeners-poten
- Potentially Harmful Interaction between Polyethylene https://ismpcanada.ca/wp-content/uploads/ISMPCSB2019-i7-PEG-Thickener.pdf
Moderate:
papaverine Alcohol (Ethanol)
Applies to: papaverine
Monitor
Certain psychotherapeutic and other CNS-active agents may have blood pressure-lowering effects and may cause dizziness, orthostatic hypotension, or syncope. These effects may be more likely during treatment initiation, dose escalation, or treatment restart. Coadministration with antihypertensives or other agents with blood pressure-lowering properties, particularly vasodilators and alpha-adrenergic blockers, may result in additive hypotensive or orthostatic effects.
Management
Monitor blood pressure and clinical response during concomitant use, especially when starting or increasing the dose of either agent. Patients should be advised to rise slowly from a sitting or lying position and to report dizziness, lightheadedness, fainting, orthostasis, palpitations, or troublesome changes in pulse or heart rate. Patients should be cautioned that alcohol may enhance blood pressure-lowering effects during concomitant use with antihypertensives or other agents with hypotensive properties. Patients should avoid driving or operating hazardous machinery until they know how the medications affect them.
References (13)
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
- (2023) "Product Information. Buprenorphine (buprenorphine)." G.L. Pharma UK Ltd
- (2023) "Product Information. Temgesic (buprenorphine)." Reckitt Benckiser Pty Ltd
- (2026) "Product Information. Urapidil (Carinopharm) (urapidil)." Imported (EU)
- (2020) "Product Information. URAPIDIL ACCORD (urapidil)." ACCORD HEALTHCARE LIMITED
- (2020) "Product Information. Ebrantil (urapidil)." CHEPLAPHARM ARZNEIMITTEL GMBH
- (2026) "Product Information. Urapidil (urapidil)." Imported (Switzerland)
Disease interactions
13 potential interactions Applies to: 12 conditions, including Seizures, Ulcerative Colitis, Heart Disease, Inflammatory Bowel Disease, and Hyponatremia.
Dehydration
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Dehydration.
Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.
Esophageal Obstruction
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Esophageal Obstruction.
Patients with impaired gag reflex, unconscious or semi-conscious patients, and patients prone to regurgitation or aspiration should be administered polyethylene glycol (PEG) electrolyte solutions cautiously. Patients experiencing severe bloating, distention or abdominal pain may need to receive PEG electrolyte solutions at a slower rate.
Gastrointestinal Obstruction
Major:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a major potential interaction with Gastrointestinal Obstruction.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
Major:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a major potential interaction with Gastrointestinal Obstruction.
The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.
Gastrointestinal Perforation
Major:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a major potential interaction with Gastrointestinal Perforation.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
Glaucoma/Intraocular Hypertension
Moderate:
papaverine
Papaverine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
The use of papaverine derivatives has been associated with an increase in intraocular pressure. Therapy with papaverine derivatives should be administered cautiously in patients with glaucoma.
Heart Block
Major:
papaverine
Papaverine has a major potential interaction with Heart Block.
The use of papaverine and papaverine derivatives is contraindicated in patients with complete AV heart block. When conduction is depressed, these agents can induce transient ectopic rhythms of ventricular origin, either premature beats or paroxysmal tachycardia. Therapy with these agents should be administered cautiously in patients with conduction disturbances, including sinus bradyarrhythmia and partial or first-degree AV block.
Heart Disease
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Heart Disease.
The use of ionic osmotic laxative products for bowel preparation has been associated with rare reports of serious arrhythmias. Use caution when prescribing PEG electrolyte solutions in patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Clinical monitoring of cardiovascular status is recommended prior to, during, and after therapy.
Hyponatremia
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Hyponatremia.
PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.
Inflammatory Bowel Disease
Major:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a major potential interaction with Inflammatory Bowel Disease.
The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.
Renal Dysfunction
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Renal Dysfunction.
Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.
Seizures
Moderate:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a moderate potential interaction with Seizures.
PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.
Ulcerative Colitis
Major:
Go-Evac
The polyethylene glycol 3350 with electrolytes in Go-Evac has a major potential interaction with Ulcerative Colitis.
The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.
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Go-Evac
A total of 420 drugs are known to interact with Go-Evac.
- Go-evac is in the drug class laxatives.
- Go-evac is used to treat the following conditions:
papaverine
A total of 398 drugs are known to interact with papaverine.
- Papaverine is in the drug class peripheral vasodilators.
- Papaverine is used to treat Vasospasm.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.