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MUSCULO-SKELETAL SYSTEM › OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM › OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM › Enzymes
chymopapain
M09AB01
Forms & Strengths
- Intrathecal injection: 2000-4000 units/mL
- Solution for injection: 2000 units/mL
- 10,000 units vial for reconstitution
Adult Dosing
- Disc herniation: 2000-4000 units intrathecally
- Dosage may vary based on disc size and herniation
Pediatric Dosing
- Not established for pediatric use
- Use with caution in patients under 18 years old
Indications
- Chemical nucleolysis of herniated lumbar intervertebral discs
- Treatment of low back pain and sciatica due to disc herniation
Mechanism of Action
- Breakdown of proteoglycans in the nucleus pulposus
- Reduction of disc volume and pressure on surrounding nerves
Contraindications
- Hypersensitivity to chymopapain
- Active tuberculosis or osteomyelitis
- Cauda equina syndrome or arachnoiditis
- Previous spine surgery or spinal fusion
Adverse Reactions
- Headache
- Back pain
- Fever
- Muscle spasms
- Allergic reactions (rare)
- Cauda equina syndrome (rare)
Drug Interactions
- Anticoagulants: increased risk of bleeding
- Nonsteroidal anti-inflammatory drugs (NSAIDs): potential for increased bleeding risk
Curated Content: Needs Vetting Before Put to Clinical Use