But shpa symptoms. How to take this drug? Some features of therapy

The antispasmodic drug of myotropic, vasodilating action, known to everyone as "No-shpa" or "Drotaverine", is a substitute for the previously popular "Papaverine". Sold without a prescription in any pharmacy in capsules, tablets, in the form of a solution for injection. It has an intense analgesic effect on the smooth muscles of the biliary tract and urinary system, the organs of the gastrointestinal tract. But even a safe "No-shpa" can provoke death in a patient. And few people know about it. According to the statistics of the World Health Organization, among the registered cases of death from taking medications, an overdose after treatment with noshpa leads to the death of 0.1% of patients.

Indications for use

Readily available drugs must be purchased with extreme caution. It is better to consult a qualified doctor in advance or carefully study the instructions. What are the indications for the use of myotropic antispasmodic "No-shpa":

• spasm of smooth muscles, contractile tissue. Kidneys, biliary system, stomach and intestines;
• irritable bowel syndrome or spastic colitis;
• pyelitis. Inflammatory process that is observed in the renal pelvis;
• proctitis. Inflammation of the colon mucosa;
• tenesmus. Irritation of the nerve plexuses of the large intestine, which causes false urge to empty;
• pylorospasm. Contraction of the sphincter between the duodenum and stomach. Accompanied by vomiting with impurities of bile and sour smell, constipation;
• gastroduodenitis. An inflammatory disease that is observed in the stomach, duodenum 12;
• ulcerative foci in the duodenum;
• endarteritis. Circulatory disorders. Associated with deformity of the arteries;
• menstrual pain.

You can take "No-shpu" and during pregnancy. The drug does not adversely affect the fetus, the central nervous and autonomic system of the mother. With the threat of spontaneous abortion and increased uterine tone, a myotropic antispasmodic is prescribed. During labor, "No-shpa" promotes the opening of the cervix of the uterus, relieves pain and reduces discomfort caused by postpartum contractions.

How to take "No-shpu"

A safe antispasmodic drug has an individual dosage for children and adults. The dosage form also determines the variety of ways to use "No-shpy": oral, intravenous, intra-arterial, subcutaneous.

The recommended daily dose of "No-shpy" for adults is 40-90 mg 3 times. Intramuscular and subcutaneous administration involves the use of 40-80 mg 1 to 3 times a day. With hepatic and renal colic, intravenous administration of the same amount of the active substance drotaverine is prescribed. Intra-arterial method - with spasms of peripheral vessels.

There is no exact indication of the age at which No-shpu can be given to a child. But doctors are trying to replace the drug for children under 3 years old. A single daily dosage of "No-shpy" for children from 3 to 6 years old is 10-20 mg. The permissible maximum intake is 120 mg. For children under 12 years old, the dosage per day is 20 mg. You can increase the amount of the drug up to 200 mg.

Side effects of "No-shpy"

Although the instructions for use of the drug indicate that the antispasmodic does not affect the central nervous, autonomic systems, it cannot be called an absolutely harmless medicine. Having a negative effect on the human body, side effects after "No-shpy" can harm the health of the patient:

1. migraine, dizziness;
2. lowering blood pressure;
3. cardiopalmus;
4. inhibition of psychomotor reactions, concentration of attention and deterioration of mental activity;
5. increased sweating;
6. allergic reactions.

These signs may also indicate poisoning of the body with noshpoy. And with weak immunity and the absence of timely provided medical care, the consequences after taking "No-shpa" can be dangerous for humans: intoxication of the body, heart failure and even death.

Contraindications

Drug therapy should be prescribed only by the attending physician and a qualified specialist. And this applies even to those medicines that are dispensed in a pharmacy without a prescription. To avoid complications after taking the drug, like "No-shpa", carefully study all possible contraindications:

1. low blood pressure;
2. atherosclerosis or damage to the coronary arteries;
3. chronic diseases of the cardiovascular system;
4. cardiogenic shock. It is characterized by insufficient work of the left ventricle, a decrease in active contraction of the myocardium;
5. hepatic, renal failure;
6. AV block. Inhibition of the function of nerve impulse transmission to the heart;
7. pregnancy I trimester. A decrease in the tone of the uterus can provoke a miscarriage;
8. period of breastfeeding;
9. benign formation of the prostate gland;
10. closed-angle glaucoma. Visual impairment due to increased intraocular pressure.

It is not recommended to combine "No-shpa" with tricyclic antidepressants, antiarrhythmic drugs "Quinidine" and "Procainamide" for people with severe arterial hypertension. A sudden drop in pressure is possible. The interaction of "No-shpa" and "Levodopa", a drug against Parkinson's disease, makes the treatment of a neurological disease ineffective.

Overdose of "No-shpoy"

The instructions that are attached to the drug do not indicate the maximum allowable daily intake of the active substance drotaverine per day for adults. That is why an overdose of "No-shpoy" is often observed, which is determined by the characteristic symptoms:

• atrioventricular, atrioventricular block. Violation of the conduction function of the nerve impulse between the atria and ventricles;
• arrhythmia. Change in heart rate;
• vomiting, nausea;
• diarrhea or constipation;
• depression of the respiratory center;
• asphyxia. Suffocation, lack of oxygen, the cause of which is paralysis of the respiratory center.

The consequences of uncontrolled use of an antispasmodic are a danger to human life. From the drug noshpa, death occurs with the so-called overdose no later than 2 hours after the first obvious symptoms. Overdose and poisoning with "No-shpa" cause a state of collapse, which is manifested by a sharp decrease in blood pressure, circulatory disorders, insufficient oxygen supply to the brain. The venous flow to the heart decreases, which leads to its stop.

Death from "No-shpy"

Do not underestimate the composition of the drug and its active ingredient drotaverine, which reduces the excretory ability of the intestine, quickly dilates blood vessels. After a decrease in the supply of the necessary calcium, which is involved in the processes of metabolism and blood clotting, the body loses the ability to excrete the drug, and you can die from No-shpa.

Unfortunately, the instructions do not indicate the very important value of LD50, the lethal dose, which in No-shpa corresponds to 135 mg per kilogram of human body weight. With an overdose and a suicide attempt, a fatal outcome occurs in 1 case out of 1000. When taken orally, you can die from a large amount of "No-shpa" in 2 hours, with intravenous administration, death will occur in 30 minutes.

Pain shows us that there is a problem in the body, something is wrong. And if the pain is strong, sharp, appears in the same part of the body all the time, then you need to consult a doctor who will conduct an examination. One of the popular painkillers, antispasmodics is now No-Shpa - people often ask for it at the pharmacy. MirSovetov wants to offer readers this information so that you can learn more about this drug.

General information about No-Shpe

The drug is manufactured by a Hungarian company. And it all started in the sixties of the last century. Then the scientists of the Khinoin plant began to experiment with the antispasmodic Papaverine, which was popular in those years. As a result of all the studies, scientists Zoltan Mesharos and Peter Szentmiklosi managed to discover a substance that far surpassed papaverine in terms of strength and duration of the therapeutic effect. The main active ingredient of the drug created in those years, No-Shpy, became this substance, the chemical name of which is drotaverine hydrochloride. And No-Shpa is a trade name patented in 1962, which can be translated from Latin as “no spasm”. In pharmacies in the USSR, the drug appeared in the seventies of the last century. Available in several forms:

• tablets of 40 mg, packed in blister packs of 20, and then in cartons;
• tablets of 40 mg, packaged in 100 pieces in polypropylene bottles;
• tablets of 40 mg, placed 60 pieces in dosing containers;
• tablets of 80 mg, 20 pieces per pack (forte);
• ampoules of 2 ml in a package of 25 ampoules of 40 mg of drotaverine.

Excipients used in the formation of tablets: talc, povidone, magnesium stearate, corn starch, lactose monohydrate. No-Shpa (40 mg) are round tablets, their shape is biconvex, yellow in color, with a slightly greenish or orange tinge. On one of the sides there is a “spa” marking (this is how manufacturers make it clear that this is not a fake).

No-Spa forte (80 mg each) are oblong, convex tablets, the color of which is also yellow with a greenish or orange tinge, but they have the “NOSPA” marking on one side, and there is a risk on the other.

No-Shpa is a medicine used in medicine for the prevention and treatment of a number of functional conditions and pain that result from spasms of smooth muscles.

Drotaverine has antispasmodic, myotropic, hypotensive, vasodilating effects.

Once in the body, No-Shpa not only reduces the amount of calcium ions entering smooth muscle cells, while reducing the tone of the smooth muscles of internal organs (uterus, intestines, urinary and bile ducts), but slows down, inhibits their motor activity, helps blood vessels expand. The drug does not affect the central nervous and autonomic systems.

If the drug is administered intravenously, the effect begins to appear after 2 minutes, and its maximum is reached after 30 minutes. The taken tablet will show its therapeutic effect in 15 minutes. MirSovetov recalls that No-Shpa has a longer and stronger effect than Papaverine. This medicine can be used with caution in prostate adenoma, angle-closure - ailments when the use of m-anticholinergics is contraindicated.

When is No-Shpa appointed?

The help of this tool, which can be purchased at any pharmacy, is resorted to in the following cases:

1. To combat spasms of smooth muscles that occur with, cholangitis, cholecystolithiasis, cholangiolithiasis (in other words, with hepatic colic), pericholecystitis, papillitis, postcholecystectomy syndrome.
2. With spasms of the urinary system, namely, with pyelitis, nephrolithiasis (renal colic), urethrolithiasis.
3. Spasms of cerebral vessels, peripheral vessels.
4. To relieve excruciating headaches associated with tension.
5. In gynecology - for pain during menstruation (and before critical days), to weaken uterine contractions, during labor to relieve pain and relieve cervical spasm, the threat of miscarriage or.
6. Spasms against the background, or duodenum; with, enterocolitis, spastic, gastroduodenitis, proctitis, irritable bowel syndrome.

How to take this drug?

No-Shpu is drunk orally in the form of tablets, and ampoule solutions are injected into a vein, muscle, under the skin. Adults are allowed to take 1-2 tablets per day, the number of doses per day is three. The dosage for children depends on the age and reasons for which the drug should be used.

No-Shpu forte, in one tablet of which there is 80 mg of the active substance, adults take 1 tablet twice or thrice a day. If the drug is injected into a vein, the patient must be in a horizontal position. On the days of treatment, you should not drive vehicles, engage in activities that require the speed of psychomotor reactions and increased attention.

No-Shpa in combination with Diclofenac enhances their analgesic effect.

With Levodopa, the medicine cannot be taken, as its therapeutic effect is reduced, in order to avoid cardiac arrest, paralysis of the respiratory system.

No-Shpa during pregnancy

This drug refers to those means that can be resorted to during the period of gestation. If it rises, then this remedy is able to reduce the tension of the muscles of this organ, in which the baby is born. Numerous studies have shown that the medicine does not have side effects on the development of the fetus. Gynecologists recommend that women with tension and pain in the abdomen take No-Shpy tablets (no more than 6 pieces per day). But before that, you should definitely consult with a gynecologist at the antenatal clinic during the next examination. The remedy can not only be taken with isthmic-cervical insufficiency. Studies show that if a pregnant woman takes No-Shpa, then this helps to normalize the activity of the fetal heart. If a baby is detected in the womb, then the woman is injected with No-Shpu into the muscle, after which the tachycardia disappears.

Are there any contraindications and side effects?

This effective drug should not be taken with:

• severe manifestations of hepatic or renal failure;
• arterial hypotension;
• low cardiac output;
• individual intolerance;
• the drug contains lactose, so it is not taken in case of lactase deficiency, galactose intolerance;
• during lactation.

Sometimes, after the use of No-Shpa, a person has side effects, for example:

• allergic reactions;
• cardiogenic shock;
• dizziness;
• cardiopalmus;
• feeling of heat;
• increased sweating;
• , gag reflex, constipation.

The manufacturers of this medicine claim that if all the No-Shpa tablets they released were laid out in a chain, then such a chain could encircle the entire globe four times. All these calculations eloquently indicate that No-Shpa is very popular among the population of different countries of the world. People have trusted little yellow pills for over 50 years, they are in almost every home first aid kit - just in case you suddenly need to eliminate pain or cramps.

Tradename: NO-SHPA ®

International (non-proprietary) name: Drotaverine

Dosage form: tablets

Compound:

active substance: drotaverine hydrochloride - 40 mg;

Excipients: magnesium stearate - 3 mg, talc - 4 mg, povidone - 6 mg,

corn starch - 35 mg, lactose monohydrate - 52 mg.

Description

Round, biconvex tablets, yellow with a greenish or orange tint, spa engraved on one side.

Pharmacotherapeutic group:

Antispasmodic.

ATX code: A03A D02

Pharmacological properties:

Pharmacodynamics

Drotaverine is an isoquinoline derivative that exhibits a powerful antispasmodic effect on smooth muscles by inhibiting the enzyme, phosphodiesterase (PDE). The enzyme phosphodiesterase is required for the hydrolysis of cyclic adenosine monophosphate (cAMP) to adenosine monophosphate (AMP). Inhibition of the enzyme phosphodiesterase leads to an increase in the concentration of cAMP; 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 Ca 2+-calmodulin complex, resulting in the inactivated form of MLCK supporting muscle relaxation. cAMP also affects the cytosolic Ca 2+ ion concentration by stimulating Ca 2+ transport into the extracellular space and sarcoplasmic reticulum. This Ca 2+ ion concentration-lowering effect of drotaverine through cAMP explains the antagonistic effect of drotaverinate with respect to Ca 2+ .

In vitro, drotaverine inhibits the PDE IV isoenzyme without inhibition of the PDE III and PDEV isoenzymes. Therefore, the effectiveness of drotaverine depends on the concentration of PDE IV in tissues, the content of which varies in different tissues. PDE IV is most important for suppressing the contractile activity of smooth muscles, and therefore, selective inhibition of PDE IV 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 PDE III 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.

Pharmacokinetics

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. The maximum plasma concentration (Cmax) is reached in 45-60 minutes.

Distribution

In vitro, drotaverine has a high association with plasma transactions (95-98%), especially with γ-albumin and β-globumins.

Drotaverine is evenly distributed throughout the tissues, penetrates into smooth muscle cells. Does not penetrate the blood-brain barrier. Drotaverine and / or its metabolites may slightly cross 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.

breeding

In humans, a two-chamber mathematical model was used to assess the pharmacokinetics of drotaverine. The terminal half-life of plasma radioactivity was 16 hours.

Within 72 hours, drotaverine is almost completely eliminated from the body. More than 50% of drotaverine is excreted by the kidneys and about 30% through the gastrointestinal tract (excretion into bile). Drotaverine is mainly excreted as metabolites; unchanged drotaverine is not found in the urine.

Indications for use

• spasms of smooth muscles associated with diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis.
• spasms of smooth muscles of the urinary tract: nephrolithiasis, urethrolithiasis, pyelitis, cystitis, bladder tenesmus.

As adjuvant therapy:

• With spasms of the smooth muscles of the gastrointestinal tract: peptic ulcer of the stomach and duodenum, gastritis, spasms of the cardia and pylorus, enteritis, colitis, spastic, colitis with constipation and irritable bowel syndrome with flatulence after excluding diseases manifested by the "acute abdomen" syndrome (appendicitis , peritonitis, ulcer perforation, acute pancreatitis, etc.).
• For tension headaches.
• With dysmenorrhea.

Contraindications

• hypersensitivity to the active substance or to any of the excipients of the drug
• Severe liver or kidney failure
• Severe heart failure (low cardiac output syndrome)
• Children's age up to 6 years
• Breastfeeding period (lack of clinical data).
• Rare hereditary galactose intolerance, lactase deficiency and glucose-galactose malabsorption syndrome (due to the presence of lactose in the preparation).

Carefully:

With arterial hypotension.

In children (lack of clinical experience).

In pregnant women (see section "Pregnancy and lactation").

Dosage and administration

adults

Usually the average daily dose in adults is 120-240 mg (daily dose is divided into 2-3 doses). The maximum single dose is 80 mg. The maximum daily dose is 240 mg.

Children

clinical studies using drotaverine in children have not been conducted.

In the case of the appointment of drotaverine to children:

For children from 6 to 12 years old, the maximum daily dose is 80 mg, divided into 2 doses.

For children over 12 years of age, the maximum daily dose is 160 mg, divided into 2-4 doses. Duration of treatment without consulting a doctor

When taking the drug without consulting a doctor, the recommended duration of taking the drug is usually 1-2 days. If during this period the pain syndrome does not decrease, the patient should consult a doctor to clarify the diagnosis and, if necessary, change therapy. In cases where drotaverine is used as adjuvant therapy, the duration of treatment without consulting a doctor may be longer (2-3 days).

Efficiency evaluation method

If the patient can easily self-diagnose the symptoms of his disease, since they are well known to him, then the effectiveness of the treatment, namely the disappearance of pain, is also easily assessed by the patient. If within a few hours after taking the maximum single dose, there is a moderate decrease in pain or no decrease in pain, or if the pain does not significantly decrease after taking the maximum daily dose, it is recommended to consult a doctor.

Side effect

The following are the adverse reactions observed in clinical research, divided by systems, organs, indicating the frequency of their occurrence in accordance with the following gradations: very frequent (≥ 10%), frequent (≥1%,<10); нечастые (≥0,1%, < 1%); редкие (≥0,01%, < 0,1%) и очень редкие, включая отдельные сообщения (< 0,01%), неизвестная частота (по имеющимся данным частоту определить нельзя).

From the side of the cardiovascular system

Rare - increased heart rate, lowering blood pressure.

From the side of the nervous system

Rare - headache, dizziness, insomnia.

From the gastrointestinal tract

Rare - nausea, constipation.

From the side of the immune system

Rare - allergic reactions (angioneurotic edema, urticaria; rash, itching) (see section "Contraindications").

Overdose

There are no data on drug overdose.

In the event of an overdose, patients should be under medical supervision and, if necessary, they should receive symptomatic and supportive treatment, including artificial vomiting or gastric lavage.

Interaction with other drugs

With levodopa

Phosphodiesterase inhibitors, like papaverine, reduce the antiparkinsonian effect of levodopa. When prescribing drotaverine simultaneously with levodopa, it is possible to increase rigidity and tremor. With other antispasmodics, including m-anticholinergics Mutual enhancement of antispasmodic action.

Drugs that significantly bind to plasma proteins (more than 80%)

Drotaverine significantly binds to plasma proteins, mainly albumin,

γ and β-globulins (see section "Pharmacokinetics"). There are no data on the interaction of drotaverine. with drugs that significantly bind to plasma proteins, however, there is a hypothetical possibility of their interaction with drotaverine at the level of protein binding (displacement of one of the drugs by another from the protein bond and an increase in the concentration of the free fraction in the blood of the drug with a less strong binding to the protein), which is hypothetical may increase the risk of pharmacodynamic and/or toxic side effects of this drug.

special instructions

No-shpa® 40 mg tablets contain 52 mg of lactose. It can cause gastrointestinal complaints in individuals suffering from lactose intolerance. This form is unacceptable for patients suffering from lactose deficiency, galactosemia or impaired glucose / galactose absorption syndrome (see section "Contraindications").

Pregnancy and lactation

As shown by animal reproduction experiments and retrospective studies of clinical data, the use of drotaverine during pregnancy does not lead to either teratogenic or embryotoxic effects. However, the use of the drug is recommended only after careful weighing of the benefit/risk ratio.
Due to the lack of necessary clinical data during lactation, it is not recommended to prescribe.

Influence on the ability to drive a car and other mechanisms

When taken orally in therapeutic doses, drotaverine does not affect the ability to drive a car and perform work that requires increased attention. If any side effects appear, 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 and working with mechanisms.

Release form

Tablets 40 mg.

6, 10 or 20 tablets in PVC/Aluminum blister.

1, 2,4 or 5 blisters of 6 tablets with instructions for use in a cardboard box.

3 blisters of 10 tablets with instructions for use in a cardboard box.

1 blister of 20 tablets with instructions for use in a cardboard box.

10 tablets in an Aluminium/Aluminum blister (laminated with a polymer).

2 blisters with instructions for use in a cardboard box.

60 or 64 tablets in a bottle of polypropylene with a polyethylene stopper,

equipped with a dispenser.

100 tablets in a polypropylene bottle with a polyethylene stopper.

1 bottle with instructions for use in a cardboard box.

Best before date

For Aluminium/Aluminum blister tablets: 5 years. For tablets in PVC/Aluminum blister packs: 3 years.

For tablets in vials: 5 years.

Do not use the drug after the expiration date indicated on the package.

Storage conditions

For Aluminium/Aluminum blister tablets: store at a temperature not exceeding 30 °C.

For tablets in PVC/Aluminum blister packs: store at a temperature not exceeding 25 °C. For tablets in vials: store in a place protected from light at a temperature of 15°C to 25°C. Keep out of the reach of children.

Terms of dispensing from pharmacies

Without recipe

Manufacturer
Hinoin Plant of Pharmaceutical and Chemical Products CJSC, Hungary st. Levai, 5,2112 Veresgyhaz, Hungary.

Claims of consumers should be sent to the address in Russia:

115035, Moscow, st. Sadovnicheskaya, 82, building 2.

No-shpa is a frequently advertised and common drug. It is always at hand in the home first aid kit, and many people consider it a panacea for all types of pain, without thinking about contraindications and possible side effects. In order to avoid unpleasant consequences due to taking, you should remember the main properties of this medicine.

pharmachologic effect

Strong antispasmodic. The drug affects the smooth muscle tissue of the organs and the circulatory system, removing the tone, which leads to muscle relaxation. Blood vessels dilate, saturating organs and tissues with oxygen. As a result, muscle spasms decrease or disappear.

Composition and form of release

The main active ingredient is drotaverine hydrochloride (in Latin - Drotaverini Hydrochloridum). The drug is distributed in two forms: round or oval tablets for internal use and ampoules with a solution for intravenous and intramuscular injection.

Injection

The solution is a clear greenish-yellow liquid. In liquid form, the solution is available in dark glass ampoules with notches for breaking. 5 such ampoules are contained in plastic pallets, which are packed in a cardboard box in the amount of 1-5 pieces.

One ampoule (2 ml) contains:

• drotaverine hydrochloride - 40 mg;
• sodium disulfite - 2 mg;
• ethyl alcohol 96% - 132 mg;
• water for injection - up to 2 ml.

Tablets

Tablets are yellow, round, biconvex, with the inscription "spa" on one side. The blister packs 6, 10, 12, 20 or 24 tablets. One carton pack contains 3 blisters of 10 pcs, or 2 blisters of 12 pcs, or 1 blister of 20 or 24 pcs. The following packaging options are also common: a polypropylene bottle with a cap, containing 60, 64, 100 pieces; polypropylene bottle for 60 tablets with a piece dispenser.

1 tablet contains:

When appointed

The tablet preparation is prescribed for:

• spasms of smooth muscle tissue in diseases of the biliary tract (cholangitis, cholecystitis, papillitis, cholecystolithiasis, pericholecystitis, cholangiolithiasis);
• spasms of smooth muscle tissue (pyelitis, cystitis, nephrolithiasis, urethrolithiasis, bladder spasms);
• spasms of smooth muscle tissue of the digestive system (peptic ulcer of the stomach and duodenum, colitis, flatulence, non-infectious gastroenteritis, gastritis, spasms of the cardia and pylorus);
• tension headaches;
• menstrual pain (dysmenorrhea).

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No-shpa for hemorrhoids

The most common are bleeding, burning, and, especially, pain in the rectum due to spasms of the anal sphincter. To reduce symptoms, the patient is prescribed antispasmodics.

Medicines for hemorrhoids are always prescribed by a specialist proctologist. They can be used only at an early stage of the disease, when there is no complicated course of hemorrhoids. But if the pain is accompanied by severe tissue inflammation, bleeding, or prolonged infringement of the hemorrhoidal veins, drotaverine will be useless. It is best to use the drug in combination with local therapy and taking anti-inflammatory drugs.

How to take No-shpa

Tablets are taken orally orally. The maximum daily dose for adults is 6 tablets (240 mg). Dosage: 1-2 tablets 2-3 times a day.

The maximum daily dose for children 6-12 years old is 2 tablets (80 mg). Dosage: 1 tablet 1-2 times a day.

The maximum daily dose for children over 12 years old is 4 tablets (160 mg). Dosage: 1 tablet 1-4 times a day or 2 tablets 1-2 times a day.

When taking the drug without consulting a doctor, it is recommended to drink the medicine for no more than 1-2 days in a row. The duration of admission with adjuvant therapy is no more than 2-3 days. In case of exacerbation of the pain syndrome, immediately consult a therapist.

When using the liquid form of the drug, the daily intake is limited to 40-240 mg (1-3 doses during the day). In acute renal colic or bile duct colic, 40-80 mg are administered intravenously (slow administration - about 30 seconds).

1. Antispasmodics do not cure, but relieve pain symptoms. Severe pain can be a signal of the development of tumors, infection or the initial stage of a dangerous disease, in this regard, the drug should not be used for more than two days in a row without consulting a specialist.
2. Do not take antispasmodics based on drotaverine before meals. You definitely need to eat something, because. with a full stomach, the substance is much better absorbed and will not show side effects.
3. With the appearance of weakness, dizziness, nausea, it is worth refusing to continue taking the drug. It should be excluded if after 20-30 minutes after application the pain has not decreased.
4. Some phenobarbital-containing drugs (for example, Luminal) and other antispasmodics can enhance the effect of the drug, but the parallel use of different drugs should always be accompanied by the supervision and recommendations of the attending physician.

How long does No-shpa work

Contraindications for use

The drug is prohibited to receive:

• children under 6 years of age;
• with severe heart failure;
• with hypersensitivity to the main component or any of the auxiliary;
• with severe renal or heart failure;
• for the period of lactation;
• with galactose intolerance, lactase deficiency and malabsorption syndrome of glucose-galactose;
• if there is hypersensitivity to sodium disulfite (for solution).

If at high blood pressure it is recommended almost without restrictions, then at low pressure the drug is used with caution and under the strict supervision of a specialist.

Side effects of the drug No-shpa

Clinical studies of the drug have shown the following possible adverse reactions in adult patients to the action of the drug:

special instructions

With therapeutic treatment and intake at the indicated dosage, the drug should not affect the management of vehicles and other equipment. With the manifestation of side effects, such as a decrease in attention, the question of working with the technique should be considered individually.

Sodium disulfite, which is part of the solution for injection, may cause an allergic reaction in patients with asthma or chronic allergic diseases. In case of hypersensitivity to disulfite, No-shpy should be avoided.

With intravenous administration of the drug, the patient with low blood pressure should lie horizontally to avoid the development of collapse.

The drug has poor compatibility with alcohol. When drinking alcohol, the load on the intestines increases, and drotaverine is quickly excreted from the body. In addition, the principle of their action on the body is similar, which causes rapid fatigue and gastrointestinal upset.

Use during pregnancy and lactation

Clinical trials have not shown teratogenic and embryotoxic effects of drotaverine on fetal development during pregnancy. But if necessary, the medicine should be taken with caution only if the benefit to the mother's body is higher than the risk to the fetus. It is better to avoid prescribing the injectable form of the drug.

At the same time, doctors recommend taking it in the early stages of pregnancy: drotaverine dilates blood vessels, and oxygen is evenly distributed throughout the body. Obstetricians recommend it for uterine tone and spasmodic pain, but not often.

During breastfeeding, it is not recommended to prescribe the drug. Also, the drug should not be used during childbirth to avoid possible postpartum atonic bleeding.

Application in childhood

The official instructions indicate doses only for children from 6 years of age. Drotaverine - the main active ingredient of the drug - is not a natural ingredient. Treatment of pain symptoms in children under this age should only occur as prescribed by a doctor at the dosage indicated by him.

It is prescribed to children in the following cases:

• white fever: high temperature with cold extremities;
• cough with stenosis or bronchitis caused by muscle spasms;
• headache caused by muscle spasms;
• spasms with gastritis or colitis;
• renal or intestinal colic;
• excessive painful manifestations of flatulence;
• spasms of smooth muscles with pyelitis or cystitis.

The drug should not be given to children:

• under the age of one year;
• under reduced pressure;
• with intolerance to drotaverine;
• with bronchial asthma;
• with suspected appendicitis;
• with liver or kidney failure;
• with vascular diseases (atherosclerosis);
• with suspected intestinal obstruction.

With white fever or acute spasmodic pain, the doctor in some cases may prescribe a few drops of the liquid form of the drug to an infant up to a year old.

When taken in children, specific side effects may occur:

1. Allergy. It manifests itself in the form of sneezing or skin rashes.
2. Tachycardia or lethargy caused by low blood pressure. Occur rarely.
3. Digestive disorders: nausea, sometimes with vomiting. Gas, constipation, and indigestion may also occur.
4. Difficulty sleeping or insomnia.

In case of side effects, the reception should be stopped immediately.

Interaction with other drugs

You can use combinations with other drugs. For example, to create a "lytic mixture" - a combination of analgesic antipyretic (Analgin), antihistamine (Suprastin or Diphenhydramine) and antispasmodic drugs. This mixture quickly and effectively brings down the temperature even in children.

Another effective combination - with Paracetamol - is more suitable for adults. Paracetamol will lower the temperature, relieve pain and start anti-inflammatory processes in the body, and drotaverine will relieve muscle spasm and dilate blood vessels.

Compatibility with other antispasmodics - papaverine, bendazole, etc. - enhances the antispasmodic effect of the drug.

Phenobarbital will enhance the relaxing effect of drotaverine on the muscles.

Analogues

A package of drug tablets costs more than 200 rubles, which is not always affordable for buyers. In pharmacies, there are other antispasmodics, sometimes several times cheaper, but equal in effectiveness.

Not all antispasmodics work in the same way. To choose an anesthetic, you need to know the origin and nature of the pain and the features of the drug. For example, drugs based on drotaverine are effective for muscle spasms or vascular spasms, but are useless for headaches and migraines. In such cases, special drugs are prescribed - Paracetamol or Analgin.

Pain due to inflammatory processes is best relieved by non-steroidal anti-inflammatory drugs - Pentalgin or Ibuprofen. Ketoprofen will relieve toothache. But it is always better to coordinate the replacement with a specialist.

Terms and conditions of storage

The drug requires storage away from children at a temperature of 15-25 ° C. Tablets must be stored for 3 years, ampoules with a solution - 5 years. After the expiration date, the drug should not be used.

Drotaverine

No-shpa is a fairly common drug that is often used in medical practice. Such a remedy is prescribed for various pains. Most often, No-shpu is used to relieve spastic pain that occurs in the organs of the peritoneum due to spasm of smooth muscles.

No-shpa is a drug that can relieve spasm and relieve pain. This drug is taken orally in the form of tablets or injections. In this article, we will look at what No-shpa is, how it works and in what dosages it should be taken for various spasmodic pains.

No-shpu is referred to as antispasmodics, drugs that relieve spasm. What does he represent? A spasm is considered an involuntary contraction of the muscles that has arisen due to physiological or pathological causes. Spasm is a symptom of some diseases. It can also provoke a particular disease, as it disrupts blood circulation in muscle tissue.

Antispasmodics, depending on the mechanism of action, are usually divided into 2 large groups:

1. Neurotropic. Such drugs are aimed at influencing the nerve endings in order to impair their transmission of impulses to the brain.
2. Myotropic. These drugs relieve spasm of muscle tissue by participating in biochemical processes in cells. Myotropic drugs (unlike neurotropic antispasmodics) do not affect the human nervous system.

No-shpu is referred specifically to myotropic antispasmodics. Its mechanism of action is due to the activity of the active ingredient - drotaverine. Its main properties:

• decreased intake of calcium ions into muscle cells;
• significant expansion of the vessels of internal organs;
• lowering blood pressure;
• increase in cardiac output.

Drotaverine is a derivative of isoquinoline, a chemical element that can inhibit a special enzyme, phosphodiesterase. This enzyme is involved in the hydrolysis of cyclic adenosine monophosphate, increasing its concentration in the blood.

This leads to a chain of biochemical reactions in muscle cells that lower the concentration of active calcium. This provokes the suppression of the contractile activity of muscle tissue. Drotaverine relieves spasm of smooth muscles of neurotic and myotic origin, leading to relaxation of the muscles of internal organs.

After ingestion, drotaverine is completely absorbed and metabolized. Its maximum concentration is observed 40 minutes after ingestion. It is evenly distributed in smooth muscle cells.

It does not have the ability to penetrate the blood-brain barrier, but it can penetrate the placenta in small quantities. The period of complete elimination of drotaverine lasts about 4 days. At the same time, half of it is excreted by the kidneys along with urine, and 30% - along with bile.

In addition to drotaverine, No-shpa contains excipients, the presence of which differs somewhat depending on the form of release of the drug:

The use of one or another pharmacological form of the drug depends on the general condition of the patient, the intensity of the pain syndrome, as well as the contraindications he has. The dosage and duration of treatment is determined by the attending physician.

How and when to take the medicine?

No-shpa is a widely known and affordable drug. However, it is worth remembering that its use is not always possible and effective. In some cases, the drug can harm the body. It is better to entrust the calculation of the dosage to a specialist.

Purpose

There are special indications when its use is appropriate. Among them:

Also, the drug has a number of contraindications that should be considered before using it. It is forbidden to use No-shpu for such phenomena:

• the presence of an allergy to drotaverine or other components of the drug;
• individual intolerance to one or more substances that are part of No-shpa (for example, lactose);
• severe pathologies of the cardiovascular system (heart failure, ischemic disease);
• children's age (categorically not recommended for children under 7 years old);
• lactation period.

With extreme caution, use the remedy for the treatment of spastic pain in pregnant women (especially in the first trimester), patients with arterial hypertension and school-age children.

Dosage

Determination of the dosage of the drug is carried out by a doctor and depends on the dosage form and age of the patient. Solution for injection is not used to treat young children.

For an adult, the maximum dose at one time is one or two tablets; no more than 240 mg of drotaverine can be administered per day.

Tablets are intended for oral administration, while drinking it, swallowing whole, and washing down with liquid. The dosage of No-shpa in tablets is carried out as follows:

• adults drink 3-6 tablets in 3 doses (it is not recommended to drink more than two tablets at a time and exceed the maximum daily dose of the active ingredient);
• children from (up to 12 years old) drink one tablet twice a day;
• teenagers can take 4 tablets per day.

Side effects

Do not exceed the dosage indicated in the instructions or prescribed by your doctor. This can lead to overdose and side effects. The following negative phenomena are distinguished:

Precautionary measures

Some precautions should be taken to avoid negative reactions. Among them:

Some features of therapy

The use of the drug and its dosage depends on certain indications. For example, No-shpu is often prescribed to relieve headaches. But it is not always effective in such a pain syndrome, since headache is a symptom of many diseases that should be treated with the help of special means.

No-shpa only relieves spasm of cerebral vessels. Therefore, it is prescribed only for tension headaches. The drug is often used for other pains, for example, dental, liver, etc.

For headache

With pain sensations of a spastic nature, No-shpa is used in tablets or in the form of a solution for injection. It is easily absorbed in the gastrointestinal tract and evenly distributed throughout the body, exerting action in the right place. When taking medication, it is important to remember:

If necessary, a patient with a tension headache may be prescribed an intramuscular injection of the drug to accelerate the effect. It is not recommended to enter more than 2 ampoules at a time.

Elena R.: “I work as a call center operator. The work is nervous. The head after the change is torn. I drink 2 No-shpy tablets, and everything goes away. Cool tool."

For other types of pain

During pregnancy and HB

Can No-shpu be used during pregnancy and breastfeeding? Pregnant women are not forbidden to drink No-shpa with spastic pains. Drotaverine crosses the placenta in small quantities and does not pose such a danger to the fetus as Analgin or Aspirin. Therefore, it is allowed in the treatment of pregnant women. But at the same time, expectant mothers should remember:

• you should be careful not to drink No-shpu uncontrollably, so as not to provoke late toxicosis;
• you can not use the medicine for isthmic-cervical insufficiency;
• before use, you need to consult a gynecologist who will assess the course of pregnancy.

Alina E., young mother:“When I was pregnant, I developed cystitis. To eliminate pain in the bladder and in the abdomen, the doctor prescribed No-shpu. I doubted whether this medicine was possible in my position. But the gynecologist convinced me that I had no contraindications, and No-shpa is safer than the same Analgin.

Drotaverine is able to penetrate into breast milk, and to eliminate the risk of negative effects on the child, you should refrain from using No-shpa during lactation.

No-shpa is an antispasmodic that relieves spasm of the smooth muscles of the internal organs and muscles. It is advisable to take it only if there are appropriate indications. In other cases, it will not help or will have a negative impact on human health.