No-Shpa: useful qualities and the possibility of overdose. What do no-shpa tablets help with?

"No-shpa" is available in tablets of 40 and 80 mg. It is an effective antispasmodic that can be purchased without a doctor's prescription. "No-shpa" does not affect the peripheral and central nervous systems, therefore, in therapeutic doses, it does not affect the concentration of attention. In the case when the source of pain is a spasm ─ "No-shpa", unlike analgesics, copes with the cause of pain.

Instruction

Take "No-shpu" inside with a small amount of water. If "No-shpa" is assigned to general treatment, take it through 30-45 minutes. after a meal, with an emergency admission, you can not adhere to this rule. The drug begins to act after 10-20 minutes, its maximum concentration in blood serum is reached after 45-60 minutes.

The maximum daily dose for

adults

─ 240 mg, usual daily dose ─ 120 mg. The daily dose is divided into 2-3 doses. one-time maximum dose─ 80 mg. "No-shpa forte" contains the maximum single dose in each tablet, if you need to take 40 mg ─ divide the tablet. If within 2 days from the start self-treatment the pain does not go away ─ see a doctor. A longer intake of "No-shpy" is unacceptable, except when the drug is prescribed as an additional therapy.

Children from 6 to 12 years old can be given "No-shpu" no more than 2 times a day, the maximum daily dose is 80 mg, i.e. 2 tablets. Children over 12 years old are given "No-shpu" 2-4 times a day, one tablet, while the maximum daily dose is 160 mg, and the maximum single dose is 40 mg.

"No-shpa" does not have an embryotoxic effect on the fetus, and therefore can be used during pregnancy, for example, to relieve uterine tone. The drug must be prescribed by a doctor, it is better to avoid injection"No-shpy." During breastfeeding the question of taking "No-shpa" should be decided on an individual basis.

Indications for taking "No-shpy": spasms of smooth muscles, tension headaches, menstrual pain. This drug should not be taken with severe forms renal, cardiac and liver failure, children up to 6 years. It should be taken with caution in patients with low blood pressure, since the active substance also acts on the muscular wall of the vessels. "No-shpa" in solutions for injection is sold only by prescription and should not be used without a doctor's prescription.

Side effects when taking therapeutic doses of "No-shpy" occur only in 0.01% of patients. Headache, increased heart rate, nausea, urticaria, insomnia ─ the most common complaints associated with taking the drug. If a large dose of "No-shpy" was taken, it is necessary to wash the stomach and take the victim to the hospital as soon as possible or call ambulance.

Tablets in aluminum / aluminum blister packs are stored for 5 years at temperatures up to 30 ° C, tablets in aluminum / PVC blister packs should be stored at a temperature not exceeding 25 ° C, their shelf life is 3 years, tablets in vials must be stored in a place protected from light at a temperature of 15-25 ° C 3 years from the date of issue. Analogues of "No-shpy" ─ any antispasmodics containing drotaverine as an active substance. It should be taken into account that their effectiveness may differ from the effectiveness of No-shpa, side effects and the frequency of their occurrence is also different.

How to drink "No-shpu"

There are medicines that should be in the first aid kit of any family. One of these drugs is No-shpa, which has established itself as a highly effective antispasmodic used to relieve pain. different nature. Due to the fact that the medication is dispensed without a prescription, it is often used uncontrollably, without taking into account the contraindications and side effects that No-shpa has, like any of the medicines.

Active substance of this drug - drotaverine, which has an antispasmodic effect on smooth muscles and therefore is able to cope even with severe pain spastic character

How to use No-shpu correctly, and in what cases will the drug bring real benefits?

The drug No-shpa refers to myotropic antispasmodics. It contains the active substance drotaverine, which affects the smooth muscles of the genitourinary, gastrointestinal, cardiovascular, biliary systems.

Drotaverine relaxes the muscles, as a result of which spasms weaken, which makes it possible to use the drug to relieve pain in diseases of the gastrointestinal tract and diseases that are accompanied by motor hyperfunction. The active ingredients of No-shpa accelerate blood circulation in the tissues, which leads to vasodilation, i.e. relieves headaches and relieves feverish conditions.

Drotaverine has no side effects on cardiovascular system, because the smooth muscle cells of the myocardium and blood vessels mainly contain the isoenzyme PDE III

The excipients that make up No-shpa contribute to better absorption of the drug: talc, starch, magnesium stearate, polyvidone, lactose monohydrate.

Release form of the drug: ampoules for intramuscular injections and more popular - tablets.

Drug analogues:

Drotaverine;
Spazmonet;
Papaverine;
Spasmol;
Nokhshaverin.

In terms of composition and action, No-shpa tablets resemble Papaverine, but have a more pronounced effect. No-shpa relieves pain of various origins, prevents the penetration of calcium ions into organs, lowers the tone of smooth muscles, but does not negative impact on the state of the nervous system.

The most popular analogue of No-shpa is Drotaverine tablets, which have the same principle of action and composition, and have the same effect, and are also much cheaper. Does it make sense to acquire No-shpu, if any inexpensive drug similar action?

No-shpa is patented, original drug, and the presence of a patent imposes special obligations on the manufacturer - must be provided production control, compliance of raw materials with quality and safety. Before getting on the shelves, the drug goes through a series of clinical trials where strict requirements are imposed on him.

After taking no-shpa tablets, pain symptoms begin to disappear after 10-12 minutes. The introduction of no-shpa intravenously provides relief within the first few minutes, but the full effect is achieved only half an hour after taking the drug.

Drotaverine, on the other hand, refers to generics, i.e. is an off-patent drug with much lower requirements. This does not mean that Drotaverine may be ineffective and adversely affect health, but it explains the great popularity of No-shpa and justifies its high cost.

How long does No-shpa work? No-shpa is the best at coping with spasms, i.e. with involuntary muscle contraction, causing pain. If conventional analgesics (for example, Analgin) are used to relieve such pain, the effect will be short-lived, while No-Shpa acts directly on the cause of the pain, resulting in unpleasant symptoms for a long time are not returned.

The drug can be used both as a main and as an auxiliary therapeutic agent for a number of pathological conditions:

spastic constipation;
Pyelite;
Colitis;
Tenesmus;
Proctitis;
Gastroduodenitis;
colic;
cholecystitis;
Algodysmenorrhea;
Spasm of the arteries;
Endarteritis;
stomach ulcer;
Dyskinesia of biliary organs;
Spasm of cerebral vessels.

In addition, No-shpa is used for certain conditions, to alleviate and relieve unpleasant symptoms.

The instruction does not indicate that No-shpa eliminates headaches. But, if pain in the head is associated with fatigue or insomnia, then the drug actively copes with the elimination of compressive headaches.

Note! No-shpa for headaches is not recommended for use simultaneously with other antispasmodics, but it can be used together with drugs from the analgesic group (paracetamol, analgin, etc.).

With constant headaches, it is not recommended to use No-shpu regularly, it is better to consult a doctor to find out the cause of the painful condition.

No-shpu can also be used for spasms of peripheral arterial vessels, as well as cerebral vessels

At elevated temperature if it is accompanied by muscle spasms (convulsions), along with antipyretic children and adults, it is recommended to give an antispasmodic - No-shpu.

How independent remedy No-shpa is not effective for lowering the temperature.

When carrying a child in pregnant women, a high tone of the uterus is often observed, which threatens with a miscarriage. To relieve spasm of the muscles of the uterus, No-shpa is often prescribed.

Before childbirth, No-shpu is often prescribed in combination with Buscopan or Papeverin in order to prepare birth canal to the normal passage of the fetus. Gynecologists say that this is quite effective in helping to facilitate future childbirth, both for the mother herself and for the child.

No-shpa does not have an expectorant and antitussive effect, therefore it is useless when coughing.

But if the inflammation coughing, is localized in the lungs and bronchi, then coughing fits can provoke spasms in respiratory tract and suffocation. In such conditions, No-shpa helps to significantly alleviate the condition, but not cure the cough.

Pain during menstruation can be so intense that it resembles labor pains. The reason for such pain are contractions of the uterus - antispasmodic No-shpa acts relaxing on the muscles of the uterus and neutralizes pain.

During painful periods, it is possible to drink up to six tablets of the drug per day.

No-shpa can be prescribed as ancillary treatment with cystitis to eliminate pain. The medicine quickly relieves heaviness in the lower abdomen and relieves pain that occurs in the lumbar region.

After taking No-shpa, the muscles Bladder relax, as a result of which the body begins to function more efficiently.

If the increase in pressure is associated with vasospasm, then No-shpa can reduce blood pressure, because. the drug improves blood circulation and has a beneficial effect on blood vessels.

When reducing pressure with the help of No-shpy, the dosage of the drug must be observed, because. uncontrolled intake can reduce blood pressure to critical numbers.

V clinical practice this medicine is used to relieve organ spasms gastrointestinal tract and bile ducts

If intestinal spasms are not associated with pathologies, but are caused by poisoning, motor disorders, long-term use medicines, then No-shpa will help to cope with pain of any intensity.

However, with prolonged pain in the intestinal area, you should not try to stop the pain with an antispasmodic, but it is better to immediately consult a doctor.

In the abdominal or retroperitoneal space, sharp cramping pains may occur. Colic can be hepatic, renal, pancreatic, intestinal, depending on the location of their localization. Their presence may cause uncontrolled reception alcohol, abuse fatty foods and other reasons.

No-shpa in this case quickly neutralizes the pain, but does not eliminate their cause. Therefore, in such conditions after anesthesia, it is better to seek medical advice.

You can drink an antispasmodic in tablets, 1-2 pieces at a time, twice or thrice a day. In the form of injections (in ampoules), the drug is injected into a vein at a dosage of 40 mg to 80 mg.

Babies, whose age is from 6 to 12 years old, should consume no more than 80 mg per day, and this amount is divided into 2-4 doses. No-shpa after 12 years of age can be used by children at a dosage of up to 160 mg of the drug, also stretching it over several doses.

Adults should not exceed daily dosage medication - 240 mg, and one-time admission should not be more than 80 mg.

In some cases, the use of No-shpa is possible without medical consultation, but before that, you should definitely study all the contraindications to the drug and recommendations for its use. Self-administration of drugs as an anesthetic should not exceed two days - after this period, it is worth contacting the doctors to identify the causes of pain.

Who is contraindicated for No-shpa:

With severe heart failure;
With intolerance to galactose;
With severe pathologies of the liver or kidneys;
With violations of intestinal absorption;
With intolerance to the components of the drug.

Taking an antispasmodic is not allowed for children who are under the age of six.

The usual average dose for adults is daily 40-240 mg of drotaverine hydrochloride (divided into 1-3 doses per day) intramuscularly. For acute colic (biliary and urolithiasis) 40-80 mg intravenously

Patients' comments indicate that usually the drug is well tolerated, only in some cases can be observed:

increased sweating;
Arrhythmia;
Allergy;
Dizziness;
Decreased blood pressure;
palpitations;
Temperature increase.

With arterial hypotension, No-shpu should be used with caution, because. the drug can provoke respiratory failure and collapse.

During the period of bearing a child, only the attending physician should decide on the advisability of using No-shpa. During lactation, the use of an antispasmodic is not recommended.

The vast majority of reviews on the use of No-shpa are positive: women write that the drug helps to cope with menstrual pain, patients indicate that it perfectly relieves stomach and intestinal spasms helps with headaches.

No-shpa is a drug for relieving spasms.

No-shpa dilates blood vessels, reduces muscle tone internal organs, reduces intestinal peristalsis, while the agent does not affect the central nervous system.

The active substance of the drug is drotaverine hydrochloride, which is similar in action to papaverine, but it is characterized by a more pronounced, lasting effect.

At intravenous administration therapeutic effect comes in 2-4 minutes.

They produce No-shpa tablets and solution.

The drug is effective for spastic constipation and spastic colitis, pyelitis, tenesmus, proctitis, gastroduodenitis, gastrointestinal ulcers, endarteritis, spasms of the coronary, cerebral and peripheral arteries, algomenorrhea.

In addition, according to the instructions, No-shpa is prescribed for the treatment and prevention of muscle spasms of internal organs in renal, intestinal, biliary colic, cholecystitis, dyskinesia of the gallbladder, bile ducts, postcholecystectomy syndrome.

No-shpa is used during pregnancy - to remove the threat of miscarriage, prevent premature birth. In obstetric practice, the remedy is used to relieve spasm of the uterine pharynx during childbirth, in case of prolonged opening of the pharynx, to relieve postpartum contractions.

The drug is also used during cholecystography, instrumental examinations.

Inside, according to the instructions, No-shpu is prescribed at a dosage of 120-240 mg (daily dose), which is taken two or three r / day. The maximum allowable single dose of No-shpa tablets is 80 mg, and the daily dose is 240 mg.

Intramuscularly, the drug is administered to adults in the amount of 40-240 mg / day for 1-3 injections. For acute biliary and renal colic the drug is administered intravenously at a dosage of 40-80 mg for 30 seconds.

No-shpu for children 6-12 liters is prescribed at a dosage of 80 mg in two doses, for children after 12 liters - 160 mg in 2-4 doses.

Permissible single dosage when prescribing No-shpa to children 6-12 liters - 20 mg, daily - 200 mg.

When using the remedy on your own, without a doctor's prescription, it should be borne in mind that therapy should last no more than one or two days. If after this period the pain has not been relieved, you should contact for medical assistance to clarify or clarify the diagnosis.

No-shpu during pregnancy is prescribed to take an average of 3-6 tablets / day when characteristic symptoms increased tone uterus - sipping and pain in the lower abdomen. good effect gives a combination of the drug with papaverine and valerian. It is recommended to take No-shpa during pregnancy only as prescribed by a doctor, strictly following the prescription.

May cause palpitations, fever, increased sweating, dizziness, decreased pressure, allergies.

Because of intravenous use No-shpa, the patient may begin to collapse, arrhythmia, respiratory depression. To prevent the development of these conditions, the patient with reduced pressure You should be in a supine position during the infusion procedure.

Due to an overdose of No-shpa, the excitability of the heart muscle may decrease, paralysis may occur. respiratory center, cardiac arrest.

The drug No-shpa according to the instructions is contraindicated in severe heart, liver failure, hypersensitivity to the agent, intolerance to sodium disulfite (for intramuscular, intravenous administration).

No-shpa tablets should not be taken with galactose-glucose malabsorption syndrome, congenital intolerance galactose, lack of lactase.

Intramuscular and intravenous administration of the drug is contraindicated in children under 18 liters, and the appointment of the No-shpa tablet form is contraindicated in children under 6 liters.

For patients with gastrointestinal ulcers, No-shpa is usually prescribed simultaneously with antiulcer drugs.

Since dizziness often begins after intramuscular, intravenous administration of the drug, it is recommended to refrain from driving a vehicle or operating other complex, potentially dangerous mechanisms for another hour after the procedure.

During therapy, it should be borne in mind that the drug can weaken the effect of Levodopa, the antispasmodic effect of Morphine, enhance the effect of Bendazole, Papaverine, and other antispasmodics. Phenobarbital increases the antispasmodic activity of the drug.

How to take Noshpa - before meals or after?

In general, almost all tablet preparations must be taken after meals. Why yes because they can all have a very harmful effect on the gastric mucosa. Therefore, they are used after meals. But that's about nosh - ne nothing is written anywhere and the drug itself is made from herbal concentrates. And so it can be used before meals.

Noshpa accept after meal, but not immediately, but ideally in an hour. Reception of noshpa at the same time with food is excluded, as this reduces its effect.

If you need to quickly relieve pain, but it does not matter when to apply before or after meals, the main thing is not during.

In the instructions for the use of this drug, dependence on food when taking is not indicated. From which we can conclude that this drug is taken regardless of food intake. The recommended daily dose for adults is 120-240 mg in two to three doses.

No-shpa is medicine, almost instant action, as for me. And if something hurts and a spasm torments me, I don’t pay attention to when I took food, I take it and drink it. It has a very pronounced analgesic and antispasmodic effect. It is used in tablets of 40-60 mg - 2 or 3 times a day, but I usually do it once. A solution - 2-4 ml intravenously or intramuscularly.

How to take No-shpu

Reception of the drug No-shpa is carried out regardless of the meal. This drug belongs to the group of nootropic antispasmodics and is used for spasms of smooth muscles, mainly in the abdominal cavity…

The instructions for taking the drug say that the use of tablets does not depend on food intake. That is, you can take it before meals, and after it. But still, I think that nosh-pu should not be taken with food, as one takes food supplements. After all, nosh-pu is usually taken as an anesthetic, and it is likely that its effectiveness will be reduced when eating.

Usually, a drug like Noshpa is taken when crazy pains already begin, so you don’t want to think about whether to eat or not, and usually you don’t feel like eating when you have pain, there is absolutely no time. But personally, I prefer to drink all medicines after meals, so that they do not damage the stomach (of course, if the instructions do not provide for taking the pill before meals).

In the instructions for this drug, they are silent about this about the time of application of No-shpa.

But I think No-shpu, like other drugs, is generally taken after meals.

At least thirty minutes, or ideally one hour.

To be honest, if pains of a spasmodic nature have begun, then I no longer think about taking a noshpu before eating or after, I just take the pain through a short time passes, that is, it turns out that there is no difference, this, as practice shows; but in the instructions for the drug, no matter how much you read, I never found about special instructions on admission this drug, hence we can conclude that there is no difference when to take: before meals or after meals.

antispasmodic drug with trade name No-Shpa used to relieve pain during spasms. Since the instructions for use do not indicate how to take No-Shpu, before meals or after, it can be concluded that the intake of this drug does not depend on the time of eating.

In this article, you can read the instructions for using the drug No-shpa. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of specialist doctors on the use of No-shpa in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Analogues of No-shpy, if available structural analogues. Use for treatment and relief spasmodic pain in adults, children, as well as during pregnancy and lactation.

No-shpa- myotropic antispasmodic, isoquinoline derivative. It has a powerful antispasmodic effect on smooth muscles due to inhibition of the PDE enzyme. The enzyme PDE is 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 (the active substance of No-shpa) 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 the suppression contractile activity smooth muscle, and therefore selective PDE4 inhibition 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, No-shpa 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 autonomic innervation drotaverine relaxes the smooth muscles of the gastrointestinal tract, biliary tract, and genitourinary system.

Pharmacokinetics

After oral administration, No-shpa is rapidly and completely absorbed. After first pass metabolism systemic circulation enters 65% taken dose drotaverine. Drotaverine is evenly distributed in tissues, penetrates into smooth muscle cells. Does not penetrate the blood-brain barrier. Drotaverine and / or its metabolites are able to slightly penetrate the placental barrier. Within 72 hours, drotaverine is almost completely eliminated from the body. More than 50% of drotaverine is excreted by the kidneys and about 30% through the intestines (excretion into bile). Drotaverine is mainly excreted as metabolites; unchanged drotaverine is not found in the urine.

Indications

spasms of smooth muscles in diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis;
spasms of smooth muscles of the urinary system: nephrolithiasis, urethrolithiasis, pyelitis, cystitis, spasms of the bladder.

As adjuvant therapy:

with spasms of smooth muscles of the gastrointestinal tract: peptic ulcer stomach and duodenum, gastritis, spasms of the cardia and pylorus, enteritis, colitis, spastic colitis with constipation and irritable bowel syndrome with flatulence after exclusion of diseases manifested by the syndrome " acute abdomen"(appendicitis, peritonitis, ulcer perforation, acute pancreatitis);
tension headaches (for oral administration);
algomenorrhea.

Release form

Tablets 40 mg.

Tablets No-shpa forte 80 mg.

Solution for intravenous and intramuscular injection(injections in ampoules for injections).

Instructions for use and dosage

The average daily dose for intramuscular injection in adults is 40-240 mg (divided into 1-3 injections per day). In acute colic (renal or biliary), the drug is administered intravenously slowly at a dose of 40-80 mg (duration of administration is approximately 30 seconds).

Clinical studies with the use of drotaverine in children have not been conducted.

In the case of the appointment of the drug No-shpa, the maximum daily oral dose for children aged 6 to 12 years is 80 mg in 2 doses, over the age of 12 years - 160 mg in 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 pain syndrome does not decrease, the patient should consult a doctor to clarify the diagnosis and, if necessary, change therapy. In cases where HO-shpa 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 illness, because they are well known to him, 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 drug at 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

cardiopalmus;
decrease in blood pressure;
headache;
dizziness;
insomnia;
nausea;
constipation;
rash;
hives;
angioedema;
reactions at the injection site.

Contraindications

severe renal failure;
severe liver failure;
severe heart failure (low cardiac output syndrome);
children's age up to 6 years (for tablets);
children's age (for parenteral administration, since no clinical studies have been conducted in children);
breastfeeding period (no clinical data);
rare hereditary galactose intolerance, lactase deficiency, glucose-galactose malabsorption syndrome (for tablets, due to the presence of lactose in their composition);
hypersensitivity to the components of the drug;
hypersensitivity to sodium disulfite (for solution for intravenous and intramuscular administration).

Use during pregnancy and lactation

Animal reproduction studies and retrospective data on clinical application, the use of No-shpa during pregnancy did not have any teratogenic or embryotoxic effects.

During pregnancy, the drug should be used with caution and only in cases where potential benefit therapy for the mother exceeds possible risk for the fetus.

Due to the lack of necessary clinical data, the drug is contraindicated during lactation (breastfeeding).

special instructions

The composition of the tablets includes 52 mg of lactose, as a result, complaints from digestive system in patients with lactose intolerance. 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 administration contains sodium bisulfite, which can cause allergic reactions, including anaphylactic and bronchospasm, in sensitive individuals (especially in people with bronchial asthma or allergic reactions in history). At hypersensitivity to sodium metabisulphite parenteral use 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 attention.

When showing any adverse reactions the question of driving vehicles and working with mechanisms requires individual consideration. In the event of dizziness after taking the drug, you should avoid potentially dangerous species activities such as managing vehicles and work 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.

drug interaction

PDE inhibitors, like papaverine, weaken the antiparkinsonian effect of levodopa. When prescribing the drug No-shpa simultaneously with levodopa, it is possible to increase rigidity and tremor.

With simultaneous use with drotaverine, there is a mutual enhancement of the antispasmodic action of papaverine, bendazole and other antispasmodics, including m-anticholinergics.

No-shpa enhances arterial hypotension caused by tricyclic antidepressants, quinidine and procainamide.

No-shpa reduces the spasmodic activity of morphine.

Phenobarbital enhances the antispasmodic effect of drotaverine.

Drotaverine is largely associated with plasma proteins, mainly albumin, beta and gamma globulins. Data on the interaction of drotaverine with drugs that significantly bind to plasma proteins are not available. However, it can be assumed that they interact with No-shpa at the level of plasma protein binding - the displacement of one of the drugs by another from the binding sites and an increase in the concentration of the free fraction in the blood of the drug with weaker protein binding. This hypothetically may increase the risk of pharmacodynamic and/or toxic side effects of this drug.

Analogues of the drug No-shpa

Structural analogues according to active substance:

Vero-Drotaverine;
Droverin;
Drotaverine;
Drotaverine forte;
Drotaverine hydrochloride;
NOSH-BRA;
Ple-Spa;
Spasmol;
Spazmonet;
Spazmonet forte;
Spazoverin;
Spakovin.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Instruction

Take "No-shpu" inside with a small amount of water. If "No-shpa" is prescribed as part of a general treatment, it is taken after 30-45 minutes. after a meal, with an emergency admission, you can not adhere to this rule. The drug begins to act after 10-20 minutes, its maximum concentration in blood serum is reached after 45-60 minutes.

The maximum daily dose for ─ 240 mg, the usual daily dose ─ 120 mg. The daily dose is divided into 2-3 doses. A single maximum dose is 80 mg. "No-shpa forte" contains the maximum single dose in each tablet, if you need to take 40 mg ─ divide the tablet. If the pain does not go away within 2 days from the start of self-treatment ─ consult a doctor. A longer intake of "No-shpy" is unacceptable, except when the drug is prescribed as an additional therapy.

"No-shpa" does not have an embryotoxic effect on the fetus, and therefore can be used during pregnancy, for example, to relieve uterine tone. The drug should be prescribed by a doctor, it is better to avoid the injection of "No-shpa". During the period of breastfeeding, the issue of taking "No-shpa" should be decided on an individual basis.

Indications for taking "No-shpy": spasms of smooth muscles, tension headaches, menstrual pain. You can not take this drug in severe forms of renal, cardiac and hepatic insufficiency, children under 6 years of age. Patients with low blood pressure should be taken very carefully, since the active substance also acts on the muscular wall of blood vessels. "No-shpa" in solutions for injection is sold only by prescription and should not be used without a doctor's prescription.

Side effects when taking therapeutic doses of "No-shpy" occur only in 0.01% of patients. Headache, palpitations, nausea, urticaria, insomnia are the most common complaints associated with taking the drug. If a large dose of "No-shpa" was taken, it is necessary to wash the stomach and take the victim to the hospital as soon as possible or call an ambulance.

Tablets in aluminum / aluminum blister packs are stored for 5 years at temperatures up to 30 ° C, tablets in aluminum / PVC blister packs should be stored at a temperature not exceeding 25 ° C, their shelf life is 3 years, tablets in vials must be stored in a place protected from light at a temperature of 15-25 ° C 3 years from the date of issue. Analogues of "No-shpy" ─ any antispasmodics containing drotaverine as an active substance. It should be taken into account that their effectiveness may differ from the effectiveness of "No-shpa", side effects and the frequency of their occurrence are also different.

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

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

efficient antispasmodic is Noshpa. Instructions for use prescribes taking tablets 40 mg, 80 mg forte (after eating in half an hour), injections in ampoules for injection to treat disorders and pain conditions provoked by muscle spasms.

Release form and composition

No-shpa is produced in the following dosage forms:

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

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

Forte tablets have an identical composition. The only difference is more high concentration active substance (80 mg / tab.).

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

pharmachologic effect

No-shpa dilates blood vessels, reduces the tone of the muscles of internal organs, reduces intestinal peristalsis, while the remedy does not affect the central nervous system. The active substance of the drug is drotaverine hydrochloride, which is similar in action to papaverine, but it is characterized by a more pronounced, lasting effect. With intravenous administration, the therapeutic effect occurs after 2-4 minutes.

What helps No-shpa (pills and injections)?

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

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

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

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

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

Instructions for use

No-shpa for adults when taken orally is prescribed in a daily dose of 120-240 mg (in 2-3 doses). Maximum single dose is 80 mg. The maximum daily dose is 240 mg. The average daily dose for intramuscular injection in adults is 40-240 mg (divided into 1-3 injections per day).

In acute colic (renal or biliary), the drug is administered intravenously slowly at a dose of 40-80 mg (duration of administration is approximately 30 seconds). Clinical studies with the use of drotaverine in children have not been conducted.

In the case of the appointment of the drug No-shpa, the maximum daily dose for oral administration for children aged 6 to 12 years is 80 mg in 2 doses, over the age of 12 years - 160 mg in 2-4 doses.

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 No-shpa is used as an adjunctive therapy, the duration of treatment without consulting a doctor may be longer (2-3 days). Efficiency evaluation method

If within a few hours after taking the drug at the maximum single dose, there is a moderate decrease in pain or no decrease in pain, or if the pain does not significantly decrease after taking the maximum daily dose, it is recommended to consult a doctor.

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

Tablets instructions for use prescribe to take 0.5 - 1 hour after eating.

Contraindications

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

With caution, the drug is prescribed to pregnant women, children and persons suffering from arterial hypotension.

Side effects

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

Children, during pregnancy and lactation

As shown by animal reproduction studies and retrospective data on clinical use, the use of No-shpa during pregnancy did not have any teratogenic or embryotoxic effects.

During pregnancy, the drug should be used with caution and only in cases where the potential benefit of therapy for the mother outweighs the possible risk to the fetus. Due to the lack of necessary clinical data, the drug is contraindicated during lactation (breastfeeding).

According to the annotation, there are no restrictions on the use of the solution for intramuscular and intravenous administration in pediatrics. Tablets of 40 mg are prescribed for children from the age of six. Clinical researches The safety and efficacy of Forte tablets in children have not been evaluated.

Indications for use in pediatric practice

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

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

special instructions

It is required to observe increased precautions in the treatment of patients suffering from atherosclerosis of the coronary vessels or low blood pressure.

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

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

According to numerous studies, No-shpa does not have a teratogenic or embryotoxic effect. However, you need to be aware of the possible risks to the fetus, and use the remedy only under strict indications with caution. The use of the drug during pregnancy in the form of injections is undesirable.

At parenteral administration No-shpy patients suffering from hypotension should be positioned horizontally due to the likelihood of collapse.

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

drug interaction

Like other papaverine-like PDE inhibitors, drotaverine weakens the antiparkinsonian effect of Levodopa. When these drugs are taken in combination, tremor and rigidity may increase.

In combination with other antispasmodics (including m-cholinergic blockers), there is a mutual enhancement of the antispasmodic effect. A significant part of the dose of drotaverine taken is in a state associated with plasma proteins (mainly with β-, γ-globulins and Albumin).

Analogues of the drug No-shpa

According to the structure, analogues are determined:

NOSH-BRA.
Spakovin.
Drotaverine hydrochloride.
Drotaverin forte.
Spazmonet.
Vero-Drotaverine.
Drotaverin.
Spazmonet forte.
Spazoverin.
Spasmol.
Ple-Spa.
Droverin.

Holiday conditions and price

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

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