In this article you can find instructions for use medicinal product No-shpa. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of No-shpa in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of No-shpa in the presence of existing structural analogues. Use for the treatment and relief of spasmodic pain in adults, children, as well as during pregnancy and breastfeeding.
No-shpa- myotropic antispasmodic, isoquinoline derivative. It has a powerful antispasmodic effect on smooth muscles due to inhibition of the PDE enzyme. The enzyme PDE is necessary for the hydrolysis of cAMP to AMP. Inhibition of PDE leads to an increase in cAMP concentration, which triggers the following cascade reaction: high concentrations of cAMP activate cAMP-dependent phosphorylation of myosin light chain kinase (MLCK). Phosphorylation of MLCK leads to a decrease in its affinity for the Ca2+-calmodulin complex, as a result of which the inactivated form of MLCK maintains muscle relaxation. In addition, cAMP affects the cytosolic concentration of Ca2+ ion by stimulating the transport of Ca2+ into the extracellular space and the sarcoplasmic reticulum. This lowering the concentration of Ca2+ ion effect of drotaverine (the active ingredient of the drug No-shpa) through cAMP explains the antagonistic effect of drotaverine in relation to Ca2+.
In vitro, drotaverine inhibits the PDE4 isoenzyme without inhibiting the PDE3 and PDE5 isoenzymes. Therefore, the effectiveness of drotaverine depends on the concentration of PDE4 in tissues (the content of PDE4 in different tissues varies). PDE4 is most important for the suppression of smooth muscle contractility, and therefore selective inhibition of PDE4 may be useful for the treatment of hyperkinetic dyskinesias and various diseases accompanied by a spastic state of the gastrointestinal tract.
The hydrolysis of cAMP in the myocardium and vascular smooth muscle occurs mainly with the help of the PDE3 isoenzyme, which explains the fact that with high antispasmodic activity, No-shpa has no serious side effects on the heart and blood vessels and no pronounced effects on the cardiovascular system .
Drotaverine is effective against smooth muscle spasms of both neurogenic and muscular origin. Regardless of the type of autonomic innervation, drotaverine relaxes the smooth muscles of the gastrointestinal tract, biliary tract, and genitourinary system.
Pharmacokinetics
After oral administration, No-Spa is quickly and completely absorbed. After first-pass metabolism, 65% of the administered dose of drotaverine enters the systemic circulation. Drotaverine is evenly distributed in tissues and penetrates smooth muscle cells. Does not penetrate the blood-brain barrier. Drotaverine and/or its metabolites are able to slightly penetrate the placental barrier. Within 72 hours, drotaverine is almost completely eliminated from the body. More than 50% of drotaverine is excreted by the kidneys and about 30% through the intestines (excretion into bile). Drotaverine is mainly excreted in the form of metabolites; unchanged drotaverine is not found in the urine.
Indications
- spasms of smooth muscles in diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis;
- spasms of smooth muscles of the urinary system: nephrolithiasis, urethrolithiasis, pyelitis, cystitis, spasms Bladder.
As adjuvant therapy:
- for spasms of smooth muscles of the gastrointestinal tract: peptic ulcer stomach and duodenum, gastritis, spasms of the cardia and pylorus, enteritis, colitis, spastic colitis with constipation and irritable bowel syndrome with flatulence after excluding diseases manifested by the syndrome " acute stomach"(appendicitis, peritonitis, ulcer perforation, acute pancreatitis);
- tension headaches (for oral administration);
- algodismenorrhea.
Release forms
Tablets 40 mg.
Tablets No-shpa forte 80 mg.
Solution for intravenous and intramuscular injection(injections in injection ampoules).
Instructions for use and dosage
Average daily dose for intramuscular administration in adults is 40-240 mg (divided into 1-3 administrations per day). For acute colic (renal or biliary), the drug is administered intravenously slowly at a dose of 40-80 mg (duration of administration is approximately 30 seconds).
Clinical studies with the use of drotaverine have not been conducted in children.
When prescribing the drug No-shpa, the maximum daily dose when taken orally for children aged 6 to 12 years is 80 mg in 2 divided doses, for those over 12 years old - 160 mg in 2-4 divided doses.
Duration of treatment without consulting a doctor
When taking the drug without consulting a doctor, the recommended duration of taking the drug is usually 1-2 days. If during this period pain syndrome does not decrease, the patient should consult a doctor to clarify the diagnosis and, if necessary, change therapy. In cases where NO-spa is used as an auxiliary therapy, the duration of treatment without consulting a doctor may be longer (2-3 days).
Performance Evaluation Method
If the patient can easily independently diagnose the symptoms of his disease, because... They are well known to him, then the effectiveness of treatment, namely the disappearance of pain, is also easily assessed by the patient. If within a few hours after taking the drug at the maximum single dose there is a moderate decrease in pain or no decrease in pain, or if the pain does not decrease significantly after taking the maximum daily dose, it is recommended to consult a doctor.
Side effect
- cardiopalmus;
- decrease in blood pressure;
- headache;
- dizziness;
- insomnia;
- nausea;
- constipation;
- rash;
- hives;
- angioedema;
- reactions at the injection site.
Contraindications
- severe renal failure;
- severe liver failure;
- severe heart failure (low cardiac output syndrome);
- children under 6 years of age (for tablets);
- children's age (for parenteral administration, because clinical trials not performed in children);
- period breastfeeding(no clinical data);
- rare hereditary galactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome (for tablets, due to the presence of lactose in their composition);
- hypersensitivity to the components of the drug;
- hypersensitivity to sodium disulfite (for solution for intravenous and intramuscular administration).
Use during pregnancy and breastfeeding
As shown by animal reproduction studies and retrospective data on clinical application, the use of No-shpa during pregnancy had neither teratogenic nor embryotoxic effects.
During pregnancy, the drug should be used with caution and only in cases where the potential benefit of therapy for the mother exceeds possible risk for the fetus.
Due to the lack of necessary clinical data, the drug is contraindicated during lactation (breastfeeding).
special instructions
The tablets contain 52 mg of lactose, which may result in complaints from digestive system in patients suffering from latose intolerance. Therefore, the drug in tablet form is not prescribed to patients with lactase deficiency, galactosemia or impaired glucose/galactose absorption syndrome.
The solution for intravenous and intramuscular administration contains sodium bisulfite, which can cause allergic reactions, including anaphylactic and bronchospasm, in sensitive persons (especially in persons with bronchial asthma or allergic reactions in the anamnesis). At hypersensitivity For sodium metabisulfite, parenteral use of the drug should be avoided.
When administering the drug intravenously to patients with low blood pressure, the patient should be in horizontal position due to the risk of collapse.
Impact on the ability to drive vehicles and operate machinery
When taken orally in therapeutic doses, drotaverine does not affect the ability to drive vehicles or perform work that requires increased concentration.
If any adverse reactions the issue of driving vehicles and working with machinery requires individual consideration. If dizziness occurs after taking the drug, potential activities should be avoided. dangerous species activities such as management vehicles and working with machinery.
After parenteral administration of the drug, it is recommended to refrain from driving vehicles and engaging in other potentially hazardous activities that require high concentration and speed of psychomotor reactions.
Drug interactions
PDE inhibitors like papaverine reduce the antiparkinsonian effect of levodopa. When No-shpa is prescribed simultaneously with levodopa, rigidity and tremor may increase.
When used simultaneously with drotaverine, the antispasmodic effect of papaverine, bendazole and other antispasmodics, including m-anticholinergics, is mutually enhanced.
No-spa increases arterial hypotension caused by tricyclic antidepressants, quinidine and procainamide.
No-spa reduces the spasmogenic activity of morphine.
Phenobarbital enhances the antispasmodic effect of drotaverine.
Drotaverine binds significantly to plasma proteins, mainly albumin, beta and gamma globulins. There are no data on the interaction of drotaverine with drugs that are significantly bound to plasma proteins. However, we can assume the possibility of their interaction with No-shpa at the level of binding to plasma proteins - displacement of one of the drugs by the other from the binding sites and an increase in the concentration of the free fraction in the blood of the drug with weaker binding to proteins. This could hypothetically increase the risk of pharmacodynamic and/or toxicity. side effects this drug.
Analogues of the drug No-shpa
Structural analogues according to active substance:
- Vero-Drotaverine;
- Droverin;
- Drotaverine;
- Drotaverine forte;
- Drotaverine hydrochloride;
- NOSH-BRA;
- Ple-Spa;
- Spasmol;
- Spasmonet;
- Spasmonet forte;
- Spazoverine;
- Spakovin.
If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.
No-spa is an antispasmodic drug.
Release form and composition
No-shpu is produced in the following dosage forms:
- Tablets: biconvex, round, yellow with an orangish or greenish tint, with “spa” engraved on one side (6 or 24 pcs in polyvinyl chloride/aluminum blisters, 1 blister in a cardboard box; 20 pcs in blisters made of aluminum/aluminum (laminated with polymer), 2 blisters in a cardboard box; 60 or 100 pieces in polypropylene bottles, 1 bottle in a cardboard box);
- Solution for intravenous and intramuscular administration: greenish-yellow, transparent (2 ml in dark glass ampoules, 5 ampoules in blister plastic packages, 1 or 5 packages in a cardboard box).
1 tablet contains:
- Auxiliary components: magnesium stearate – 3 mg; talc – 4 mg; povidone – 6 mg; corn starch– 35 mg; lactose monohydrate – 52 mg.
1 ampoule (2 ml) contains:
- Active substance: drotaverine hydrochloride – 40 mg;
- Auxiliary components: sodium disulfite (sodium metabisulfite) – 2 mg; 96% ethanol – 132 mg; water for injection – up to 2 ml.
Indications for use
- Spasms of smooth muscles in diseases of the biliary tract: papillitis, cholangiolithiasis, cholecystolithiasis, cholecystitis, cholangitis, pericholecystitis;
- Smooth muscle spasms urinary tract: urethrolithiasis, nephrolithiasis, pyelitis, bladder spasms, cystitis;
- Smooth muscle spasms gastrointestinal tract: gastritis, peptic ulcer of the stomach and duodenum, colitis, spasms of the cardia and pylorus, enteritis, spastic colitis with irritable bowel syndrome with flatulence and constipation (simultaneously with other drugs);
- Dysmenorrhea (simultaneously with other drugs);
- Tension headaches (tablets, along with other drugs);
- The period of stretching during physiological labor to shorten the phase of cervical dilatation and contraction total duration childbirth (injection solution).
Contraindications
- Severe heart failure (low cardiac output syndrome);
- Severe liver or kidney failure;
- Lactase deficiency, hereditary galactose intolerance, galactose-glucose malabsorption syndrome (tablets, due to the presence of lactose monohydrate in their composition);
- Age up to 6 years (tablets);
- Breastfeeding period (due to the lack of necessary clinical data confirming the safety and effectiveness of No-shpa for this group of patients);
- Hypersensitivity to the components of the drug.
No-shpa should be used with caution against the background of arterial hypotension, in children and during pregnancy.
At intravenous administration injection solution due to the risk of collapse, the patient must lie down.
Directions for use and dosage
Pills
- Adults: single dose– 1-2 tablets, frequency of administration – 2-3 times a day (maximum – 240 mg);
- Children from 12 years of age: single dose – 1-2 tablets, frequency of administration – 1-4 times a day (maximum – 160 mg);
- Children 6-12 years old: single dose – 1 tablet, frequency of administration – 1-2 times a day.
The recommended duration of taking No-shpa without consulting a doctor is usually 1-2 days. If the drug is used for auxiliary therapy, the duration of the course without medical advice can be increased to 3 days. If there is no improvement, you should consult a doctor.
If the patient can independently diagnose the symptoms of his illness, since they are well known to him, he can also evaluate the effectiveness of therapy (disappearance of pain). If, within several hours after taking No-shpa at the maximum single dose, the pain decreases moderately or does not decrease at all, or if there is no significant improvement in the condition after taking the maximum daily dose, you should consult a doctor.
Injection solution
No-shpa solution is administered intravenously or intramuscularly.
The average adult daily dose is 40-240 mg of drotaverine hydrochloride (divided into 1-3 doses) intramuscularly.
For acute stone colic (cholelithiasis and/or kidney stones), the solution is administered intravenously at a dose of 40-80 mg.
In order to shorten the dilatation phase of the cervix at the beginning of the stretching period during physiological labor, 40 mg of No-shpa is administered intramuscularly; within 2 hours, if the effect is unsatisfactory, the solution can be re-administered.
Side effects
During the use of No-shpa at any dosage form the following disorders may develop (>10% - very common; >1% and<10% – часто; >0.1% and<1% – нечасто; >0.01% and<0,1% – редко; <0,01%, включая отдельные сообщения – очень редко; с неизвестной частотой – при невозможности определить частоту развития побочных действий по имеющимся данным):
- Nervous system: rarely - dizziness, headache, insomnia;
- Digestive system: rarely – constipation, nausea;
- Cardiovascular system: rarely - palpitations, decreased blood pressure;
- Immune system: rarely - allergic reactions (in the form of angioedema, itching, urticaria, rash).
special instructions
1 tablet contains 52 mg of lactose monohydrate, which is why patients with lactose intolerance may experience problems with the digestive system. No-shpu in this dosage form should not be taken by patients with lactase deficiency, galactosemia, or galactose/glucose malabsorption syndrome.
The injection solution contains bisulfite, which can lead to the development of allergic-type reactions, including anaphylactic symptoms and bronchospasm, especially in patients with a history of asthma or allergic diseases. In case of hypersensitivity to sodium metabisulfite, parenteral use of No-shpa is not recommended.
If any adverse reactions develop while taking the drug orally, the question of the ability to drive vehicles and operate machinery requires individual consideration. If dizziness occurs after taking No-shpa, it is recommended to avoid performing potentially hazardous types of work. After parenteral, especially intravenous administration, you should refrain from working on machines and driving a vehicle for 1 hour after using the drug. 4.91 Rating: 4.9 - 22 votes
No-spa is one of the most popular drugs for relieving pain and spasms. A package of these tablets is probably in every home medicine cabinet. No-spa is a cardiovascular drug and is part of the group of antispasmodics - drugs that can quickly relax smooth muscles.
The drug will effectively help with cramps, pain in the stomach and intestines. The tablets are taken to treat spastic constipation. The drug is very effective in case of an attack of cholelithiasis and urolithiasis.
No-spa will relieve an attack of angina pectoris and help with spasm of peripheral vessels.
The effect of the drug is similar to that of papaverine, but unlike it, No-shpa has a more powerful effect. In this case, the medicine does not affect the central, autonomic and nervous systems. No-spa has an effective therapeutic effect for a wide variety of diseases. Let's find out when the drug no spa can help, its use, contraindications, what it does, what it does, what it can be replaced with?
To find out all this, I suggest you read the description of the drug, which is based on the factory instructions. The description is compiled to make it easier to understand the text of the instructions and to enable patients to familiarize themselves with the drug if they do not have it at hand. Before starting treatment, be sure to carefully read the original leaflet yourself.
What is the composition of No-shpa?
Tablets: the tablet form contains 40 mg of drotaverine hydrochloride, the active substance of the drug. Other auxiliary substances. For example, the composition contains magnesium stearate, talc and povidone. There is corn starch and lactose.
Solution for IV and IM: The contents of the ampoule include 20 mg or 40 mg of drotaverine hydrochloride. Other auxiliary substances. For example, the composition contains sodium disulfite, ethanol and water, treated in a special way.
What are No-shpa's analogues?
No-shpa has many structural analogues. For example, the same active ingredient is found in the preparations: Vero Drotaverine, Droverine and Drotaverine. You can replace No-shpa with medications: Drotaverine hydrochloride, Spasmonet, as well as Spasmol, Spakovin, etc.
What are No-shpa's indications for use? What do the instructions say?
The drug is prescribed to relieve spasms, alleviate the condition of diseases such as cholelithiasis, cholecystitis and pericholecystitis. Prescribed for cholangitis, papillitis.
Taken for spasms of smooth muscles that occur due to pathologies of the urinary system. For example, the drug is effective for urolithiasis, pyelitis and cystitis. Relieves spasms of smooth muscles of the bladder.
No-spa is often used during obstetrics. In this case, the medicine is administered intravenously and intramuscularly. The use of the solution shortens the time when the cervix dilates.
The drug is also indicated in the presence of spasms of smooth muscles of the gastrointestinal tract. The tablets are taken for peptic ulcers and various types of gastritis. The tablets are taken for enteritis, colitis, especially when constipation and flatulence are observed. Indications are spasms of the cardia and pylorus.
The drug is taken for headaches and dysmenorrhea. The solution is used IV or IM during obstetrics when strong contractions are observed.
What is the dosage and use of No-shpa?
Adults: tablets - 120-240 mg per day. The dosage is divided into 2-3 doses. The maximum dose per dose is 80 mg. The daily dosage should not exceed the recommended 240 mg.
Solution for intramuscular use - daily dose 40-240 mg of solution. It is administered in 1-3 doses. In the treatment of acute colic, the solution is used intravenously. The administration is slow, the dosage is 40-80 mg, administered in approximately 30 seconds.
Children from 6 to 12 years: tablets - 80 mg per day. The dosage is divided into 2 doses.
Children over 12 years old: tablets - 160 mg per day. The dosage is divided into 2, 3 or 4 doses.
If the drug is taken by the patient independently, without medical advice, treatment should not exceed 1-2 days. If there is no effect in eliminating pain and spasm, you should consult a doctor. It is necessary to establish or clarify the diagnosis.
What are the side effects of No-shpa?
When using the drug No Shpa, the instructions for use warn of possible negative reactions of the body. For example, there may be dizziness and increased heart rate. Patients may complain of a feeling of heat, increased sweating, and allergies. After intramuscular or intravenous administration, blood pressure may decrease. Arrhythmia and respiratory depression are observed. AV block may occur.
What are No-shpa's contraindications for use?
The drug is not prescribed for obvious hepatic or renal failure, in the presence of arterial hypotension, or hypersensitivity. There are contraindications for cardiogenic shock and CHF. You should not take No-Spa if you have 2nd or 3rd degree AV block.
With great caution, always under medical supervision, you can take the drug for atherosclerosis of the coronary arteries and angle-closure glaucoma. Also, according to strict indications, the drug is used for prostatic hyperplasia, as well as at the beginning of pregnancy (1st trimester) and when breastfeeding.
Like any other medicine, No-shpa should be prescribed by a doctor. When taken on its own, you should not abuse this medicine. Be healthy!
“No-spa” is an effective antispasmodic drug that has been tested for decades. Most people are familiar with this drug and keep it in their home medicine cabinet “just in case.” However, not many people know whether No-shpu can be used to treat children and how to do it correctly. In order not to harm the baby, before using any medications, you should consult a specialist and carefully read the instructions for use of the drug.
No-spa - general description of the drug
"No-spa" (drotaverine) is a myotropic antispasmodic. In terms of composition and pharmacological action, the drug is close to papaverine, but, unlike it, it has a longer and more effective antispasmodic effect. The substance drotaverine was obtained by synthesis in 1961 in Hungary, a year later it was patented under the trade name “No-shpa”. From 1970 to the present, the drug has been widely used in Russia, as well as in 50 other countries around the world.
“No-spa” relieves excessive tension in blood vessels, relaxes the smooth muscle tissue of internal organs and reduces intestinal motor activity. Does not affect the autonomic nervous system. When taken orally, it is well absorbed and evenly adsorbed into smooth muscle tissue. Drotaverine hydrochloride is effective when the pain is provoked by muscle or vascular spasm; the drug does not have an independent analgesic effect (like, for example, analgin).
Composition and release form
In the production of No-shpa, the following substances are used, calculated per tablet: drotaverine hydrochloride - 40 mg (in No-shpa Forte - 80 mg). Additional substances: magnesium stearate, talc, povidone, corn starch, lactose. 2 ml (1 ampoule) of solution contains 40 mg of drotaverine and auxiliary components: sodium metabisulfite, ethanol, distilled water.
Through the pharmacy chain, “No-shpa” is sold in the form of:
- Tablets of a yellow or orange hue, having a biconvex shape with the inscription “spa” on one side and a smooth surface on the other. The drug is available in the following dosages: “No-shpa” – 0.4 g and “No-shpa Forte” – 0.8 g. The tablets are packaged in plastic-aluminum or aluminum blisters and packed in a cardboard box of 6, 12, 24, 60, 100 pieces including instructions for use. Manufacturers also produce tablets packaged in PVC containers.
- Solutions for intramuscular and intravenous administration (20 mg/ml). The medicine appears to be a yellow liquid with a greenish tint. Available in 2 ml brown glass ampoules, which are packaged in a cardboard pack of 5 or 25 pieces.
How does No-shpa work?
“No-spa” is a fairly effective remedy in the treatment of many diseases, but it does not treat the cause of the disease, but only relieves pain caused by spasm. Most often, doctors prescribe the drug as an adjuvant in combination with the main therapy, including for headaches, fever and severe cough.
In the case when a child’s temperature exceeds 39 degrees, accompanied by chills and spasm of peripheral vessels (characterized by hands and feet that are pale and cold to the touch), drotaverine helps to quickly improve the patient’s condition.
As a result of dilation of blood vessels, heat transfer through the skin increases, causing the temperature to decrease.
It is also advisable to give the child “No-shpu” if the baby has a severe fever or there is a risk of febrile seizures. It should be remembered that the drug itself does not have antipyretic properties, so to reduce high fever it must be used in combination with non-steroidal anti-inflammatory drugs (paracetamol, analgin, ibuprofen).
For pain in the abdominal cavity, the antispasmodic relaxes the stiff muscles of the internal organs. “No-Spa” also helps well with headaches caused by spasm of blood vessels.
Experts have different opinions when answering the question: “Does No-Spa help with a child’s cough?” Some consider the drug useless in the treatment of cough, but most doctors are of the opinion that with a strong spasmodic cough, No-Spa relaxes the smooth muscles of the respiratory tract and dilates the blood vessels of the lungs, which, in combination with expectorants, significantly facilitates the discharge of sputum. The drug also has a positive effect on laryngitis, relieving and preventing the recurrence of laryngeal spasm.
Instructions for use for children
No-shpu should be given to preschool children only on the recommendation of a doctor, since the drug has contraindications for use and possible undesirable effects. In addition, self-administration of the drug may blur the symptoms of the disease, which will complicate the diagnosis.
The effect of the drug does not depend on the time of food intake. The tablets have a bitter taste, so it is advisable to crush them, then mix them with a small amount of some sweet syrup, and offer the child to drink the medicine with a sufficient amount of water.
To achieve an antipyretic effect, No-shpu is taken in combination with non-steroidal anti-inflammatory drugs. For inflammatory diseases, drotaverine is an adjuvant and is taken in combination with the main treatment.
Taking No-shpa for severe vomiting helps to alleviate the patient’s condition and reduce the urge. However, vomiting can be a symptom of dangerous diseases (for example, appendicitis) - self-administration of antispasmodics in this case is contraindicated.
Indications
Pediatricians prescribe No-shpa in the following cases:
- “white” fever is a condition in which, against the background of a high temperature, the child experiences a spasm of the blood vessels in the extremities, they become pale and cold to the touch;
- body temperature above 39 degrees, history of febrile convulsions;
- headache caused by spasm of blood vessels;
- bronchitis or laryngitis, accompanied by a severe cough;
- intestinal colic;
- stool retention due to intestinal spasm;
- spasm of smooth muscles in inflammatory diseases of the abdominal organs (gastritis, colitis, pyelitis) and pelvis (cystitis).
Dosage
“No-spa” is a strong antispasmodic of synthetic origin, so the doctor prescribes it for children under 6 years old only in case of urgent need. Do not exceed recommended dosages, as this may lead to undesirable consequences.
The dose of the drug for children aged 6 to 12 years is 1 tablet. for one dose up to 2 times a day; over 12 years old - 1 table. up to 4 times a day or 2 tablets. up to 2 times a day.
Only a doctor can prescribe a dosage for children under 6 years of age. In this case, the medication is distributed evenly throughout the day, 1/3 of a tablet (the interval between doses is at least 2-3 hours) or 1/2 of a tablet (no more than 1 time in 4 hours). The medicine is given as needed if the baby experiences a spasm, if the indicated dosage is enough for, for example, 6 hours, there is no need to take drotaverine more often.
How to use the drug in ampoules?
Sometimes pediatricians recommend giving children No-shpa in the form of a solution for infusion instead of tablets. In this case, 1 ml of the drug (20 mg) per dose is sufficient. Self-prescription and administration of drotaverine solution to children intramuscularly and intravenously is prohibited and can only be prescribed by a doctor in exceptional cases.
Contraindications
It is prohibited to give No-shpa to children in the following cases:
- age up to 6 years;
- allergy to the components included in the composition;
- arterial hypotension;
- atherosclerosis of heart vessels;
- acute abdominal pain of unknown etiology (perhaps the child has appendicitis or intestinal obstruction);
- status asthmaticus;
- glaucoma;
- renal or liver failure.
Side effects and overdose
Taking drotaverine may cause side effects from the gastrointestinal tract: nausea, vomiting, changes in stool. The following symptoms are also possible: dizziness, headache, increased sweating, allergic manifestations. If any adverse reactions occur, you should stop taking the drug and consult a doctor.
If you take the drug in large quantities uncontrolledly, serious changes in the functioning of the body are possible, so you should carefully calculate the dose and store the medicine out of the reach of children. If the permissible dosage has been exceeded, it is necessary to call an ambulance and rinse the child’s stomach before the doctor arrives. An overdose is dangerous due to possible disruption of the heart muscle, up to cardiac arrest, so the patient requires specialist supervision.
What do you need to remember?
“No-spa” is an artificially synthesized drug (that is, not on a natural basis), so you should take precautions and not prescribe treatment to children yourself. To eliminate pain of spastic origin in preschool children, weaker drugs are usually used and only if they are ineffective, No-shpu is prescribed. Before giving your child medications containing drotaverine hydrochloride, you should consult your doctor. He will make a diagnosis, assess the patient’s condition and prescribe the correct treatment.
Analogs: Drotaverine or No-shpa?
A complete analogue of “No-shpa” in terms of chemical components and pharmacological action is “Drotaverine”, but the cost of these drugs differs significantly. Whether it makes sense to overpay - everyone decides for themselves. “No-spa” is an imported medicine, therefore it undergoes stricter pharmacological control. On the other hand, expensive drugs are often counterfeited and there is a risk of buying a “dummy”.
The drugs are absorbed into the bloodstream at the same rate and relax the smooth muscles of the internal organs. They have the same contraindications for use and side effects.
Most specialists do not see a significant difference between No-shpa and Drotaverine, leaving the choice to the patient.
Shelf life and storage conditions
The duration and storage conditions of No-shpa depend on the type of packaging in which it is produced by the manufacturer:
- tablets in all-aluminum blisters are stored at a temperature not exceeding 30 degrees for 5 years;
- tablets in aluminum + PVC blisters can be used within 3 years from the date of production, stored at room temperature;
- tablets packaged by the manufacturer in PVC bottles remain usable at temperatures up to 25 degrees, shelf life is 5 years;
- the solution for intramuscular and intravenous infusions in ampoules is stored in a dark place at a temperature of 15 - 25 degrees for 5 years.
Pharmacodynamics. Drotaverine is an isoquinoline derivative that has an antispasmodic effect on smooth muscles by inhibiting the action of the PDE IV enzyme, causing an increase in the concentration of cAMP and, due to the inactivation of myosin light chain kinase (MLCK), leads to relaxation of smooth muscles.
In vitro drotaverine inhibits the action of the PDE IV enzyme and does not affect the action of the PDE III and PDE V isoenzymes. PDE IV is of great functional importance for reducing the contractile activity of smooth muscles, therefore selective inhibitors of this enzyme can be useful for the treatment of diseases that are accompanied by motor hyperfunction, as well as various diseases during which gastrointestinal spasms occur.
In the smooth muscle cells of the myocardium and blood vessels, cAMP is hydrolyzed to a greater extent by the PDE III isoenzyme, therefore drotaverine is an effective antispasmodic agent that does not have significant side effects on the cardiovascular system and a strong therapeutic effect on this system.
Drotaverine is effective for smooth muscle spasms of both nervous and muscular origin. Drotaverine acts on the smooth muscles of the gastrointestinal, biliary, genitourinary and cardiovascular systems, regardless of the type of innervation. Increases blood circulation in tissues due to its ability to dilate blood vessels.
The action of drotaverine is more effective than that of papaverine, absorption is faster and more complete, it binds less to blood plasma proteins. The advantage of drotaverine, unlike papaverine, is that after its parenteral administration there is no such side effect as stimulation of respiration.
Pharmacokinetics. Drotaverine is quickly and completely absorbed after parenteral and oral administration. It binds to a high degree (95-98%) with blood plasma proteins, especially albumin, gamma and beta globulins. After primary metabolism, 65% of the administered dose enters the blood circulation unchanged. Metabolized in the liver. The half-life is 8-10 hours.
Within 72 hours, drotaverine is almost completely eliminated from the body, more than 50% is excreted in the urine and approximately 30% in feces. Drotaverine is mainly excreted in the form of metabolites and is not found in unchanged form in the urine.
Indications for use of the drug No-shpa
Pills. For therapeutic purposes in adults and children over 1 year of age with:
- spasms of smooth muscles associated with diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis;
- spasms of smooth muscles in diseases of the urinary tract, cystitis, bladder tenesmus.
As an auxiliary treatment for:
- spasms of smooth muscles of the gastrointestinal tract: gastric and duodenal ulcers, gastritis, cardio- and/or pylorospasm, enteritis, colitis, spastic colitis with constipation and irritable bowel syndrome accompanied by flatulence;
tension headaches; - gynecological diseases (dysmenorrhea).
Solution for injections. Spasms of smooth muscles associated with diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis.
Spasms of smooth muscles in diseases of the urinary tract: nephrolithiasis, urethorolithiasis, pyelitis, cystitis, bladder tenesmus.
During uncomplicated labor at the dilatation stage: to reduce the cervical dilatation phase and the duration of labor.
As an auxiliary treatment (when the use of the drug in tablet form is not possible):
for spasms of smooth muscles of the gastrointestinal tract: gastric and duodenal ulcers, gastritis, cardio- and/or pylorospasm, enteritis, colitis;
for gynecological diseases: dysmenorrhea, severe labor pains.
Use of the drug No-shpa
Pills. Adults: The usual average dose is 120-240 mg per day in 2-3 divided doses.
Children aged 1-6 years: The usual average dose is 40-120 mg per day in 2-3 divided doses. Children over 6 years old: The usual average dose is 80-200 mg per day in 2-5 divided doses.
Solution for injections: The usual average daily dose for adults is 40-240 mg (in 1-3 separate administrations) IM.
For attacks of renal or hepatic colic - 40-80 mg IV slowly.
To reduce the dilatation phase of the cervix during uncomplicated labor at the beginning of the dilatation stage - 40 mg IM. If this dose is ineffective, another 40 mg of No-Shpa is administered at intervals of 2 hours.
Contraindications to the use of the drug No-shpa
Hypersensitivity to drotaverine or any component of the drug, severe liver, kidney or heart failure (low cardiac output syndrome). Lactase deficiency, galactosemia or glucose/galactose malabsorption syndrome. Breastfeeding period. Children under 1 year of age.
Side effects of the drug No-shpa
Side effects observed in clinical studies and caused by taking drotaverine are classified by organs and systems, as well as by frequency of occurrence: very often (≥1/10), often (≥1/100, but ≤1/10), infrequently (≥ 1/1000, but ≤1/100), rare (≥1/10,000, but ≤1/1000), very rare (≤1/10,000), including isolated cases.
Gastrointestinal disorders: rarely - nausea, constipation.
From the nervous system: rarely - headache, dizziness, insomnia.
From the cardiovascular system: rarely - tachycardia, arterial hypotension.
From the immune system: isolated: allergic reactions, especially in patients with hypersensitivity to metabisulfite.
Special instructions for the use of the drug No-shpa
Each tablet of No-Shpa contains 52 mg of lactose. When used according to recommended doses, up to 156 mg of lactose can enter the body at one time, which can cause gastrointestinal complaints in patients with lactose intolerance.
Do not use for the treatment of patients with congenital lactase deficiency, galactosemia or glucose-galactose malabsorption syndrome.
Use with caution to treat children, since no studies have been conducted on the effect of drotaverine on children.
Use with caution in case of hypotension.
Due to the risk of collapse during intravenous administration of the drug No-Shpa, the patient should be in a supine position.
The drug contains metabisulfite, which may cause allergic-type reactions, including symptoms of anaphylactic shock and bronchospasm, especially in patients with a history of asthma or allergies. In case of hypersensitivity to sodium metabisulfite, parenteral administration of the drug should be avoided.
You need to be careful when administering the drug parenterally to women during pregnancy.
Use during pregnancy and lactation. As shown by the results of retrospective clinical studies, oral administration of the drug did not have a teratogenic or embryotoxic effect. However, caution should be exercised when prescribing the drug to women during pregnancy.
Due to the lack of relevant research data, administration of the drug during breastfeeding is not recommended.
Impact on the ability to drive a car and perform work that requires increased attention. If patients experience dizziness after using the drug, they should avoid potentially dangerous activities. It is necessary to warn patients that after parenteral, especially intravenous administration of the drug, it is recommended to refrain from driving and performing work that requires increased attention.
Interactions of the drug No-shpa
PDE inhibitors (No-Shpa, papaverine) reduce the antiparkinsonian effect of levodopa. Caution must be exercised when using the drug simultaneously with levodopa, since the antiparkinsonian effect of the latter is reduced and an increase in tremor and rigidity is observed.
Overdose of the drug No-shpa, symptoms and treatment
There is no data regarding an overdose of drotaverine. In case of overdose, the patient should be under close medical supervision and receive symptomatic and supportive treatment. It is recommended to induce vomiting and/or lavage the stomach.
Storage conditions for the drug No-shpa
In a place protected from light at a temperature of 15-25 °C.
List of pharmacies where you can buy No-shpa:
- Saint Petersburg
