A prick of a nose from which it helps. No-Shpa injections: instructions for use. What No-Shpy pills help from

SANOFI SANOFI-AVENTIS Quinoin Plant Pharmac. and Chemical Products, CJSC Hinoin Plant of Pharmaceutical and Chemical Products

Country of origin

Australia Hungary

Product group

Painkillers

Antispasmodic.

Release forms

• 100 - polypropylene bottles (1) - packs of cardboard. 10 - blisters (2) - packs of cardboard. 2 ml - dark glass ampoules (5) - plastic cell packaging (1) - cardboard packs. 2 ml - dark glass ampoules (5) - plastic cell packaging (5) - cardboard packs. 6 - blisters (1) - cardboard packs 60 - polypropylene bottles with a piece dispenser (1) - cardboard packs. 100 - polypropylene bottles (1) - packs of cardboard. 6 - aluminum blisters (2) - cardboard packs. pack of 100 tablets pack of 24 tablets pack of 24 tablets pack of 25 ampoules of 2ml pack of 5 ampoules of 2ml pack of 60 tablets

Description of the dosage form

• The solution for intravenous and intramuscular administration is clear, greenish-yellow in color. solution for intravenous and intramuscular injection solution for intravenous and intramuscular administration Tablets Tablets are convex, oblong, yellow with a greenish or orange tint, on one side the marking "NOSPA", on the other - a line Tablets are round, biconvex, yellow with a greenish or orange tint , marked "spa" on one side. Tablets are light yellow, interspersed with a lighter and darker color, elongated, with a dividing risk on both sides. Tablets Tablets

pharmachologic effect

Antispasmodic, an isoquinoline derivative, is similar in chemical structure and pharmacological properties to papaverine, but has a stronger and longer-lasting effect. It has a powerful antispasmodic effect on smooth muscles due to inhibition of the PDE enzyme. The enzyme PDE is required 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 Ca2+ ion concentration by stimulating Ca2+ transport into the extracellular space and sarcoplasmic reticulum. This Ca2+ ion concentration-lowering effect of drotaverine through cAMP explains the antagonistic effect of drotaverine with respect 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 suppressing the contractile activity of smooth muscles, 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. 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, drotaverine has no serious side effects on the heart and blood vessels and pronounced effects on the cardiovascular system. Drotaverine is effective in spasms of smooth muscles 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. Due to its vasodilating action, drotaverine improves blood supply to tissues.

Pharmacokinetics

In humans, a two-chamber mathematical model was used to assess the pharmacokinetics of drotaverine. Absorption After oral administration, drotaverine is rapidly and completely absorbed. After first pass metabolism, 65% of the accepted dose of drotaverine enters the systemic circulation. Cmax in blood plasma is reached in 45-60 minutes. Distribution In vitro, drotaverine is highly bound to plasma proteins (95-98%), especially to albumin, beta and gamma globulins. Drotaverine is evenly distributed in tissues, penetrates into smooth muscle cells. Does not penetrate the BBB. Drotaverine and / or its metabolites are able to slightly penetrate the placental barrier. Metabolism In humans, drotaverine is almost completely metabolized in the liver by O-deethylation. Its metabolites are rapidly conjugated with glucuronic acid. The main metabolite is 4"-deethyldrotaverine, in addition to which 6-deethyldrotaverine and 4"-deethyldrotaveraldine have been identified. Withdrawal T1 / 2 is 8-10 hours. The final T1 / 2 of plasma radioactivity was 16 hours. Within 72 hours, drotaverine is almost completely excreted 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 as metabolites; unchanged drotaverine is not found in the urine.

Special conditions

The composition of the tablets includes 52 mg of lactose, as a result, complaints from the digestive system in patients with lactose intolerance are possible. Therefore, the drug in the form of tablets is not prescribed to patients with lactase deficiency, galactosemia or impaired glucose / galactose absorption syndrome. The composition of the solution for intravenous and intramuscular injection contains sodium bisulfite, which can cause allergic reactions, including anaphylactic and bronchospasm, in sensitive individuals (especially those with a history of bronchial asthma or allergic reactions). In case of hypersensitivity to sodium metabisulphite, parenteral use of the drug should be avoided. When in / in the introduction of the drug in patients with low blood pressure, the patient should be in a horizontal position due to the risk of collapse. Influence on the ability to drive vehicles and control mechanisms When taken orally in therapeutic doses, drotaverine does not affect the ability to drive vehicles and perform work that requires increased concentration. If any adverse reactions occur, the issue of driving vehicles and working with mechanisms requires individual consideration. In the event of dizziness after taking the drug, you should avoid engaging in potentially hazardous activities, such as driving vehicles and working with mechanisms. After parenteral administration of the drug, it is recommended to refrain from driving vehicles and engaging in other potentially hazardous activities that require a high concentration of attention and speed of psychomotor reactions.

Compound

• drotaverine hydrochloride 40 mg Excipients: magnesium stearate - 3 mg, talc - 4 mg, povidone - 6 mg, corn starch - 35 mg, lactose monohydrate - 52 mg. drotaverine hydrochloride 20 mg Excipients: sodium metabisulphite, ethanol 96%, water for injection. Drotaverine hydrochloride 40 mg Excipients: magnesium stearate, talc, polyvidone, corn starch, lactose monohydrate. drotaverine hydrochloride 80 mg Excipients: magnesium stearate, talc, povidone, corn starch, lactose monohydrate. drotaverine hydrochloride 20mg / 40mg - ampoule / Auxiliary substances: sodium metabisulfite 2.0 mg, ethanol 96% 132.0 mg, water for injection up to 2.0 ml. paracetamol 500 mg drotaverine hydrochloride 40 mg codeine phosphate (in the form of hemihydrate) 8 mg

No-shpa indications for use

• - spasms of smooth muscles associated with diseases of the biliary tract: cholelithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis; - spasms of smooth muscles of the urinary system: urolithiasis, pyelitis, cystitis, bladder tenesmus; - in physiological childbirth - shortening the phase of the opening of the cervix and thereby reducing the total duration of labor (for a solution for intravenous and intramuscular injection). As an adjuvant therapy: - with spasms of smooth muscles of the gastrointestinal tract: peptic ulcer of the stomach and duodenum, gastritis, spasms of the cardia and pylorus, enteritis, colitis, accompanied by constipation and flatulence; - tension headaches (for oral administration); - with gynecological diseases (dysmenorrhea); - strong labor pains (for solution for intravenous and intramuscular administration). When used as an adjuvant, the drug is administered parenterally when it is impossible to use tablets.

No-shpa contraindications

• - severe renal failure; - severe liver failure; - severe heart failure (low cardiac output syndrome); - children's age up to 6 years (for tablets); - children's age (for parenteral administration, since no clinical studies have been conducted in children); - the period of breastfeeding (clinical data are not available); - 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). With caution, the drug is used for arterial hypotension (due to the risk of collapse), during pregnancy; in children (for tablets).

No-shpa dosage

• 20 mg/ml 40 mg 80 mg

No-shpa side effects

• From the side of the central nervous system: headache, dizziness, drowsiness. From the side of the cardiovascular system: arterial hypotension, tachycardia, hot flashes. From the digestive system: nausea, constipation; rarely (when taken in high doses and long-term use) - toxic liver damage. From the side of the hematopoietic system: agranulocytosis, thrombocytopenia. Allergic reactions: skin rash; very rarely - bronchospasm, swelling of the nasal mucosa. When taking the drug in very high doses, a lethal outcome (irreversible tissue necrosis) is possible. When using the drug according to indications in recommended doses, side effects are rare.

drug interaction

Drug interaction due to drotaverine With the simultaneous use of No-shpalgin with levodopa, drotaverine reduces its effect, which can lead to increased tremor and muscle rigidity. Drug interaction due to paracetamol With the simultaneous use of No-shpalgin with inducers of microsomal liver enzymes (salicylamide, barbiturates, antiepileptic drugs, tricyclic antidepressants, ethanol, rifampicin), an increase in the toxicity of paracetamol is noted. With the simultaneous use of No-shpalgin with chloramphenicol, T1 / 2 of chloramphenicol is extended and its toxicity increases. With the simultaneous use of No-shpalgin with doxorubicin, there is a risk of developing a hepatotoxic effect. Paracetamol with simultaneous use reduces the effectiveness of uricosuric agents. Metoclopramide and domperidone enhance the absorption of paracetamol, while cholestyramine reduces it.

Overdose

nausea, vomiting, circulatory disorders and respiratory depression are the main symptoms of codeine overdose. The condition of a patient who has taken an excessively high dose of paracetamol may be satisfactory during the first 3 days, and only after that there are signs of liver damage.

Storage conditions

• keep away from children
• store in a place protected from light

Information provided by the State Register of Medicines.

Synonyms

• Drotaverine, No-shpa, Nosh-Bra, Spazmol, Spakovin.

A drug called no-shpa has become widespread. This drug is used, if not for the treatment of diseases, then for the removal of unpleasant and painful symptoms. Practice shows that the drug no-shpa, despite its effectiveness, has many contraindications. Before taking the medicine, you need to consult with your doctor. But first, the doctor must conduct an examination of the patient, after which, based on the diagnosis, prescribe treatment. No-shpa injections instructions for use provide for the use of the drug for severe spasms to relieve pain. Injections differ from tablets only in that they act on the pain focus much faster, eliminating the unpleasant symptoms of pain.

Features of the drug No-shpa

The main advantage of no-shpa is its effective masking of the symptoms of various diseases. The remedy is used in extreme cases with the development of such serious diseases as cancer of the kidneys, liver, stomach and other types of neoplasms.

It is unacceptable to use the drug in persons with a tendency to develop allergic reactions, which can eventually lead to anaphylactic shock. The drug is also dangerous for people who have problems with diseases such as bronchial asthma and other types of ailments associated with the respiratory system. The use of a noshpa for such patients can lead to asphyxia and obstruction of the respiratory organs with a transition to pulmonary edema.

As you can see, the drug is quite powerful, so its improper use can lead to the most unpleasant consequences. Before administering the drug intramuscularly, be sure to read its instructions for use. It is important to know not only the features of the application and dosage, but also the presence of contraindications. We learn more about the no-shpa preparation from the material below.

Instructions for using No-shpa in the form of injections

The drug no-shpa is based on drotaverine hydrochloride, through which pain symptoms are relieved. The drug has an antispasmodic effect, whereby the drug in the form of injections has a wider range of applications than the tablet form. No-shpa in the form of ampoules is used for such diseases:

1. With attacks of gallstone disease.
2. For postoperative conditions.
3. In the period after the abortion.
4. With ulcerative ailments of the stomach and intestines.
5. With urolithiasis, as well as with the passage of stones through the ureters.

The drug but shpa solution for injection can be used for both intravenous and intramuscular use. The intravenous method of using no-shpa involves diluting the drug with saline. You can use no-shpu in the form of injections for a dropper. This option of intravenous administration of the drug allows for a prolonging effect of the drug. This type of injection is often used after operations. One unit of the drug contains 40 mg of the active ingredient drotaverine hydrochloride.

Indications for use

No-shpa helps to relieve pain spasms in those places where there are muscles. A pharmacological agent in the form of injections quite effectively copes with its purpose, eliminating pain quickly and effectively. Most people with the development of headaches prefer drugs such as Citramon or Askofen. But with severe and prolonged pain, no-shpa helps. In this case, the drug is used mainly in the form of tablets. To relieve pain symptoms with cuts, open and closed injuries, no-shpu is used in the form of injections.

In addition, the medicine is so effective that even with the slightest dislocations or sprains, it is used in order to get rid of unpleasant pain symptoms. It should be noted the important advantage of the drug no-shpa over non-steroidal drugs. The advantage lies in the absence of a negative effect on the digestive tract. This suggests that the drug eliminates pain, thereby not harming the body.

Dosage and application features

The instructions for use of the no-shpa medicine indicate dosages for adults and children. The drug can be used even for children from a year old, but only as directed by the attending physician. For children from one to six years old, the dosage of no-shpa is 120 mg per day. Moreover, this dose should be divided into three times, which avoids the development of allergic manifestations of the drug.

For children from 6 years to 12 years of age, the dosage of no-shpa per day is 200 mg. This dosage is recommended to be divided into two times. For adults, the dosage of drotaverine hydrochloride is 240 mg per day. This dosage can be divided into 2-3 times according to the decision of the attending physician. In acute pain, the agent is injected directly into the focus of the development of the pain syndrome. For example, if pain develops in renal or urolithiasis, then no-shpu should be administered in an amount of 80 mg intravenously. The duration of the introduction of this dosage in time should not be faster than 30 seconds.

During labor or after an abortion, it is allowed to administer no-shpa intravenously and intramuscularly in an amount of 80 mg with a time interval of at least 2 hours. When using the drug at home without a doctor's prescription, you should carefully read the instructions.

Contraindications

But shpa injections instructions for use have a mandatory paragraph, which indicates the reasons for contraindications to the use of the drug. These contraindications are:

1. The presence of an allergy to the composition of the drug.
2. During childbearing at any stage of pregnancy.
3. During the period of breastfeeding.
4. In the presence of bronchial asthma.
5. With cardiac arrhythmias.
6. If the patient shows signs of low blood pressure.

Children often have an allergy to lactose, which is contained in no-shpe tablets. Before giving a No-shpa tablet to a child, you should make sure that he does not have an allergy.

Side effects

Despite the effectiveness of the drug, it also has side effects that occur in frequent cases with an overdose. This happens when, with frequent use of painkillers, its effectiveness decreases. The patient arbitrarily increases the dose in order to get a positive result from the drug, thereby putting his life at risk.

The main side effects of no-shpy include the following manifestations:

• lowering blood pressure;
• development of nausea and vomiting;
• increased heart rate;
• rash on the body;
• swelling at the injection site;
• development of anaphylactic shock, which in frequent cases ends in death.

Side effects occur not only with an overdose, but also with frequent use of the drug. If the effectiveness of the anesthetic drug decreases, then it should be replaced with another medicine that has a distinctive composition.

No-shpa in the form of injections: what is the medicine for?

In ampoules, the drug is used in those exceptional cases when taking tablets is not possible. Reasons why pills may be prohibited are the body's lactose intolerance. Even if the body does not have an individual intolerance to the drug, then lactose has a negative effect on the digestive system. These are stomach pains, as well as nausea and, in rare cases, vomiting.

If a person has signs of impaired glucose absorption, then a form of application of no-shpa in the form of injections is prescribed for them. Intravenously or intramuscularly, an anesthetic is prescribed for pancreatitis. After all, this type of ailment often manifests itself in the form of the development of signs of vomiting. Tablets with such symptoms will be simply useless. Due to the fact that injections have a rapid antispasmodic effect, many tend to use the medicine in this form, especially for pain in the back, stomach, kidneys, etc.

When the medicine starts to work

Drotaverine is much more effective than Papaverine. No-shpa in the form of tablets is absorbed by the body much faster than preparations based on papaverine. Often, a decrease in pain begins to appear 10-15 minutes after taking the pill.

Intramuscular and intravenous injection allows you to achieve the desired result after 5 minutes. That is why no-shpa injections are widespread.

It is important to note that no-shpa injections can be stored for no more than three years from the release date. Store the drug should be subject to the temperature regime, which should range from 15 to 25 degrees.

It's important to know! If you make a choice, which is better and more effective, No-shpa medicine or Drotaverine. Both drugs are based on drotaverine hydrochloride, only no-shpa is a foreign analogue of Drotaverine. Accordingly, the difference lies in the cost, but since No-shpa is a foreign medicine, many patients and doctors prefer it.

In conclusion, it is worth noting that the cost of No-shpa in the form of ampoules ranges from 100 to 500 rubles. It depends on the pharmacy and the number of ampoules in the preparation. The manufacturer of both tablets and No-shpa injections is the Hinoin company, located in Hungary.

This Hungarian antispasmodic has been well known since Soviet times as an extremely effective remedy for relieving spasmodic pain. It is still considered the most popular and fastest tool for the general relief of spasms of smooth muscle tissues. No-shpa is produced in ampoules, tablets, instructions for use for which describe in some detail how both forms of the drug should be taken. It is most often used as a fast-acting analgesic to relieve pain symptoms.

The popularity of No-shpa is due to the fact that it is effective, after its use, adverse reactions very rarely occur, especially when compared with anticholinergic antispasmodics. But the drug has contraindications and is not suitable for everyone, therefore it is prescribed by a doctor after all the necessary studies, including testing. Self-medication is fraught with unpredictable consequences.

The main component here is drotaverine hydrochloride. 2 ml of injection substance contains:

• 40 milligrams of the main substance;
• sodium pyrosulfite (E223);
• ethanol (E1510);
• injection water.

The drug No-shpa is administered through injections (injections) according to the indications of the attending physician.

Papaverine also belongs to the active components, however, Drotaverine is more effective and absorbed faster, after the injection it allows you to get the effect after 5 minutes.

pharmachologic effect

The drug gives excellent performance in the treatment of spastic syndrome of the gastrointestinal tract (gastrointestinal tract), urinary and genital areas, with spasms of the cerebral vessels of the brain, with depression and neurosis, Raynaud's disease.

However, care must be taken in prostate diseases, because due to the relaxation of the smooth muscles of the bladder, problems with urination can occur.

No-shpa in the form of injections: what is the medicine for?

Sometimes oral administration is undesirable for one reason or another. For example, due to lactose intolerance in the patient's body. Then he is given injections of the solution. It turns out a quick antispasmodic result. This form is effective for pancreatitis, pain in the back and internal organs.

Indications

No-shpa is a broad spectrum spasm policy that is used to:

• symptomatic therapy. The purpose of the drug is justified to relieve pain without making changes to the clinical picture of the disease;
• etiotropic therapy. The drug is prescribed to eliminate the cause of the disease state. The effect is expressed in the relief of spasm of smooth muscle tissues;
• preliminary medical preparation before a series of medical manipulations.

The liquid form is prescribed for:

• diseases of the biliary system;
• rehabilitation after surgical operations;
• ulcers of the gastrointestinal tract;
• urolithiasis.

If No-shpa is injected intravenously, then it must be diluted in saline. In addition to injection, it is used in droppers, as a rule, this is practiced after surgical operations.

The use is indicated for the removal of spasms in mice, prolonged headaches. For fractures of any form, injections are used due to obtaining a quick result.

When is it used with caution?

Like any pharmacological agent, the drug requires caution in use. The main reason why the tablet form can cause problems is lactose deficiency in the patient. Even if a person does not have a personal intolerance to lactose itself, a negative effect on the digestive tract is quite possible, which can be manifested by intestinal colic or vomiting.

With symptoms indicating poor absorption of sucrose, the active substances are administered to the patient with a syringe. No-shpa (solution for injection) is recommended for inflammation of the pancreas, when oral use of the drug is highly undesirable, because this disease often develops vomiting.

Contraindications

Any medicine (regardless of its origin - artificial or natural) has contraindications. Here are these:

• the presence of allergens in the composition;
• during the entire period of pregnancy or breastfeeding;
• bronchial asthma, other diseases of the respiratory system. The use of No-shpa for this category of patients can result in asphyxia and obstruction of the respiratory organs, followed by pulmonary edema and death;
• arrhythmia;
• any manifestation of hypotension, since an even greater drop in pressure is possible with all the ensuing consequences.

Some children and adults are often allergic to lactose present in tablets, so it is necessary to consult a specialist before use.

The use of pills by a person with an allergy may well cause anaphylactic shock, which is deadly.

The drug is characterized by a strongly pronounced pharmacological effect, therefore, spontaneous or improper use of it is dangerous with adverse consequences. This medicinal product must be used with caution.

No-shpa in injections: instructions for use

Injections of this antispasmodic are prescribed for all diseases in which spasmodic attacks are frequent. This is typical for diseases of the kidneys, gastrointestinal tract, urinary tract, pancreas, gynecological pathologies such as algomenorrhea.

In addition, injections are given when the patient has contraindications to oral medication, which are determined by the attending specialist. The duration of therapy is determined by the attending physician. Independent use of the product is allowed, but not longer than three days.

The introduction of injections to patients under 18 years of age is contraindicated. For an adult, the maximum volume for consumption is 240 ml. It is entered for 1-3 times. Further dosage and frequency of injections are determined by the patient's condition.

Dosage

The instructions clearly define dosages for children, adults. It is allowed to apply to children from one year old, but only on the recommendation of a doctor and in a hospital, so that the patient is under constant supervision. This is done because clinical trials on minors have not been conducted, therefore, in the instructions for the drug, age up to 18 years is indicated as a contraindication.

From a year to 6 years, the daily dose is 120 ml, which is divided into three doses. This makes it possible to reduce the likelihood of allergic reactions. Children aged 6-12 years can be administered up to 200 ml per day, which are divided into two doses.

The adult dose is 240 ml per day. It is possible to divide into 2-3 doses.
In the presence of acute pain, the injection solution is injected directly into the painful focus. If the pain is caused by an attack of kidney or urolithiasis, then the agent is administered intravenously, starting from 80 ml. Moreover, the introduction should be made within 30 seconds and no faster.

During childbirth or after an abortion, intravenous or intramuscular administration of the drug in a volume of 80 ml is possible, subject to an interval of at least 2 hours. If there are no specific instructions from the doctor, then the daily dosage is 40-240 ml (divided into three doses) into a vein or muscle. In acute colic caused by cholelithiasis or urolithiasis, 40-80 mg of the drug is prescribed intravenously.

How to inject No-shpa intravenously and intramuscularly

Injections are used both intravenously and intramuscularly. In this case, the active active substances are diluted with sodium chloride. A drip ampoule is used to inject the drug into a vein. This practice allows you to achieve a longer action of the components of the drug. Often used after surgery.

When the medicine starts to work

When using tablets, the result appears after 10-15 minutes. Injections significantly accelerate the decrease in the intensity of the pain syndrome, and relief occurs within 5 minutes. It is thanks to this effect that injections have gained great popularity and distribution.

Possible adverse reactions and overdose

Any medicine can have unwanted effects. No-shpa is no exception. This is especially true for overdoses. This is possible with the frequent use of the remedy, then its effectiveness begins to decrease, and the patient begins to independently increase the dose, hoping for a quick effect. This approach is very dangerous and leads to unpredictable consequences.

Possible side effects:

• lowering blood pressure;
• nausea and vomiting;
• tachycardia;
• rash on the body;
• the appearance of swelling at the injection site;
• anaphylactic shock, often fatal.

Similar phenomena are caused by excessive drug addiction. With a decrease in efficiency for a while, you need to leave it and start using some alternative remedy.

An overdose also does not bring anything good and leads to a violation of the rhythm, conduction, and finally, cardiac arrest and death. In case of an overdose, it is necessary to provide the patient with maintenance therapy with full medical supervision.

special instructions

Particular attention should be paid to the use of the drug for the treatment of patients with atherosclerosis of the coronary vessels and hypotension.

Drug Interactions

The combination with other antispasmodics leads to synergism. The antispasmodic effect increases, the pressure decreases faster. Usually such results are given by a combination with quinidine, procainamide, phenobarbital.

Due to the high degree of binding to plasma proteins (over 80%), competition of the described drug with analogues is quite likely. When combining such drugs, you can get an increase in toxicity after taking the drugs.

The ability to influence the reaction rate when driving vehicles or working with mechanisms

In this matter, everything is decided strictly individually, especially in terms of the negative impact on the driver. In general, it is more than desirable when injecting the drug to completely abandon driving a car and working with complex equipment for some time.

Interaction with alcohol

No-shpa and alcohol have the same effect on the body, that is, they relax, dilate blood vessels, and lower muscle tone. Therefore, after drinking a sip of wine, the patient can get a quick result in getting rid of the spasm. However, there is also a downside to the coin, and it is quite possible to get unpleasant consequences of such a combination:

• a sharp development of hypotension, as a result, a feeling of general weakness and headache;
• frequent urge to urinate due to relaxation of the smooth muscles of the bladder;
• increased uncontrolled flatulence and frequent urge to empty the bowels;
• the occurrence of swelling of the tissues in the injection area, the appearance of a rash on the skin and itching;
• heart palpitations and difficulty breathing, these symptoms can generally lead a person to resuscitation.

Of course, one glass of champagne or wine does not guarantee the manifestation of the described symptoms, but stronger drinks in excessive doses may well provide this.

If such manifestations are not frightening for a person, then the use of alcohol in the treatment of No-shpa is quite possible. In addition, its active substances limit the absorption of ethanol into the blood, which prevents rapid intoxication. By the way, this is used by narcologists when removing some alcohol lovers from hard drinking.

However, such information should not be taken as a recommendation to drink alcohol simultaneously with the drug. Although the injection is not a categorical prohibitive factor. At the same time, it is well known that excessive alcohol consumption in itself does not lead to anything good. And the use of alcohol in combination with drugs - even more so (even with such as No-shpa).

It should be borne in mind that in diseases characterized by the frequent occurrence of spasms, alcohol is categorically excluded. It:

• gastritis or ulcer;
• cystitis;
• colitis.

During the exacerbation of these diseases, the use of alcohol is a categorical contraindication.

Terms of dispensing from pharmacies

This is a prescription drug, sold in pharmacies according to the appropriate prescription from a doctor.

Terms and conditions of storage

Ampoules should be protected from direct sunlight and light.

At 15-20 degrees, the drug retains its properties for 5 years from the date of production.

Analogues

There are few of them, for the most part, produced by Russian manufacturers.

1. "Drotaverine". Identical to the described drug, although there are differences in bioavailability and bioequivalence. The release of "Drotaverin" is carried out by 9 Russian manufacturers.
2. "Drotaverin-Ellara" - produces LLC "Ellara".
3. "Nosh-Bra" - is produced in tablets and ampoules by the Russian pharmaceutical manufacturer Bryntsalov V.A.
4. "Spazmol" in tablet and injection forms is produced by the Russian company "Pharmstandard-UfaVITA".
5. "Spakovin" - ampoules and tablets. Produced by the Indian company "M.J. Biopharm".
6. An analogue of No-shpa is produced by the Belarusian Borisov ZMP.

International non-proprietary name

Drotaverine

Dosage form

Solution for injection 40 mg/2 ml

Compound

2 ml of solution contains:

active substance- drotaverine hydrochloride 40.0 mg

Excipients: sodium metabisulphite, ethanol 96%, water for injection.

Description

Clear greenish-yellow liquid.

Pharmacotherapeutic group

Drugs for the treatment of functional disorders of the gastrointestinal tract.

Papaverine and its derivatives. Drotaverin.

ATX code A03AD02

Pharmacological properties

Pharmacokinetics

Drotaverine is rapidly absorbed both after oral and parenteral administration. It is highly bound to plasma albumin (95-98%), alpha and beta globulins.

The maximum concentration in blood serum is reached in 45-60 minutes after oral administration.

After first pass metabolism, 65% of the accepted dose of drotaverine enters the systemic circulation in unchanged form.

Drotaverine is metabolized in the liver, its biological half-life is 8-10 hours. Within 72 hours, the drug is almost completely eliminated from the body, with approximately 50% excreted in the urine, and about 30% in the feces. Drotaverine is excreted mainly in the form of metabolites, the unchanged form of the drug in the urine is not detected.

Pharmacodynamics

No-shpa is an isoquinoline derivative that has an antispasmodic effect directly on smooth muscles. Inhibition of the phosphodiesterase enzyme and the subsequent increase in cAMP levels are the determining factors in the mechanism of action of the drug and lead to smooth muscle relaxation through inactivation of the myosin kinase light chain (MLKM).

No-shpa inhibits the enzyme phosphodiesterase (PDE) IV in vitro without inhibition of PDE III and PDE V isoenzymes. In practice, PDE IV plays an important role in reducing smooth muscle contractility; in this regard, selective PDE IV inhibitors may be useful in the treatment of hyperkinetic disorders and various diseases accompanied by spastic conditions of the smooth muscles of the gastrointestinal tract. PDE III enzyme hydrolyzes cAMP in myocardial and vascular smooth muscle cells; this explains the fact that drotaverine is an effective antispasmodic that does not cause serious cardiovascular side effects and does not have a pronounced therapeutic effect on the cardiovascular system.

No-shpa is effective for spasms of smooth muscles of both neurogenic and muscular origin. Regardless of the type of autonomic innervation, Ho-shpa has the same effect on the smooth muscles of the gastrointestinal tract, biliary tract, genitourinary system and blood vessels. Due to its vasodilating effect, it improves the blood supply to tissues.

The action of the drug No-shpa is stronger than that of papaverine, and absorption is faster and more complete, it binds less to blood serum proteins. The advantage of No-shpa is that it does not have a stimulating side effect on the respiratory system, which is observed after parenteral administration of papaverine.

Indications for use

C smooth muscle spasmsat diseasesbiliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis

C spasms of smooth muscles of the urinary tract: nephrolithiasis, urethrolithiasis, pyelitis, cystitis, bladder tenesmus

As adjuvant therapy (when the patient is unable to take pills):

With spasms of smooth muscles of the gastrointestinal tract: peptic ulcer of the stomach and duodenum, gastritis, spasms of the cardia and pylorus, enteritis, colitis

For gynecological diseases: dysmenorrhea (painful menstruation)

Dosage and administration

Adults: the usual dose is 40-240 mg per day (divided into 1-3 doses) IM.

To relieve acute colic in nephrolithiasis or cholelithiasis: 40-80 mg IV.

Side effects

Rcaustically

- headache, dizziness, insomnia

- nausea, severe constipation

Rapid heart rate, low blood pressure

Allergic reactions (angioedema, urticaria, rash, itching).

Reactions at the injection site

Frequency unknown

Fatal and non-fatal anaphylactic shock has been reported in patients treated by injection.

Contraindications

Hypersensitivity to the active substance or to any of the excipients of the drug

Hypersensitivity to sodium bisulfite

Severe liver or kidney failure

Severe heart failure (low cardiac output syndrome)

Children and adolescents up to 18 years of age

Drug Interactions

Phosphodiesterase inhibitors, like papaverine, reduce the antiparkinsonian effect of levodopa. Therefore, with the simultaneous use of No-shpa® with levodopa, tremor and rigidity may increase.

special instructions

Clinical studies involving children have not been conducted.

With hypotension, the use of the drug requires increased caution. Due to the risk of collapse during intravenous administration of the drug, the patient should only be in the supine position.

The composition of the drug contains sodium bisulfite, which can cause allergic reactions, including anaphylactic symptoms and bronchospasm in sensitive individuals, especially in individuals with bronchial asthma or a history of allergic reactions.

Patients with hypersensitivity to sodium bisulfite should not be injected (see "Contraindications").

The use of the drug during pregnancy requires special care.

Pregnancy and lactation period

When conducting retrospective clinical studies involving people who took the drug orally, and in preclinical studies, neither teratogenic nor embryotoxic effects were demonstrated. However, the use of the drug during pregnancy requires increased caution. Drotaverine should not be used during childbirth.

Selection drotaverine in breast milk has not been studied in preclinical studies. As a result, taking the drug during breastfeeding is not recommended.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

When prescribing therapeutic doses parenterally, especially intravenously, patients should be warned that they should avoid potentially hazardous activities, such as driving a car or other mechanisms.

Overdose

No cases of overdose of drotaverine have been reported. In case of overdose, it is necessary to carefully monitor the patient's condition, it is recommended to carry out symptomatic and supportive treatment.

Release form and packaging

2 ml of the drug is placed in brown glass ampoules with one break point.

Ampoules are labeled with self-adhesive paper.

5 ampoules in a blister pack made of polyvinyl chloride film.

1 or 5 blisters, together with instructions for medical use in the state and Russian languages, are placed in a cardboard box.

Storage conditions

To store in the place protected from light at a temperature from 15 °C to 25 °C.

Keep out of the reach of children!

Shelf life

Do not use after the expiration date.

Terms of dispensing from pharmacies

On prescription

Manufacturer

HINOIN Plant of Pharmaceutical and Chemical Products CJSC, Hungary

Location address: 3510 Miskolc, Csanyikvolgy, Hungary

Registration certificate holder

sanofi-aventis CJSC, Hungary

Address of the organization accepting claims from consumers on the quality of products (goods) on the territory of the Republic of Kazakhstan

The instructions are for:

Compound

The active substance of No-shpy is drotaverine.

Release form

• tablets of 40 mg No. 12, No. 20, No. 24 - in blisters; No. 60 in a container with a dispenser; No. 100 in a container;
• solution for injections 20 mg/ml, 2 ml No. 25 (5x5) in ampoules.

Description

No-shpa is a myotropic antispasmodic. The drug is effective in spasms of smooth muscles of both nervous and muscular origin.

Drotaverine acts on the smooth muscles of the gastrointestinal tract, biliary, genitourinary and vascular systems. Increases blood circulation in tissues due to its ability to dilate blood vessels.

The action of drotaverine is stronger than the action of papaverine, absorption is faster and more complete, it binds less to plasma proteins. The advantage of drotaverine is also that, unlike papaverine, after its parenteral administration, there is no such side effect as respiratory stimulation.

No-shpa is rapidly absorbed both after oral administration and after parenteral administration.

The maximum concentration in blood serum is reached within 45-60 minutes after ingestion and 30 minutes after injection.

Indications

Spasms of smooth muscles:

• cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis;
• nephrolithiasis, urethrolithiasis, pyelitis, cystitis, bladder tenesmus.

As an adjuvant treatment:

• with spasms of smooth muscles of the gastrointestinal tract: peptic ulcer of the stomach and duodenum, gastritis, cardio- and / or pylorospasm, enteritis, colitis, spastic colitis with constipation and irritable bowel syndrome, accompanied by flatulence;
• tension headache;
• dysmenorrhea.

Contraindications

• hypersensitivity to drotaverine or to any component of the drug;
• severe liver, kidney or heart failure (low cardiac output syndrome).

Dosage and administration

Ampoules

• solution for injection is administered intramuscularly and intravenously;
• daily dose - 1-6 ampoules (40-240 mg), 1-3 separate injections.

Tablets

Adults - daily dose - 3-6 tablets (120-240 mg), divided into 2-3 doses.

Children 6-12 years old - the daily dose is -2 tablets (80 mg), divided into 2 doses.

Children over 12 years old - the daily dose is 4 tablets (160 mg), divided into 2-4 doses.

Children

For children under 6 years of age, the use of the drug is contraindicated.

Use during pregnancy or lactation

During pregnancy, it is necessary to prescribe the drug with caution.

During lactation, the use of the drug is not recommended.

The ability to influence the reaction rate when driving vehicles or operating other mechanisms

If a patient experiences dizziness after using the drug, they should avoid potentially hazardous activities, such as driving a car and performing work that requires increased attention.

Application Features

Use with caution in arterial hypotension.

Do not use in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption syndrome.

Overdose

With a significant overdose of no-shpa, cardiac arrhythmias and conduction disturbances were observed, including complete blockade of the bundle of His and cardiac arrest, which can be fatal.

In cases of overdose, the patient should be under close medical supervision and receive symptomatic treatment, including inducing vomiting and/or gastric lavage.

Side effects

• allergic reactions, including angioedema, urticaria, rash, itching, skin flushing, fever, chills, fever, weakness;
• palpitations, arterial hypotension;
• headache, dizziness, insomnia;
• nausea, constipation, vomiting.

Storage conditions

Ampoules - prescription.

FAQ

What is spasm?

Why does spasm occur?

Spasm is an involuntary contraction of a muscle or group of muscles, usually accompanied by sharp, cramping and aching pain. There are spasms of skeletal muscles and smooth muscles (vascular wall), bronchi, esophagus (cardiospasm), intestines. Spasms of skeletal muscles make movement difficult. Spasms of smooth muscles disrupt various organ functions. The causes of spasmodic reactions in the abdomen are not always obvious, especially when spasms cause muscle contractions deep within the body. The causes of cramps can be diseases of the gastrointestinal tract, appendicitis, food poisoning, diverticulitis, menstrual pain. But most often the cause of spastic conditions of the intestines, gallbladder or its ducts is a violation of the diet, emotional stress, frequent stress and depression.

What is the difference between spasm and pain?

Spasm is a convulsive contraction of the muscles of the limbs or the muscular wall of blood vessels, the esophagus, intestines and other hollow organs with a temporary narrowing of their lumen.

Pain is an unpleasant sensation caused by damage to nerve endings, the purpose of which is to alert the body to an injury or hazard that must be stopped or avoided. Pain is usually a warning sign that the body is in danger, overworked, or sick.

Does spasm always turn into pain?

Most often, a spasm is a protective reaction of the body, those who have ever experienced spasms of the stomach and intestines know how painful they are. We feel pain when sensitive nerve endings are stimulated, when the excitability of nerve fibers becomes excessive, exceeding the effective level of exposure to a painful stimulus, which leads to hypersensitivity to pain, after which the signal is transmitted along the nerve axon to the spinal cord and further to the brain. Pain receptors can sense various stimuli such as heat, pressure, or stretching. It is believed that functional pain in the abdomen is the result of a disorder in the activity of the autonomic nervous system, because the work of the intestine is directly related to nervous regulation. That is why patients often suffer from a stomach after they get nervous or just get very upset.

What diseases can cause pain / spasm and of what nature?

Inflammation of the mucosa, headache, spasm, menstruation, dysfunction of the liver, kidneys, poor functioning of the gastrointestinal tract - there are a lot of causes and types of pain. Pain and spasmodic sensations are characteristic of many diseases and conditions of the body.

About NO-ShPA®

Where are NO-ShPA® tablets produced?

No-shpa is a drug that has antispasmodic, myotropic, vasodilating, hypotensive effects. Produced at the HINOIN plant in Hungary, by the French pharmaceutical company Sanofi.

Where and when was NO-ShPA® developed?

The drug was synthesized in 1961 by employees of the Hungarian pharmaceutical company Hinoin. In 1962, the drug was patented under the trade name No-Shpa.

What is NO-ShPA®?

No-shpa is a myotropic antispasmodic. Reduces the tone of smooth muscles of internal organs and intestinal peristalsis, dilates blood vessels. The drug is used for spasms of varying intensity and origin.

And somewhere else, except for Ukraine, NO-ShPA® tablets are sold?

The drug is used in Central and Eastern Europe, and is also registered in more than 50 countries around the world.

Application of NO-ShPA®

What types of pain can HO-ShPA® help with?

No-shpa quickly eliminates pain, spastic conditions, eliminates the causes of pain associated with spasm of the smooth muscles of the digestive tract, biliary tract, organs of the genitourinary system, including renal colic, spasms of peripheral, cerebral and coronary arteries, and is also used for menstrual syndrome .

How many HO-ShPA® tablets should I take?

Adults use 1-2 tablets up to 3 times a day. The maximum daily dose is 120-240 mg (3-6 tablets).

Children over 12 years of age take 1 tablet up to 3 times a day. The maximum daily dose is 160 mg (4 tablets).

Children from 6-12 years old use 1 tablet up to 2 times a day. The maximum daily dose is 80 mg (2 tablets).

How fast does NO-ShPA® work?

After oral administration, it is rapidly absorbed. The maximum effect occurs after 45-60 minutes.

What is the difference between the action of NO-ShPA® tablets and analgesics?

Analgesics block the transmission of the pain impulse, but do not eliminate the cause of the pain syndrome, No-shpa relieves spasm of the muscles of the internal organs and alleviates the condition. It is also a kind of diagnostic tool for establishing the cause of pain, if the pain syndrome did not go away after taking No-shpa.

Is HO-ShPA® effective for tension headache?

Spasm, increased blood pressure, narrowing of the lumen of blood vessels leads to impaired blood circulation in the brain. This causes sudden and severe pain syndrome. No-shpa reduces the tone of cerebral vessels, dilates blood vessels. Normal blood circulation is restored, the pain disappears. A constant headache is dangerous. To eliminate the cause of it, it is necessary to diagnose and establish a diagnosis, for the correct treatment of pain attacks.

Does NO-ShPA® help with stomach pain?

Most often, the causes of discomfort in the abdomen are cramps, colic, a feeling of bloating (flatulence), intestinal motility disorders, manifested by diarrhea, constipation, or their alternation. Such problems can occur both in healthy people and those suffering from diseases of the digestive tract. No-shpa is well suited to relieve these symptoms, it relaxes smooth muscles, quickly and effectively relieves pain. If the pain does not go away, it is necessary to consult a doctor for further diagnosis and establishing the cause of the pain.

Use of NO-ShPA® during pregnancy

Can NO-ShPA® be taken during pregnancy?

Clinical studies on animals have not revealed teratogenic and embryotoxic effects, as well as adverse effects on the course of pregnancy. However, if it is necessary to use the drug, care should be taken and the drug should be prescribed only after assessing the ratio of the potential benefit to the mother and the possible risk to the fetus.

Method of application of the drug in children

Can children take NO-ShPA®?

The drug is approved for use in children over 6 years of age.

Side effects

When combined with levodopa, its therapeutic effect decreases, and tremor and rigidity increase.

Is it necessary to take NO-ShPA® tablets in combination with analgesics during cramps during menstruation, or is NO-ShPA® alone sufficient?

The combination of drugs for the treatment of menstrual syndrome is established individually with the doctor for more correct therapy.

Characteristics

The instructions for No-shpa are presented for informational purposes only and are not a reason for self-treatment.
Only your doctor can decide whether to use No-shpa, prescribe treatment regimens and dosages, as well as discuss the compatibility of No-shpa with your medications, explain side effects and contraindications.
Remember - self-medication is dangerous for your health.