Noshpa indications. Registration of the drug and permits for its use. No-spa - mechanism of action

No-spa is an antispasmodic that has an effective myotropic effect on the smooth muscles of organs and blood vessels.

At the same time, this medicine does not affect the central nervous system, but only reduces the tone of smooth muscles and moderately dilates blood vessels. In terms of its effectiveness, the medicine is in many ways superior to the well-known papaverine - the instructions for use of No-shpa state that the drug can be used even when other antispasmodics are prohibited.

In this article we will look at why doctors prescribe the drug No-shpa, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Noshpa, leave your feedback in the comments.

Composition and release form

Pharmacological group: myotropic antispasmodic. Forms of release of the drug:

• No-Shpa Forte tablets No. 20, 10 pcs. in blisters, 2 blisters in a cardboard box;
• No-Shpa tablets, 6 or 24 pcs. in blisters, 1 blister per package, 60 pieces in polypropylene bottles equipped with a piece dispenser, 1 bottle per pack;
• No-Shpa injections, No. 25 (5×5), 2 ml in an ampoule, 5 ampoules (located in a tray), in cardboard box 5 pallets.

Tablet composition: 40 mg drotaverine (in the form of hydrochloride), magnesium stearate, povidone, talc, corn starch, lactose (in the form of monohydrate). Forte tablets have an identical composition. The only difference is more high concentration active substance (80 mg/tab.).

Composition of No-Shpa in ampoules: drotaverine hydrochloride at a concentration of 20 mg/ml, 96% ethanol, sodium metabisulfite, water for injection.

What is No-shpa used for?

The drug is effective in such cases:

• spasms of smooth muscles of the urinary system: urolithiasis, pyelitis, cystitis, tenesmus Bladder.
• smooth muscle spasms associated with diseases of the biliary tract: cholelithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis.
• during physiological childbirth - shortening the dilation phase of the cervix and thereby reducing total duration childbirth (for solution for intravenous and intramuscular administration).

As an adjuvant therapy No-spa helps in such situations:

• tension headaches (for oral administration).
• at gynecological diseases(dysmenorrhea).
• strong labor pains (for solution for IV and IM administration).
• with spasms of smooth muscles of the gastrointestinal tract: gastric ulcer and duodenum, gastritis, spasms of the cardia and
• pylorus, enteritis, colitis, accompanied by constipation and flatulence.

When used as an adjuvant, the drug is administered parenterally if it is not possible to use tablets.

pharmachologic effect

Myotropic antispasmodic. By chemical structure And pharmacological properties close to papaverine, but has a stronger and longer-lasting effect. Reduces the entry of Ca2+ into smooth muscle cells (inhibits PDE, leads to the accumulation of intracellular cAMP). Reduces smooth muscle tone internal organs and intestinal peristalsis, dilates blood vessels. Does not affect the autonomic nervous system, does not penetrate the central nervous system.

The presence of a direct effect on smooth muscles allows its use as an antispasmodic in cases where drugs from the group of m-anticholinergics are contraindicated (angle-closure glaucoma, prostatic hypertrophy).
With intravenous administration, the onset of effect is after 2-4 minutes, the maximum effect develops after 30 minutes.

Instructions for use

If you plan to use No-shpa for treatment, the instructions for use should be taken into account.

• According to the instructions, No-shpu is prescribed orally in a dosage of 120-240 mg (daily dose), which is taken two or three times a day. Maximum permissible single dosage No-shpa tablets are 80 mg, and the daily dose is 240 mg.
• The drug is administered intramuscularly to adults in a volume of 40-240 mg/day for 1-3 administrations. For acute biliary and renal colic the drug is administered intravenously at a dosage of 40-80 mg over 30 seconds.
• For children under 6 years of age when taken orally, a single dose is 10-20 mg, 6-12 years old - 20 mg, frequency of use 1-2 times a day.

When using the product independently, without a doctor’s prescription, it should be taken into account that therapy should last no more than one or two days. If after this period the pain has not been relieved, you should seek medical advice. medical assistance to clarify or clarify the diagnosis.

Contraindications for use

You should not use the drug in the following cases:

• severe renal or heart failure;
• children under 6 years of age (tablets), not prescribed in the form of a solution until 18 years of age;
• lactation period (due to the lack of clinical data on the penetration of the drug into mother’s milk);
• hereditary intolerance to the monosaccharide galactose, glucose-galactose malabsorption syndrome, lactase deficiency (for tablets);
• hypersensitivity to sodium disulfite (for solution).

Pregnancy and lactation

Use with caution during pregnancy and lactation (breastfeeding).

Side effect

When using the drug, you must follow the dosage indicated in the instructions for use, otherwise the following may develop: adverse reactions:

• from the gastrointestinal tract: rarely: nausea, constipation
• from the cardiovascular system:
• from the nervous system: rarely: headache, dizziness, insomnia
• rarely: increased heart rate, decreased blood pressure. If side effects occur, you must stop taking the drug.

If side effects not mentioned in the instructions occur, you must inform your doctor.

Analogs

Most famous Russian analogue No-Shpy is Drotaverine. Other generics of the drug: Vero-Drotaverine, Bioshpa, Nosh-Bra, Ple-Spa, Spasmonet, Spasmol, Spazoverine, Spakovin.

Prices

The average price of NO-SPA in pharmacies (Moscow) is 178 rubles.

Drotaverine or No-shpa

Drotaverine is a generic drug offered to the consumer under an international, and therefore non-proprietary, name. The clinical effectiveness of generics is not fully proven, since less stringent requirements are put forward for this group of drugs.

No-shpa is original drug, patented dosage form. Having a patent is not just an excuse high cost drug, but also certain obligations that are imposed on the manufacturer: the quality of raw materials, production control, the safety of the drug must be at top level. In order to obtain a patent, a drug must meet a number of strict requirements and undergo the necessary clinical trials.

It turns out that the patented drug is subjected to more tests before hitting the pharmacy counter. However, this does not mean that the generic drug has a negative impact on health.

Storage conditions

Store at temperatures between 15 and 25°C. Protect tablets from light. The shelf life of the tablet is five years. Solution - three years.

Terms of sale

Tablets 40 and 80 mg - without a prescription. Injection form - according to prescription.

No-SPA (NO-SPA) is a popular drug that has a rapid antispasmodic effect on smooth muscles. It is applied for:

• etiotropic therapy to eliminate spasm muscle tissue, which serves as the basis of the pathological condition;
• symptomatic treatment of smooth muscle spasm, which is a symptom of the disease without affecting its pathogenesis;
• premedication during patient preparation to some procedures (ureteral catheterization, urethra etc.).

Since the drug acts exclusively on smooth muscles, it is practiced in situations where there are contraindications to antispasmodics from the group of anticholinergics (prostatic hypertrophy,).

Pharmacological group: myotropic antispasmodic.

Drotaverine or No-shpa

Surely each of us has had to take the famous yellow pills with a special aftertaste for certain health problems. The drug contains the active ingredient drotaverine, and it is under this name that the most popular competitor of No-shpa and an analogue in composition is produced. What is the difference between Drotaverine and No-shpa?

Having studied the instructions for the drugs, it becomes clear that the composition, the principle of action, and the effect produced are similar. Therefore, a reasonable question arises: does it make sense to overpay for No-shpu?
No-spa is an original drug, a patented dosage form. The presence of a patent is not only a justification for the high cost of the drug, but also certain obligations that are imposed on the manufacturer: the quality of raw materials, production control, and the safety of the drug must be at the highest level. In order to obtain a patent, a drug must meet a number of strict requirements and undergo the necessary clinical trials.

Drotaverine is a generic drug offered to the consumer under an international, and therefore non-proprietary, name. The clinical effectiveness of generics is not fully proven, since less stringent requirements are put forward for this group of drugs.

It turns out that a patented drug undergoes more testing before it hits the pharmacy counter. However, this does not mean that the generic drug has a negative impact on health.

Physico-chemical properties, composition, price

The drug is available in two dosage forms– tablets for internal use and solution for intramuscular and intravenous administration.

	Main substance	Excipients	Physicochemical characteristics
No-spa tablets 6, 20, 24 tablets in aluminum blisters. 60, 100 tablets in polypropylene bottles, in cardboard packs. No. 6: 50-70 rub; No. 24: 180-220 rub.	Drotaverine hydrochloride: 40 mg	Magnesium stearate 3 mg, corn starch 35 mg, talc 4 mg, povidone 6 mg, lactose monohydrate 52 mg.	Yellowish-greenish tablets, round, biconvex, engraved with “spa” on one side.
Solution 2 ml in glass ampoules made of dark glass with a break notch. 5 ampoules per package, in cardboard packs. No. 25: 450-480 rub.	Drotaverine hydrochloride: 20 mg in 1 ml or 40 mg in 1 ampoule	Sodium disulfite 2 mg, 96% ethanol - 132 mg, liquid water - up to a volume of 2 ml.	Transparent greenish-yellow solution.

pharmachologic effect

Drotaverine hydrochloride is an isoquinoline derivative with a powerful antispasmodic effect on smooth muscles. This effect is possible due to the inhibition of an enzyme called PDE (phosphodiesterase).

PDE is involved in the hydrolysis reaction of cAMP to AMP. Inhibition of phosphodiesterase is characterized by an increase in the concentration of cAMP, which triggers chain reaction. High concentrations of cAMP are an activator of cAMP-dependent phosphorylation of MLCK (myosin light chain kinase). This leads to a decrease in the affinity of MLCK for the Ca2+-calmodulin complex, and inactivated form MLCK creates muscle relaxation.

cAMP affects the cytosolic concentration of Ca2+ ion, lowering it. This is due to the stimulation of Ca2+ transport into the sarcoplasmic reticulum and extracellular space.

The effectiveness of drotaverine hydrochloride depends on the concentration of the phosphodiesterase enzyme in tissues, which varies significantly.

Hydrolysis of cAMP in cardiac muscle tissue and vascular smooth muscle is carried out using the PDE3 isoenzyme. This explains the absence of serious adverse reactions from the cardiovascular system with high antispasmodic activity.

Selective PDE4 inhibitors, which is drotaverine, can reduce the sensitivity of the uterus to the action of the hormone oxytocin and lead to accelerated relaxation of the muscle tissue of the organ, which helps stop premature birth.

In addition to the antispasmodic effect, drotaverine reduces swelling and inflammation in muscle tissue. Elimination of spasm leads to improved blood supply to organs. The drug is effective for pain, and also helps restore the passage of the internal contents of hollow organs.

At the same time, drotaverine does not directly interfere with the mechanism pain sensitivity and does not erase symptoms acute conditions unlike analgesics.

The effectiveness of drotaverine is high for spasms of smooth muscle tissue of neurogenic and muscular origin. No-spa relaxes smooth muscle fibers Gastrointestinal tract, genitourinary and biliary tract.

Pharmacokinetics

After oral administration, the active substance is completely and quickly absorbed, distributed evenly throughout the tissues and penetrates into smooth muscle cells. About 65% enters the blood active substance. Maximum concentration in the blood is determined 45-60 minutes after administration. Passes slightly through the placental barrier. Does not enter the central nervous system and does not affect the autonomic nervous system.

When administered intravenously or intramuscularly, drotaverine binds to plasma proteins by 95-98%, achieving maximum effect in 30 minutes.

Metabolism of the substance occurs in liver cells through O-deethylation reactions. Drotaverine metabolites are conjugated with glucuronic acid.

It is excreted by the kidneys (more than 50%) and intestines (30%) in the form of metabolites, complete elimination occurs within 72 hours.

Indications for use

The instructions for use of No-shpa indicate the following readings for etiotropic therapy:

• Spasms of smooth muscle tissue in diseases of the biliary tract: cholangiolithiasis, cholecystolithiasis, pericholecystitis, cholecystitis, cholangitis, papillitis;
• Spasms of smooth muscle tissue in pathologies of the urinary system: nephrolithiasis, pyelitis, urethrolithiasis, cystitis, spasms and tenesmus of the bladder;

What else does No-shpa help with? As an auxiliary therapy drug (tablets or solution if it is impossible to take tablets):

• for spasms of smooth muscle tissue of the gastrointestinal tract: gastritis, peptic ulcer and duodenum, spasms of the pylorus and gastric cardia, colitis, spastic colitis with constipation, enteritis, dysfunction of the sphincter of Oddi, irritable bowel syndrome;
• for tension headaches (tablet form). No-spa is not effective for headaches associated with migraine or increased ICP;
• with dysmenorrhea.

Contraindications

• severe renal or heart failure;
• children up to 6 years of age (tablets). Nosh-pa in the form of a solution is not prescribed to children under 18 years of age;
• lactation period (due to the lack of clinical data on the penetration of the drug into mother’s milk);
• hereditary intolerance to the monosaccharide galactose, glucose-galactose malabsorption syndrome, lactase deficiency (for tablets);
• hypersensitivity to sodium disulfite (for solution).

special instructions

The drug is prescribed with caution when arterial hypotension, since there is a risk of collapse during pregnancy and pediatrics. When administered intravenously, people with low blood pressure should be in a supine position.

There may be complaints of gastrointestinal dysfunction when using the drug in people with lactose intolerance (52 mg of lactose per 1 tablet).

The tablet form does not affect the ability to perform work that requires significant concentration and drive a car. After parenteral administration of No-shpa, you should refrain from precision work and driving.

No-spa during pregnancy

Very often the drug is prescribed for early stages pregnancy with uterine tone to reduce the threat of spontaneous miscarriage.

Animal studies and retrospective data on clinical application drotaverine in pregnant women indicate that the drug in therapeutic dosages had neither embryotoxic nor teratogenic effects on the fetus. But, since the drug penetrates the placenta to some extent, the prescription is justified if there is a real risk of miscarriage.

The drug cannot be used during labor activity, since there is a risk of developing atonic bleeding in the postpartum period.

Dosage of No-shpa

The duration of treatment is individual. You can take the drug on your own for 1-3 days.

For tablets

• Adult patients: 120-240 mg per day, dividing the dose into 2-3 doses. Maximum dose for a single dose – 80 mg.
• Children 6-12 years old: 80 mg per day, divided into 2 doses.
• Children over 12 years old: 160 mg per day, divided into 2-4 doses.

For maximum effectiveness, the drug is taken 1 hour after a meal with a sufficient amount of water.

For solution

Adult patients: 40-240 mg per day, divided into 1-3 administrations. For acute spasmodic pain, the drug is administered intravenously slowly, with a dose of 40-80 mg over 30 seconds. IM injections are administered without diluting the solution with other drugs.

The patient himself can usually assess the effectiveness of the drug by observing a significant decrease or disappearance of the spasmodic pain syndrome within several hours after taking the tablet or injection.

Side effects

• CVS: tachycardia or decreased blood pressure is rarely observed;
• Nervous system: insomnia, headache and dizziness are rarely observed;
• Gastrointestinal tract: sometimes there is nausea and constipation;
• The immune system: rarely develop allergic reactions(rash, itching). There have been cases anaphylactic shock With fatal and without it (frequency unknown). In persons with bronchial asthma or allergy sufferers may develop bronchospasm when using a solution of the drug.
• Local reactions: swelling at the injection site.

Overdose

If significantly exceeded therapeutic dose disturbances in cardiac conduction and rhythm develop up to complete blockade bundle branches and cardiac arrest. Treatment is only inpatient.

Drug interactions

• Levodopa – weakening of the antiparkinsonian effect, increased rigidity and tremor;
• Other antispasmodics– increased antispasmodic effect;
• Tricyclic antidepressants– increased arterial hypotension (only when combined with No-shpa solution);
• Morphine – decrease in spasmogenic activity (only when combined with No-shpa solution);
• Phenobarbital – enhances the antispasmodic effect of No-shpa;
• Drugs that bind to plasma proteins– pharmacodynamic and toxic effects of these drugs may occur.

Analogs

No-shpa forte, Drotaverin, Drotaverin-Forte, Spasmonet, Drotaverin-sti, Spasmol.

Drotaverine hydrochloride 40 mg. 20 tab. 12-20 rub.	Spasmonet 40 mg. 20 tab. 55-80 rub.	Drotaverine forte 80 mg. 20 tab. 50 rub.	Spasmol 40 mg. 20 tab. 32 rub.

The drug no spa is widely advertised today on television screens and on the pages fashion magazines. This medicine is presented as a real panacea for all diseases and problems. But this is far from true. In practice, the drug but spa has a large number of contraindications and should be taken only after consulting a doctor and full examination your body. In particular, the instructions for use recommend using no-spa tablets no more than once a day to relieve pain before going to the doctor. It is not permissible when the spa is used in the form of everyday “vitamins” or food supplements.

First of all, this drug is able to effectively mask various symptoms serious illnesses, such as liver cancer, stomach cancer, kidney cancer and many other neoplasms. Is it worth risking your health like that?

The second point is that the drug, the use of which should be limited in persons with allergic reactions, can cause anaphylactic shock. The drug but spa in injections is especially dangerous for people who suffer from bronchial asthma or other problems with respiratory system. However, their use may cause respiratory arrest or obstruction. respiratory tract With pulmonary edema and death.

Less dangerous, but no less unpleasant consequences can cause noshpa in tablets. It contains lactose, which is contraindicated for anyone who suffers from intolerance. cow's milk. In such persons, the use of no spa can cause persistent impairment of activity intestinal tract, accompanied loose stools And severe pain in a stomach.

And that's just small part those consequences of the drug Noshpa, the instructions for use about which the attending physicians and their patients are informed. Therefore, you should not always blindly trust what you are told from the TV screen. In relation to tablets but spa, this is definitely not worth doing. Next, we will look in more detail at where no-spa finds its application, how to take no-spa tablets and in what cases you should immediately consult a doctor. We will also answer the questions that you send us by email about the drug no spa.

Instructions for use

Tablets but spa are classified as antispasmodics. The active ingredient is drotaverine hydrochloride, it is similar. Therefore, it is a direct analogue of noshpa. After hitting gastrointestinal tract, but spa tablets are quickly absorbed into the blood and act on smooth muscles, relaxing them.

Usually one tablet contains 40 or 80 mg. For quick removal pain syndrome, you can take 1 tablet but spa 80 mg or 2 tablets but spa 40 mg.

The instructions for use recommend using tablets for diseases such as:

• painful menstruation;
• gallbladder spasms;
• pain in the kidneys and bladder;
• spasm of cerebral vessels and resulting headache.

Tablets but spa instructions for use do not refer to medicinal drugs. This symptomatic remedy, which does not provide therapeutic effects. Tablets but spa can only a short time take off pain syndrome. After the effect of drotaverine wears off, the pain will return again. Therefore, spa can only be used as aid. It is necessary first of all to eliminate the cause of the pain, that is, take specific treatment.

But spa in ampoules instructions for use

The drug no spa in ampoules has similar to tablets antispasmodic effect. But this form medicinal substance is used much more widely. In particular, noshpa in ampoules can be used for conditions such as:

• attack of gallstone disease;
• urolithiasis, including when a stone moves through the ureter;
• postoperative conditions;
• preparation for childbirth to speed up the process of opening the cervix;
• after abortion;
• during therapy peptic ulcer stomach and duodenum.

The drug no spa in ampoules can be used for intravenous and intramuscular administration. For intravenous administration, it is necessary to use saline solution to dilute the drug. Sometimes noshpa in ampoules is made in the form of droppers to prolong the action of the medicinal substance. But spa in ampoules contains 40 mg of drotaverine in one unit.

Indications and dosage

The pharmacological drug but spa has a wider application than described above. Wherever a person has smooth muscles, this drug can help relieve painful spasms. In particular, no spa can be used in the treatment of spastic colitis, accompanied by constipation and difficulties with bowel movements. Also, the drug no spa helps relieve headaches and toothache. We cannot replace this drug for cuts, especially deep ones that affect muscle fibers.

For various dislocations and sprains, the spa effectively relieves pain.

The main advantage that the use of no spa has over non-steroidal anti-inflammatory drugs is complete absence negative impact on the organs of the gastrointestinal tract.

Price

For Noshpa tablets and injections, the price depends on the amount of active ingredient and the number of tablets or ampoules in the package. Today, the price for no sips can be quite affordable. If you want to have a small supply in your first aid kit this drug to relieve sudden pain, then buy a small package of 20 or 5 tablets. In this case, the price for the drug no spa will be quite affordable. A full package of shpa contains 100 tablets and its cost can reach up to 200 rubles.

Contraindications during pregnancy and breastfeeding

Instructions for use but spa during pregnancy is prohibited. its use may provoke both spontaneous miscarriage, and weakness of labor activity subsequently.

When breastfeeding, taking the drug no spa is prohibited. This may cause negative effects in infant, ranging from stool disorder and ending with respiratory arrest

Injections and tablets for children

All injections and tablets but spa can be prescribed to children only by the attending physician under close control of the blood picture and monitoring their general condition. In children, no spa often causes allergic reactions. If a child suffers from lactose intolerance, then tablets are contraindicated for him.

The drug nospa is contraindicated for children under one year of age. At the age of 1 to six years, noshpa is given to children according to a special scheme. After six years of age, nospa can be given to children according to the recommendations of the attending physician. For more detailed dosage of noshpa for children, see the table on this page.

Contraindications for use

Absolute contraindications to the use of noshpa are:

• pregnancy;
• the period during which breastfeeding is performed;
• infancy;
• lactose intolerance when using noshpa tablets;
• bronchial asthma;
• heart rhythm disturbances;
• low blood pressure.

Application of medicine in practice in questions and answers:

We tried to give you everything necessary information so that you can independently decide for yourself how much you need a footwear, the use of which after reading this material will be safer for you.

In addition, we receive a large number of letters asking us to tell us about the drug Noshpa, the use of which is widespread today. We will try to fulfill your requests and tell you accessible language about this modern drug.

In what cases is the drug used during pregnancy?

The drug no spa is used during pregnancy in obstetric care. Noshpa during pregnancy and childbirth helps to speed up the opening of the cervix and relieve pain during labor.

Can the medicine be changed while breastfeeding?

Tablets and injections are strictly prohibited when breastfeeding. During lactation, but spa can come from breast milk baby

What are the dangers of the drug when breastfeeding?

Medicine but spa during breastfeeding is dangerous due to various devices in the baby. The child may vomit. Also, when breastfeeding, spasm can cause respiratory spasms and respiratory arrest in the baby.

What is more effective in pain relief: analgin, but spa or ketanov

The drugs analgin and but spa have different purposes. Their actions are completely different. If analgin blocks the production of substances that irritate nerve endings and cause pain, then the spa simply relieves spasm of smooth muscles. These are drugs that differ in their action. Where the spa is effective, analgin is useless. Just like where analgin is more effective, but the spa will not bring relief

Why is noshpa produced in ampoules?

The industry produces silo in ampoules so that it is possible to use this medicine for those who are lactose intolerant. There is no this substance in ampoules. Also, spa in ampoules allows you to achieve a faster effect using injections.

What diseases do injections help with?

No-spa injections help relieve spasms of smooth muscles, facilitate the process of childbirth and help a person after undergoing surgery on the abdominal or other cavity. Also, no-spa injections effectively relieve pain during urolithiasis and biliary colic.

Can noshpa injections lead to the death of a patient?

Such cases are quite rare in medical practice. Self-administered injections can lead to respiratory arrest and death of the patient from collapse or anaphylactic shock. You should not do spa injections yourself.

Is it true but spa is drotaverine

Indeed, but the spa is drotaverine hydrochloride. The main manufacturer of the drug is located abroad. This leaves an imprint on the cost, but the shpa can be replaced with more affordable domestic drotaverine.

In what cases does it help with headaches?

Practical help of medicine no spa for headaches is achieved by eliminating spasm of cerebral vessels. After blood flow is restored, the supply of oxygen to the cerebral cortex and other tissues improves, and decay products begin to be eliminated in a timely manner. The headache goes away. But spa for headaches also helps if the pain syndrome is caused by high blood pressure.

What analogue exists

There is more than one analogue but spa. A direct analogue of no spa is drotaverine hydrochloride. Not a direct analogue but shpy - .

Will the drug help with menstruation?

If you have painful menstruation, then the spa will help. But you should not abuse this remedy. No more than three tablets per person menstrual cycle. Only in this case, the noshpa during your period will help you for the tenth and hundredth time.

In this medical article you can familiarize yourself with the drug No-shpa. The instructions for use will explain in what cases you can take injections in ampoules or tablets, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about No-shpa, from which you can find out whether the medicine helped in the treatment and relief of spasmodic pain in adults and children, for which it is also prescribed. The instructions list analogues of No-shpa, prices of the drug in pharmacies, as well as its use during pregnancy.

Noshpa is an effective antispasmodic agent. Instructions for use prescribe taking 40 mg tablets, 80 mg forte (half an hour after meals), injections in injection ampoules for the treatment of disorders and pain conditions provoked by muscle spasms.

Release form and composition

No-spa is produced in the following dosage forms:

1. Tablets 40 mg.
2. Tablets No-shpa forte 80 mg.
3. Solution for intravenous and intramuscular injection(injections in injection ampoules).

Composition of tablets: 40 mg of drotaverine (in the form of hydrochloride) - active substance.

Forte tablets have an identical composition. The only difference is the higher concentration of the active substance (80 mg/tablet).

Composition of No-Shpa in ampoules: drotaverine hydrochloride at a concentration of 20 mg/ml, 96% ethanol, sodium metabisulfite, water for injection.

pharmachologic effect

No-spa dilates blood vessels, reduces muscle tone of internal organs, reduces intestinal peristalsis, while the drug does not affect the central nervous system. Active substance The drug is drotaverine hydrochloride, which is close in action to papaverine, but is characterized by a more pronounced, long-lasting effect. At intravenous administration therapeutic effect occurs in 2-4 minutes.

What does No-shpa (tablets and injections) help with?

Indications for the use of No-shpa are the prevention and treatment of organ functional disorders and pain caused by muscle spasms:

• hepatobiliary system with inflammation of the gallbladder or its ducts, hyperkinetic form of biliary dyskinesia, cholelithiasis;
• urinary system with kidney stones, urolithiasis, pyelitis, cystitis, neurogenic bladder;
• digestive tract for ulcers, dyskinesia, gastritis, pancreatitis, spastic enteritis, colitis or proctitis, as well as for spasms of the cardia or pylorus, irritable bowel syndrome, flatulence, spastic constipation, tenesmus.

Indications for treatment of the reproductive system with the drug are as follows:

• spasm of the uterine pharynx during childbirth;
• threatened abortion;
• excitability of the uterus during pregnancy;
• prolonged opening of the uterine pharynx;
• pain during menstruation;
• afterpains.

No-shpa is also used for peripheral and cerebral vessels, postoperative colic as a result of gas retention, postcholecystectomy syndrome, preparation for instrumental research.

Instructions for use

No-spa for adults when taken orally is prescribed in daily dose 120-240 mg (in 2-3 doses). The maximum single dose is 80 mg. The maximum daily dose is 240 mg. The average daily dose for intramuscular administration in adults is 40-240 mg (divided into 1-3 administrations per day).

At acute colic(renal or biliary) the drug is administered intravenously slowly at a dose of 40-80 mg (duration of administration 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.

When taking the drug without consulting a doctor, the recommended duration of taking the drug is usually 1-2 days. If pain does not decrease during this period, 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.

How to take No-shpa: before meals or after?

The instructions for use recommend taking the tablets 0.5 - 1 hour after meals.

Contraindications

• lactase deficiency, galactose intolerance, glucose/galactose malabsorption syndrome (for tablets);
• severe forms of renal and liver failure;
• hypersensitivity to drotaverine or any other substance in the solution/tablets;
• low cardiac output.

The medicine is prescribed with caution to pregnant women, children and persons suffering from arterial hypotension.

Side effects

• headache;
• dizziness;
• insomnia;
• nausea;
• decrease in blood pressure;
• cardiopalmus.

Children, pregnancy and breastfeeding

As studies of reproduction in animals and retrospective data on clinical use have shown, 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 potential benefit 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).

According to the annotation, there are no restrictions on the use of the solution for IM and IV administration in pediatrics. 40 mg tablets are prescribed to children from the age of six. Clinical studies of the safety and effectiveness of Forte tablets in children have not been conducted.

Indications for use in pediatric practice

It is advisable to give medicine to children for cystitis and nephrolithiasis, sudden spasms of the duodenum or stomach, gastritis, enteritis, colitis, flatulence, constipation, spasm of peripheral arteries, high temperature and severe headaches.

For children from one to six years of age, a single oral dose is 0.5-1 tablet. You should take the medicine 2 or 3 times a day. To kid school age No-Shpu is given from 2 to 5 r/day. a whole tablet.

special instructions

Required to comply increased measures caution when treating patients suffering from atherosclerosis coronary vessels or low blood pressure.

The use of an antispasmodic during labor can provoke the development of postpartum atonic bleeding.

In the preparation as excipient contains sodium disulfite (metabisulfite), which must be taken into account if you have hypersensitivity to it. No-shpu can be used in complex treatment hypertensive crisis.

According to numerous studies, No-shpa does not have teratogenic or embryotoxic effects. However, you need to remember the possible risks to the fetus, and use the product only according to strict indications and with caution. The use of the drug during pregnancy in the form of injections is undesirable.

When administering No-shpa parenterally, patients suffering from hypotension should be positioned horizontally due to the likelihood of collapse.

The issue of driving a vehicle when using the drug is decided individually, especially when it appears negative influence. It is advisable to refrain from driving and working with complex mechanisms when using an antispasmodic in injection form. If dizziness develops after using No-shpa, driving and performing this type of work is prohibited.

Drug interactions

Like other PDE inhibitors similar to papaverine, drotaverine weakens the antiparkinsonian effect of Levodopa. When taking these drugs in combination, tremor and rigidity may increase.

In combination with other antispasmodics (including m-anticholinergic blockers), a mutual enhancement of the antispasmodic effect is noted. Substantial part dose taken drotaverine is in a state associated with plasma proteins (mainly with β-, γ-globulins and albumin).

Analogues of the drug No-shpa

Analogues are determined by structure:

1. NOSH-BRA.
2. Spakovin.
3. Drotaverine hydrochloride.
4. Drotaverine forte.
5. Spasmonet.
6. Vero-Drotaverine.
7. Drotaverine.
8. Spasmonet forte.
9. Spazoverin.
10. Spasmol.
11. Ple-Spa.
12. Droverin.

Vacation conditions and price

The average price of No-shpa (40 mg tablets No. 6) in Moscow is 67 rubles. Tablets of 40 and 80 mg are sold without a prescription. The injection form is available with a doctor's prescription.

Ampoules should be stored at a temperature of 15-25 degrees, protected from sunlight and children's access. The antispasmodic is suitable for use for 5 years from the date of release.

Compound medicinal product NO-SHPA

NO-SHPA®

table 40 mg, No. 20 6.81 UAH.

table 40 mg, No. 100 20.38 UAH.

Drotaverine hydrochloride 40 mg

Other ingredients: magnesium stearate, talc, lactose, corn starch, povidone.

No. P.01.03/05723 from 01/10/2003 to 01/10/2008

solution d/in. 40 mg amp. 2 ml, No. 25 42.82 UAH.

Drotaverine hydrochloride 20 mg/ml

Other ingredients: sodium metabisulfite, ethyl alcohol 96%, water for injection.

No. P.01.03/05724 from 08/17/2007 to 08/17/2011

NO-SHPA® FORTE

table 80 mg, No. 10

table 80 mg, No. 20 12.31 UAH.

Drotaverine hydrochloride 80 mg

Other ingredients: magnesium stearate, talc, povidone, corn starch, lactose.

Dosage form

pills

Pharmacological properties

drotaverine - antispasmodic, an isoquinoline derivative, acts directly on smooth muscle by inhibiting phosphodiesterase and intracellular cAMP accumulation, resulting in smooth muscle relaxation due to inactivation of myosin light chain kinase. The antispasmodic effect of drotaverine does not depend on the nature of the autonomic innervation; the drug is active against the smooth muscles of the gastrointestinal, biliary, urogenital and cardiovascular systems.

Drotaverine is rapidly absorbed both parenterally and oral administration. The maximum concentration in the blood serum is achieved 45–60 minutes after oral administration. Metabolized in the liver. The half-life is 16–22 hours. In 72 hours, it is almost completely excreted from the body, about 50% in urine, 30% in feces. Mainly in the form of metabolites; unchanged form is not detected in urine. Drotaverine and/or its metabolites practically do not penetrate the placental barrier.

Indications for use of NO-SPA

No-Shpa

Smooth muscle spasms caused by diseases biliary tract- cholelithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis; to reduce the cervical dilatation phase of physiological labor and the duration of labor; in the placental stage of labor to facilitate the administration of Crede and prevent incarceration; spasms of smooth muscles of the urinary tract with nephrolithiasis, urethrolithiasis, pyelitis, cystitis, bladder tenesmus. The drug can be used as an adjuvant therapy for spasms of smooth muscles of the digestive tract - with peptic ulcer stomach and/or duodenum, gastroduodenitis, enteritis, spastic colitis, cardiospasm and pyloric spasm, irritable bowel syndrome, spastic constipation, flatulence, pancreatitis; for gynecological diseases - dysmenorrhea, adnexitis, severe painful labor contractions, uterine tetany, threatened abortion; for headaches of vascular origin.

No-Shpa Forte

Spasms of smooth muscles caused by diseases of the biliary tract, cholelithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis. Spasms of smooth muscles of the urinary tract with nephrolithiasis, urethrolithiasis, pyelitis, cystitis, bladder tenesmus. The drug is effective and safe when used as an adjuvant therapy for spasms of smooth muscles of the gastrointestinal tract - peptic ulcers of the stomach and duodenum, gastritis, enteritis, colitis, cardiospasm and pyloric spasm, irritable bowel syndrome, spastic constipation or flatulence, pancreatitis; for gynecological diseases - dysmenorrhea, adnexitis; for headaches of vascular origin.

Contraindications

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.

Cautions for use

the drug can cause dyspeptic symptoms in patients with lactose intolerance due to its content in the tablets. In case of arterial hypotension, use with caution. IV is administered only in the supine position (risk of collapse). When hypersensitivity sodium metabisulfite should be avoided parenteral use drug. After parenteral, especially intravenous, administration of the drug, it is recommended to refrain from administering it for 1 hour. vehicles and performing work that requires increased attention.

The experiment did not establish the presence of teratogenic and embryotoxic effects in the drug. Does not affect the course of pregnancy. During breastfeeding, the drug should be prescribed taking into account the risk-benefit ratio.

Interactions with drugs

Caution must be exercised when using No-Shpa simultaneously with levodopa, since the antiparkinsonian effect of the latter is reduced and an increase in tremor and rigidity is observed.

Directions for use and dosage of NO-SPA

No-Shpa

Adults orally - 120–240 mg/day in 2–3 doses. For attacks of renal or hepatic colic, 40–80 mg (2–4 ml) are administered slowly (over 30 s), usually in combination with analgesics. For other spastic conditions, administer intramuscularly or subcutaneously at a dose of 40–80 mg; if necessary, re-administer the same dose up to 3 times a day, or subsequently administer orally at a daily dose of 120–240 mg.

To facilitate cervical dilatation during childbirth, a dose of 40 mg is administered intramuscularly at the beginning of labor. If this dose is ineffective, re-administer the same dose after 2 hours.

Children aged 1 year - 6 years orally - 40-120 mg / day (2-3 times 1/2-1 tablet), over 6 years - 80-200 mg / day (2-5 times 1 tablet).

Side effects

side effects noted with clinical studies and caused by taking drotaverine, classified by organs and systems, as well as by frequency of occurrence: very often (≥1/10), often (≥1/100, but
Gastrointestinal disorders: rarely - nausea, constipation.

From the nervous system: rarely - headache, dizziness, insomnia.

From the cardiovascular system: rarely - tachycardia, arterial hypotension.