No-Shpa is an antispasmodic drug that has been produced for over 60 years and has many positive reviews from consumers. It is very popular in the CIS countries, Eastern Europe and Asia. According to English-language sources, the main active component of this medicine, drotaverine, is mainly used intravenously to relieve pain during labor. Numerous studies have shown that drotaverine is effective in various situations and take No-Shpu with:
- menstruation;
- stomach cramps;
- headache.
The drug is also completely safe for children. Let's consider all the features of But Shpa : method of use, contraindications, how it affects the body and how it interacts with other medications.
Release form
Forms of release of the drug:
- 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 Forte tablets No. 20, 10 pcs. in blisters, 2 blisters in a cardboard box;
- No-Shpa injections, No. 25 (5×5), 2 ml per ampoule, 5 ampoules (located in a tray), 5 trays in a cardboard box.
Tablets 40 mg are biconvex, round, yellow with an orange or greenish tint. Each tablet is engraved with "spa".
No-Shpa Forte is a biconvex, oblong-shaped tablet of yellow color with an orange or greenish tint. There is a fault line on one side and "NOSPA" is engraved on the other.
The drug in injection form has the appearance of a transparent yellow-green liquid.
Compound
The main active ingredient contained in the drug is drotaverine. This substance is a modified papaverine, a painkiller made from the opium poppy.
1 tablet of No-Shpa contains:
- drotaverine hydrochloride – 40 mg;
- magnesium stearate – 3 mg;
- talc – 4 mg;
- povidone – 6 mg;
- corn starch – 35 mg;
- lactose monohydrate – 52 mg.
The dosage form of the drug is convex yellow tablets with a greenish or orange tint and “spa” engraving on one side.
Pharmacodynamics and pharmacokinetics
Drotaverine is a myotropic antispasmodic . The action of the drug is aimed at reducing the tone and motor activity of the smooth muscles of internal organs. Moreover, these effects are accompanied by a moderate dilation of blood vessels.
Compared to Papaverine, it has greater antispasmodic activity and duration of action. There are no pronounced effects on the cardiovascular, central and autonomic nervous systems.
The drug is effective for both muscle spasms and spasms of neurogenic origin. Regardless of the type of autonomic innervation, it helps to relax the smooth muscles of the biliary tract, digestive and urogenital tracts.
Since drotaverine acts directly on smooth muscles, it can be used to relieve spasms even in cases where the use of drugs from the group of anticholinergics (for example, with prostatic hypertrophy or glaucoma ).
When taken orally, absorption of drotaverine is one hundred percent. The substance is absorbed from the digestive tract very quickly. During the first passage (passage) through the liver, only 65% of the dose enters the bloodstream. TCmax - from 45 minutes to 1 hour.
Drotaverine in tissues and penetrates smooth muscle cells. Does not pass through the BBB. The substance and/or products of its metabolism can pass through the placental barrier in small concentrations.
T1/2 - from 8 to 10 hours. Within 72 hours, the substance is almost completely eliminated from the body. More than half of the drug is excreted - mainly in the form of metabolites - by the kidneys, about a third - through the gastrointestinal tract (excretion into bile). Unchanged drotaverine is not found in urine.
Indications for use of No-Shpy
What do No-Shpy tablets help with?
Indications for use of No-Shpy:
- spasms of smooth muscles caused by diseases of the biliary tract ( cholecystitis , cholangitis , cholangiolithiasis , cholecystolithiasis , pericholecystitis , papillitis );
- spasms of smooth muscles of the urinary tract with cystitis , uro- and nephrolithiasis , pyelitis , bladder tenesmus .
As an addition to the main therapy, the drug can be used to relieve spasm of smooth muscles, which is caused by diseases of the stomach and intestines . Indications for use are: peptic ulcer , flatulent forms of spastic colitis , as well as SRCT with constipation , spasms of the pylorus and cardia .
In addition, it is advisable to take No-Shpu for headaches and dysmenorrhea . No-Spa for headaches is effective if the cause of the pain is a spasm of blood vessels (tension headache or tension pain).
Forte tablets are prescribed when it is necessary to provide a longer lasting effect and reduce the frequency of use.
What is No-Shpa for injectable form?
No-Spa in ampoules is used mainly in situations where taking pills is impossible.
The tablets contain lactose. Its content in one tablet is 40 mg - 52 mg, and in one tablet 80 mg - 104 mg. In this regard, patients with lactose intolerance may experience complaints from the digestive system.
People with glucose/galactose malabsorption syndrome, lactase deficiency and galactosemia should be prescribed only No-Shpa injections.
Parenteral administration of the drug is also indicated for pancreatitis : the disease is often accompanied by debilitating vomiting, due to which taking pills does not give the desired effect.
Does No-Spa help with toothache?
It is generally accepted that the drug does not help with toothache. And this is not surprising, since the main effect of drotaverine is antispasmodic. The cause of toothache is:
- damage to tooth enamel or dentin;
- inflammation of the tissues surrounding the tooth root;
- pulp inflammation.
Smooth muscles do not play a role in the development of pain, therefore, taking No-Shpa for toothache does not make sense. However, in some cases, tablets can still help. If you put the tablet on your tongue, you may feel that your tongue begins to quickly go numb at the point of contact with it.
While not an analgesic , the drug provides an analgesic effect, and this allows it to be used to alleviate the condition in situations where it is not possible to quickly see a doctor. To relieve pain, the tablet is applied to the diseased tooth or placed in a carious cavity.
It should be noted that the medicine will only work if the pulp chamber has already opened.
No-Spa for menstruation
According to doctors, No-Shpa is one of the best remedies for relieving pain that occurs during menstruation. Drotaverine helps relax the uterus, while providing an analgesic effect.
For menstrual pain, drugs that suppress Pg synthesis in the body (for example, Brufen , Butadione or Indomethacin ) can be added to No-Shpe.
Reviews
I was diagnosed with a stomach ulcer quite a long time ago, because of which I often have to suffer from pain in the stomach area. In such cases, I almost always use No-shpa - it is inexpensive and helps quickly - almost always everything goes away in 30 minutes. I did not find any side effects during use. I usually take 2 tablets after meals; if there are any special circumstances, I call my doctor, he will advise me on how to calculate the dosage.
Andrey, 37 years old
Excellent medicine, I have been using it for many years, I always have it on hand. When I take a severe headache along with analgin, they get along well, there are no side effects, and all the symptoms go away. In general, all relatives, when any pain or spasms appear, take noshpa, even my grandmother drinks for high blood pressure.
Irina, 29 years old
I most often take it for headaches, although it also helps with stomach and back pain. A doctor prescribed No-shpa to a friend for prostatitis, and my sister takes it for vegetative-vascular dystonia. It starts to work in about half an hour, not always the effect that we would like, but in terms of price/quality ratio it’s simply top!
Oleg, 26 years old
Contraindications
Contraindications for No-Shpu:
- hypersensitivity to drotaverine or any other substance in the solution/tablets;
- severe forms of renal and liver failure ;
- low cardiac output syndrome;
- lactase deficiency , galactose intolerance, glucose/galactose malabsorption syndrome (for tablets).
The medicine is prescribed with caution to pregnant women, children and persons suffering from arterial hypotension.
Side effects
The drug usually does not have side effects, however, it must be taken into account that during treatment the following may sometimes be observed:
- decreased blood pressure ;
- increased heart rate;
- insomnia;
- headache;
- dizziness;
- constipation;
- nausea;
- hypersensitivity reactions.
If the drug is administered intramuscularly or intravenously, local reactions at the injection site are possible.
Instructions for use of No-Shpa (Method and dosage)
No-Shpa tablets: instructions for use
To alleviate the condition, it is recommended for an adult to take from 120 to 240 mg of drotaverine during the day. Thus, the daily dose is from 3 to 6 tablets of No-Shpa. It is recommended to divide it into 2-3 doses.
The maximum permissible single dose is 2 tablets of 40 mg, the daily dose is 240 mg.
The standard dose for a child under 12 years of age is 80 mg/day. (the dose is divided into 2 doses), for a child over 12 years old - 160 mg/day. (the dose is divided into 2-4 doses).
The recommended duration of use without consulting a doctor is no more than 2 days. If the condition does not improve within 48 hours, you should consult a doctor to clarify the diagnosis and select the correct treatment regimen.
In situations where No-Shpa is used as an addition to the main therapy, the recommended duration of use without consulting a doctor is 2-3 days.
Instructions for No-Shpa Forte
Forte tablets are taken in the same way as 40 mg tablets. The daily dose of the drug is 3-6 tablets, divided into 2-3 doses.
No-Shpa ampoules: instructions for use
The average daily dose of drotaverine in ampoules for an adult is from 40 to 240 mg. The drug is administered intramuscularly in 1-3 separate injections.
No-Shpa is administered intravenously to patients with stones in the bile or urinary tract during acute colic . Single dose - from 40 to 80 mg (the solution should be administered slowly).
How long does it take for the medicine to work?
The effectiveness of No-Shpa is three to four times higher than the effectiveness of Papaverine . In addition, the drug is characterized by 100% bioavailability. When taking a tablet, drotaverine is very quickly absorbed from the gastrointestinal tract: the half-absorption period of the substance is 12 minutes.
When taken orally, the effect of No-Shpa appears within 10-15 minutes, and when administered intramuscularly, within 5 minutes.
Dosage for animals
Dosage for dogs: 40 mg (1 tablet) for every 10 kg of weight. If parenteral administration of the drug is indicated for the animal, the dose is 1 ml/kg.
Dosage for cats is 0.1 ml/kg, injections are given 2 times a day.
Effect on driving
When taken orally in small doses, No-Shpa has no effect on people driving or operating other equipment. However, during treatment with the drug when driving a vehicle or other activities that require increased concentration, you should be careful. If dizziness occurs after taking No-Shpa, then these types of activities should be abandoned. The question of whether it is possible to drive a car and operate machinery if there are side effects from using No-Shpa is decided by the attending physician.
Overdose
A severe overdose of No-Shpa is accompanied by cardiac arrhythmia and disturbances in the conduction function of the heart, up to complete blockade of the branches of the PG (bundle of His) and cardiac arrest , which can lead to the death of the patient.
The literature indicates that the lethal dose of drotaverine is 1.6-2.4 grams (from 40 to 60 tablets of 40 mg). Death occurred 2-3 hours after the drug was taken. Wikipedia states that the LD50 of drotaverine is approximately 135 mg/kg.
After taking a large dose of drotaverine, the victim should be under medical supervision. Treatment is symptomatic, including gastric lavage, induction of vomiting and maintenance of vital body functions.
Interaction
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.
of drotaverine taken is in a state associated with plasma proteins (mainly with β-, γ-globulins and albumin ).
There are no data on the interaction of the substance with drugs that significantly bind to plasma proteins; however, their interaction is hypothetically possible at the level of protein binding (one of the drugs may be displaced from this bond, as a result of which the concentration of the free fraction of the drug in the patient’s blood whose binding to the protein is weaker).
Hypothetically, this is fraught with the occurrence of toxic and/or pharmacodynamic effects of such a drug.
Interaction with other drugs
PDE inhibitors like papaverine, which includes drotaverine, which is part of No-Shpa, weaken the antiparkinsonian effect of the substance levodopa (dihydroxyphenylalanine). Therefore, the combination of No Shpa and drugs containing levodopa can lead to increased tremor and rigidity. In combination with other antispasmodic drugs, No Shpa enhances its analgesic effect. Before combining this drug with other medications, you should consult your doctor.
special instructions
The tablets contain lactose, which should be kept in mind when prescribing the drug to people with glucose/galactose malabsorption syndrome, lactase deficiency and galactosemia.
When administering the solution intravenously, due to the risk of collapse, the patient should be in a supine position.
The drug should be used with caution in patients suffering from arterial hypotension .
The injection form of No-Shpa contains sodium metabisulfite, which can cause allergic reactions . In sensitive patients (especially those with a history of bronchial asthma or allergies ), bronchospasm and symptoms of anaphylactic shock .
Patients with known hypersensitivity to sodium metabisulfite should avoid the use of No-Shpa injections.
Precautionary measures
No-Shpa contains disulfite, a substance that can cause allergic reactions, including anaphylactic symptoms and bronchospasm in people with hypersensitivity, especially in patients with asthma or allergic diseases. If you are sensitive to parenteral disulfite, you should not take the drug. When administering drotaverine intravenously, patients with low blood pressure should be in a horizontal position to minimize the risk of collapse.
Analogues of No-Shpa
Level 4 ATC code matches:
Spasmol
Drotaverine Hydrochloride
Papaverine
Drotaverine
The most famous Russian analogue of No-Shpa is Drotaverin . Other generics of the drug: Vero-Drotaverine , Bioshpa , Nosh-Bra , Ple-Spa , Spasmonet , Spasmol , Spazoverine , Spakovin .
Which is better: Drotaverine or No-Shpa?
drotaverine hydrochloride as an active substance . Based on this, we can conclude that Drotaverine is essentially No-Shpa.
The only significant difference between the drugs is the price: Drotaverine is several times cheaper than its imported counterpart.
No-Shpa for children
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 fever and severe headaches .
Contraindications for children
In children, the use of No-Shpa is contraindicated in case of cardiac, renal or liver failure , individual intolerance to the components of the drug, low blood pressure, impaired absorption of galactose/lactose, angle-closure glaucoma , bronchial asthma , atherosclerosis of the coronary arteries .
The use of tablets is strictly contraindicated in children under 12 months, but it is considered safest to give the drug from the age of six. Very young children are given such a powerful antispasmodic only in cases where there is no alternative.
To improve the taste of the tablet, it can be crushed into powder and mixed with sweet syrup.
Dosage of No-Shpa for children
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. A school-age child is given No-Shpu from 2 to 5 r/day. a whole tablet.
Dosage for children with fever
For fever in children, No-Shpa is used as one of the components of the so-called “triad”.
In addition to the antispasmodic, such a mixture may include:
- Analgin and Diphenhydramine ;
- Analgin and Paracetamol ;
- Suprastin and Analgin ;
- Paracetamol and Suprastin .
To bring down the temperature, you can also use a simple combination “No-Spa + Analgin ”.
The dosage of each drug is calculated depending on the age of the child. So, for example, for a 2-year-old child, ⅓ Analgin tablet and ⅓ No-Shpa tablet are enough.
No-Shpa during pregnancy and breastfeeding
Drotaverine has a relaxing effect on all smooth muscle structures of the body, while provoking dilation of blood vessels and helping to increase blood flow to various organs.
During pregnancy , the remedy is used mainly for uterine tone in the early stages. It is not prescribed before childbirth, this is due to the fact that taking No-Shpa before childbirth will help relax and dilate the cervix.
Taking the drug during childbirth helps to normalize the contractile activity of the uterine muscles and reduce pain, reduces the risk of injury, and also reduces the period of labor. Despite this, in many European countries, the administration of No-Shpa during childbirth is considered a relic of the old school.
No-Shpa is considered a safe drug for pregnant women. Clinical experience with the use of the drug in pregnant women, as well as the results of reproductive studies conducted on animals, show that drotaverine has neither embryotoxic nor teratogenic effects.
However, during pregnancy it is necessary to balance the potential benefits for a woman with the possible risks for her unborn child.
Dosage of No-Shpa during pregnancy
For pregnant women, the form of the drug and the daily dose are selected individually. With increased uterine muscle tone in early pregnancy, the recommended dose varies from 80 to 240 mg/day.
No-Spa in ampoules is usually used to prepare for childbirth. Injections of drotaverine accelerate the process of dilation of the cervix. The medicine is injected into the muscle at a dose of 40 mg. After a few hours, the injection is repeated if necessary.
Women who took the drug during pregnancy - the reviews are confirmation of this - claim that No-Shpa not only copes well with severe cramps in the first months of pregnancy, but also greatly facilitates the course of childbirth.
No-Shpa during breastfeeding
Due to the fact that there are few necessary clinical data on the use of No-Shpa during lactation , it is not recommended to prescribe the drug during breastfeeding.
During menstruation
The peculiarity of drotaverine, which is part of No Shpa, is that it relaxes the smooth muscles of various organs, including the uterus. It relieves spasms and improves blood flow, which helps get rid of painful sensations. The drug is taken 1-2 pills 2-3 times a day for 1-2 days or until the pain disappears. The maximum dosage of no spa is 2 tablets at a time. Note! But Shpu should be taken during menstruation only if you are sure that this is pain during a natural process.
Reviews about No-Shpe
Reviews about No-Spe vary: for some, the drug literally saves them (especially during pregnancy), while others consider it completely ineffective.
The main advantages of the drug are:
- high safety profile, which is confirmed by the results of a large number of clinical and post-marketing studies;
- the ability to reliably prevent smooth muscle spasm and reduce its severity;
- availability of 2 dosage forms;
- absence of side effects that are typical for certain antispasmodics with anticholinergic effects ;
- the ability to eliminate spasms of various origins (No-Spa is effective for spasms caused by urological and gynecological diseases , gastrointestinal and obstetric diseases; the drug is a first-line drug when it comes to providing emergency care).
Another important feature of No-Shpa is that it does not mask the symptoms of an “acute abdomen”.
Question answer
Unlike analgesics, No-shpa eliminates the spasm that causes pain. The medicine has a high safety profile and is well tolerated by various groups of people.
The manufacturer does not indicate the time of taking the drug, so it is most often taken after meals. In order to relieve acute pain, No-shpa can be drunk outside, regardless of meals.
the manufacturer of the original drug has registered the official trademark NO-SHPA, therefore any analogues produced as domestic analogues are fakes. The original packaging of No-shpa contains a holographic image confirming its originality. Another one is to purchase medications from large, reputable chain pharmacies.
Alcohol in large quantities can cause side effects of the drug: headache, dizziness, nausea, heart palpitations, etc. During the course of treatment, you must stop drinking alcohol. It is strictly forbidden to treat hangover syndrome with No-shpa.
How much does No-Shpa cost?
The price of No-Shpa in 40 mg tablets in Russian pharmacies is from 55 rubles (cost 6 pieces). You can buy 24 tablets of 40 mg for an average of 110 rubles, and 24 tablets of 80 mg for 160-200 rubles. The price of No-Shpa in ampoules is from 98 to 447 rubles. (depending on the number of ampoules in the package).
The price of No-Shpa in tablets in Ukraine is from 50 UAH (24 tablets of 40 mg). Injections in Kharkov or Kyiv can be bought for 245-260 UAH (25 ampoules of 2 ml). Price No-Shpa Forte - from 100 UAH.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
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