Camylofin in the management of prolonged labor: a review of evidence

Abstract

Prolonged labor can lead to increased maternal and neonatal morbidity and mortality. Hence, it warrants an early detection and appropriate clinical management. Active management of labor has shown to decrease the occurrence of prolonged labor. Administering antispasmodics during labor facilitates a faster and more effective dilatation of the cervix. Hence, antispasmodics can be used to decrease the incidence of prolonged labor. Camylofin, a potent antispasmodic, with a dual mode of action, has been used in the augmentation of labor for more than six decades. There is a growing body of evidence to support the efficacy and tolerability of Camylofin in the active management of labor. A review of published evidence suggests that Camylofin has superior efficacy in augmentation of labor on multiple counts like rate of cervical dilation, duration of active phase of first stage of labor and induction delivery interval, when compared to other spasmolytics like drotaverine, hyoscine and valethemate. It also has a benefit of a convenient single dose as compared to the other spasmolytics listed earlier. Camylofin has other advantages like a quick onset of action, prolonged action, no adverse effects on uterine contractility, no contraindication for use in uterine inertia cases and overall good tolerability for both mother and fetus. Given the superior efficacy and benefits that this drug exhibits, coupled with its excellent tolerability profile, Camylofin should be the first choice and may be preferred over other drugs for cervical dilatation and acceleration of active phase of labor.

Camylofin dihydrochloride injection: a drug monograph review

“…It can also be used in cases of uterine inertia. 13 There is no strong clinical trial evidence to recommend the use of camylofin in other indications associated with abdominal pain like spastic constipation, gastritis, peptic ulcer etc.…”

“…This dual mode of action has been demonstrated in animal experiments, where in camylofin abolished the spasm inducing effects of both carbachol (cholinergic spasms) and barium chloride (muscular spasms. 13,[19][20][21] Musculotropic action…”

“…Unlike the musculotropic action which is comparable to papaverine, the neurotropic action is only 1/7th that of the potency of atropine. 5,13,[19][20][21] Hence, camylofin overall, has a comprehensive and potent spasmolytic action on the smooth muscles of the viscera (Gastrointestinal, renal, biliary tracts) and cervix, but its action on the glands, eyes, heart and circulation is minimal. 13,[19][20][21]…”

“…Thus, there is a painful spasm of the cervix, prolonging the labor. 13,20 Here again, camylofin primarily acts on the smooth muscles of the cervix. This action of camylofin is unique since, it is a preferential cervical dilator, i.e.…”

The Effect of Intramuscular Hyoscine and Hyoscine-Promethazine on the Duration of Labor in Nulliparous Pregnant Women (Triple-Blind Randomized Controlled Trial)

“…Studies indicate that atropine, which is a broad-spectrum anticholinergic drug, is associated with reducing active phase of labor, total length of labor, and an increase in cesarean sections, and side effects like dry mouth, tachycardia, and urinary retention might appear [14]. In multiple studies of antispasmodic drugs used in labor [15][16][17][18][19][20][21][22][23][24][25], hyoscine is an antimuscarinic medication (anticholinergic and antispasmodic) and competes with the action of acetylcholine on muscarinic receptors. It is helpful in reducing the types of spasms and is known under other commercial brands as scopolamine, HBB, and Buscopan, and its pregnancy category is C [26].…”