The drug "No-Shpa" refers to antispasmodic medications. It relieves pain from smooth muscle spasms. The drug is taken to relieve pain in diseases of the stomach, intestines, liver, kidneys and other internal organs. The product rarely causes side effects and is effective.
Release form
Forms of release of the drug:
- No-Shpa tablets, 6 or 24 pcs. in blisters, 1 blister per package, 60 pieces in polypropylene bottles equipped with a piece dispenser, 1 bottle per pack;
- No-Shpa Forte tablets No. 20, 10 pcs. in blisters, 2 blisters in a cardboard box;
- No-Shpa injections, No. 25 (5×5), 2 ml per ampoule, 5 ampoules (located in a tray), 5 trays in a cardboard box.
Tablets 40 mg are biconvex, round, yellow with an orange or greenish tint. Each tablet is engraved with "spa".
No-Shpa Forte is a biconvex, oblong-shaped tablet of yellow color with an orange or greenish tint. There is a fault line on one side and "NOSPA" is engraved on the other.
The drug in injection form has the appearance of a transparent yellow-green liquid.
Pharmacodynamics and pharmacokinetics
Drotaverine is a myotropic antispasmodic . The action of the drug is aimed at reducing the tone and motor activity of the smooth muscles of internal organs. Moreover, these effects are accompanied by a moderate dilation of blood vessels.
Compared to Papaverine, it has greater antispasmodic activity and duration of action. There are no pronounced effects on the cardiovascular, central and autonomic nervous systems.
The drug is effective for both muscle spasms and spasms of neurogenic origin. Regardless of the type of autonomic innervation, it helps to relax the smooth muscles of the biliary tract, digestive and urogenital tracts.
Since drotaverine acts directly on smooth muscles, it can be used to relieve spasms even in cases where the use of drugs from the group of anticholinergics (for example, with prostatic hypertrophy or glaucoma ).
When taken orally, absorption of drotaverine is one hundred percent. The substance is absorbed from the digestive tract very quickly. During the first passage (passage) through the liver, only 65% of the dose enters the bloodstream. TCmax - from 45 minutes to 1 hour.
Drotaverine in tissues and penetrates smooth muscle cells. Does not pass through the BBB. The substance and/or products of its metabolism can pass through the placental barrier in small concentrations.
T1/2 - from 8 to 10 hours. Within 72 hours, the substance is almost completely eliminated from the body. More than half of the drug is excreted - mainly in the form of metabolites - by the kidneys, about a third - through the gastrointestinal tract (excretion into bile). Unchanged drotaverine is not found in urine.
Pharmacodynamics
Drotaverine is an isoquinoline derivative that exhibits a powerful antispasmodic effect on smooth muscle due to inhibition of the enzyme phosphodiesterase type IV (PDE IV).
Inhibition of the PDE IV enzyme leads to an increase in cAMP concentration, inactivation of myosin light chain kinase, which subsequently causes relaxation of smooth muscles. The effect of drotaverine, which reduces the concentration of Ca2+ ions through cAMP, explains the antagonistic effect of drotaverine towards Ca2+ ions.
In vitro, drotaverine inhibits the PDE IV enzyme without inhibiting the PDE III and PDE V enzymes. Therefore, the effectiveness of drotaverine depends on the concentrations of PDE IV 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.
The hydrolysis of cAMP in the myocardium and vascular smooth muscle occurs mainly with the help of the enzyme PDE III, which explains the fact that with high antispasmodic activity, drotaverine has no serious side effects on the heart and blood vessels and no pronounced effects on the cardiovascular system.
Drotaverine is effective against smooth muscle spasms 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 effect, drotaverine improves blood supply to tissues.
Thus, the mechanisms of action of drotaverine described above eliminate spasm of smooth muscles, which leads to a decrease in pain.
Indications for use of No-Shpy
What do No-Shpy tablets help with?
Indications for use of No-Shpy:
- spasms of smooth muscles caused by diseases of the biliary tract ( cholecystitis , cholangitis , cholangiolithiasis , cholecystolithiasis , pericholecystitis , papillitis );
- spasms of smooth muscles of the urinary tract with cystitis , uro- and nephrolithiasis , pyelitis , bladder tenesmus .
As an addition to the main therapy, the drug can be used to relieve spasm of smooth muscles, which is caused by diseases of the stomach and intestines . Indications for use are: peptic ulcer , flatulent forms of spastic colitis , as well as SRCT with constipation , spasms of the pylorus and cardia .
In addition, it is advisable to take No-Shpu for headaches and dysmenorrhea . No-Spa for headaches is effective if the cause of the pain is a spasm of blood vessels (tension headache or tension pain).
Forte tablets are prescribed when it is necessary to provide a longer lasting effect and reduce the frequency of use.
What is No-Shpa for injectable form?
No-Spa in ampoules is used mainly in situations where taking pills is impossible.
The tablets contain lactose. Its content in one tablet is 40 mg - 52 mg, and in one tablet 80 mg - 104 mg. In this regard, patients with lactose intolerance may experience complaints from the digestive system.
People with glucose/galactose malabsorption syndrome, lactase deficiency and galactosemia should be prescribed only No-Shpa injections.
Parenteral administration of the drug is also indicated for pancreatitis : the disease is often accompanied by debilitating vomiting, due to which taking pills does not give the desired effect.
Does No-Spa help with toothache?
It is generally accepted that the drug does not help with toothache. And this is not surprising, since the main effect of drotaverine is antispasmodic. The cause of toothache is:
- damage to tooth enamel or dentin;
- inflammation of the tissues surrounding the tooth root;
- pulp inflammation.
Smooth muscles do not play a role in the development of pain, therefore, taking No-Shpa for toothache does not make sense. However, in some cases, tablets can still help. If you put the tablet on your tongue, you may feel that your tongue begins to quickly go numb at the point of contact with it.
While not an analgesic , the drug provides an analgesic effect, and this allows it to be used to alleviate the condition in situations where it is not possible to quickly see a doctor. To relieve pain, the tablet is applied to the diseased tooth or placed in a carious cavity.
It should be noted that the medicine will only work if the pulp chamber has already opened.
No-Spa for menstruation
According to doctors, No-Shpa is one of the best remedies for relieving pain that occurs during menstruation. Drotaverine helps relax the uterus, while providing an analgesic effect.
For menstrual pain, drugs that suppress Pg synthesis in the body (for example, Brufen , Butadione or Indomethacin ) can be added to No-Shpe.
What do No-Spa tablets help with?
The drug is taken in tablets, as well as in the form of injections (both intramuscularly and intravenously) to quickly relieve spasms of smooth muscles. This is necessary to relieve pain that manifests itself against the background of such diseases:
- pyelitis;
- cystitis;
- cholecystitis;
- papillitis;
- pnephrolithiasis;
- cholecystolithiasis;
- Urolithiasis
“No-Shpu” is also used to relieve spasms associated with pathologies of the stomach and intestines. Such symptoms may occur due to constipation, ulcers, colitis, IBS and other disorders. Another indication for use is headache and dysmenorrhea. However, in this case, the drug will only work if the pain is associated with vasospasm (felt like tension in the head).
In ordinary cases, the “No-Shpa” form is used. An increased concentration in the composition of the drug “No-Shpa Forte” is used if necessary to ensure a lasting long-term effect (for days, weeks in advance). Forte is also taken if it is necessary to reduce the frequency, for example, to 1 time per day.
Contraindications
Contraindications for No-Shpu:
- hypersensitivity to drotaverine or any other substance in the solution/tablets;
- severe forms of renal and liver failure ;
- low cardiac output syndrome;
- lactase deficiency , galactose intolerance, glucose/galactose malabsorption syndrome (for tablets).
The medicine is prescribed with caution to pregnant women, children and persons suffering from arterial hypotension.
Side effects
The drug usually does not have side effects, however, it must be taken into account that during treatment the following may sometimes be observed:
- decreased blood pressure ;
- increased heart rate;
- insomnia;
- headache;
- dizziness;
- constipation;
- nausea;
- hypersensitivity reactions.
If the drug is administered intramuscularly or intravenously, local reactions at the injection site are possible.
Side effects of the drug No-shpa
Side effects observed in clinical studies and caused by taking drotaverine are classified by organs and systems, as well as by frequency of occurrence: very often (≥1/10), often (≥1/100, but ≤1/10), infrequently (≥ 1/1000, but ≤1/100), rare (≥1/10,000, but ≤1/1000), very rare (≤1/10,000), including isolated cases. Gastrointestinal disorders: rarely - nausea, constipation. From the nervous system: rarely - headache, dizziness, insomnia. From the cardiovascular system: rarely - tachycardia, arterial hypotension. From the immune system: isolated: allergic reactions, especially in patients with hypersensitivity to metabisulfite.
Instructions for use of No-Shpa (Method and dosage)
No-Shpa tablets: instructions for use
To alleviate the condition, it is recommended for an adult to take from 120 to 240 mg of drotaverine during the day. Thus, the daily dose is from 3 to 6 tablets of No-Shpa. It is recommended to divide it into 2-3 doses.
The maximum permissible single dose is 2 tablets of 40 mg, the daily dose is 240 mg.
The standard dose for a child under 12 years of age is 80 mg/day. (the dose is divided into 2 doses), for a child over 12 years old - 160 mg/day. (the dose is divided into 2-4 doses).
The recommended duration of use without consulting a doctor is no more than 2 days. If the condition does not improve within 48 hours, you should consult a doctor to clarify the diagnosis and select the correct treatment regimen.
In situations where No-Shpa is used as an addition to the main therapy, the recommended duration of use without consulting a doctor is 2-3 days.
Instructions for No-Shpa Forte
Forte tablets are taken in the same way as 40 mg tablets. The daily dose of the drug is 3-6 tablets, divided into 2-3 doses.
No-Shpa ampoules: instructions for use
The average daily dose of drotaverine in ampoules for an adult is from 40 to 240 mg. The drug is administered intramuscularly in 1-3 separate injections.
No-Shpa is administered intravenously to patients with stones in the bile or urinary tract during acute colic . Single dose - from 40 to 80 mg (the solution should be administered slowly).
How long does it take for the medicine to work?
The effectiveness of No-Shpa is three to four times higher than the effectiveness of Papaverine . In addition, the drug is characterized by 100% bioavailability. When taking a tablet, drotaverine is very quickly absorbed from the gastrointestinal tract: the half-absorption period of the substance is 12 minutes.
When taken orally, the effect of No-Shpa appears within 10-15 minutes, and when administered intramuscularly, within 5 minutes.
Dosage for animals
Dosage for dogs: 40 mg (1 tablet) for every 10 kg of weight. If parenteral administration of the drug is indicated for the animal, the dose is 1 ml/kg.
Dosage for cats is 0.1 ml/kg, injections are given 2 times a day.
Use of the drug No-shpa
Pills . Adults : The usual average dose is 120–240 mg per day in 2–3 divided doses. Children aged 1–6 years : the usual average dose is 40–120 mg per day in 2–3 divided doses. Children over 6 years of age : the usual average dose is 80–200 mg per day in 2–5 divided doses. Solution for injection : the usual average daily dose for adults is 40–240 mg (in 1–3 separate administrations) IM. For attacks of renal or hepatic colic - 40–80 mg IV slowly. To reduce the dilatation phase of the cervix during uncomplicated labor at the beginning of the dilatation stage - 40 mg IM. If this dose is ineffective, another 40 mg of No-Shpa is administered at intervals of 2 hours.
Overdose
A severe overdose of No-Shpa is accompanied by cardiac arrhythmia and disturbances in the conduction function of the heart, up to complete blockade of the branches of the PG (bundle of His) and cardiac arrest , which can lead to the death of the patient.
The literature indicates that the lethal dose of drotaverine is 1.6-2.4 grams (from 40 to 60 tablets of 40 mg). Death occurred 2-3 hours after the drug was taken. Wikipedia states that the LD50 of drotaverine is approximately 135 mg/kg.
After taking a large dose of drotaverine, the victim should be under medical supervision. Treatment is symptomatic, including gastric lavage, induction of vomiting and maintenance of vital body functions.
Interaction
Like other PDE inhibitors similar to papaverine, drotaverine weakens the antiparkinsonian effect of Levodopa . When taking these drugs in combination, tremor and rigidity may increase.
In combination with other antispasmodics (including m-anticholinergic blockers), a mutual enhancement of the antispasmodic effect is noted.
of drotaverine taken is in a state associated with plasma proteins (mainly with β-, γ-globulins and albumin ).
There are no data on the interaction of the substance with drugs that significantly bind to plasma proteins; however, their interaction is hypothetically possible at the level of protein binding (one of the drugs may be displaced from this bond, as a result of which the concentration of the free fraction of the drug in the patient’s blood whose binding to the protein is weaker).
Hypothetically, this is fraught with the occurrence of toxic and/or pharmacodynamic effects of such a drug.
Pharmacokinetics
Absorption
Compared with papaverine, drotaverine, when taken orally, is absorbed faster and more completely from the gastrointestinal tract. After first-pass metabolism, 65% of the administered dose of drotaverine enters the systemic circulation. The maximum concentration (Cmax) of drotaverine in blood plasma is reached after 45-60 minutes.
Distribution
In vitro, drotaverine has a high binding to plasma proteins (95-98%), especially with albumin, γ- and β-globulins.
Drotaverine is evenly distributed in tissues and penetrates smooth muscle cells. Does not penetrate the blood-brain barrier. Drotaverine and/or its metabolites may slightly penetrate the placental barrier.
Metabolism
Drotaverine is almost completely metabolized in the liver.
special instructions
The tablets contain lactose, which should be kept in mind when prescribing the drug to people with glucose/galactose malabsorption syndrome, lactase deficiency and galactosemia.
When administering the solution intravenously, due to the risk of collapse, the patient should be in a supine position.
The drug should be used with caution in patients suffering from arterial hypotension .
The injection form of No-Shpa contains sodium metabisulfite, which can cause allergic reactions . In sensitive patients (especially those with a history of bronchial asthma or allergies ), bronchospasm and symptoms of anaphylactic shock .
Patients with known hypersensitivity to sodium metabisulfite should avoid the use of No-Shpa injections.
Special instructions for the use of the drug No-shpa
Each tablet of No-Shpa contains 52 mg of lactose. When used according to recommended doses, up to 156 mg of lactose can enter the body at one time, which can cause gastrointestinal complaints in patients with lactose intolerance. Do not use for the treatment of patients with congenital lactase deficiency, galactosemia or glucose-galactose malabsorption syndrome. Use with caution to treat children, since no studies have been conducted on the effect of drotaverine on children. Use with caution in case of hypotension. Due to the risk of collapse during intravenous administration of the drug No-Shpa, the patient should be in a supine position. The drug contains metabisulfite, which may cause allergic-type reactions, including symptoms of anaphylactic shock and bronchospasm, especially in patients with a history of asthma or allergies. In case of hypersensitivity to sodium metabisulfite, parenteral administration of the drug should be avoided. You need to be careful when administering the drug parenterally to women during pregnancy. Use during pregnancy and lactation. As shown by the results of retrospective clinical studies, oral administration of the drug did not have a teratogenic or embryotoxic effect. However, caution should be exercised when prescribing the drug to women during pregnancy. Due to the lack of relevant research data, administration of the drug during breastfeeding is not recommended. Impact on the ability to drive a car and perform work that requires increased attention. If patients experience dizziness after using the drug, they should avoid potentially hazardous activities. It is necessary to warn patients that after parenteral, especially intravenous administration of the drug, it is recommended to refrain from driving and performing work that requires increased attention.
Analogues of No-Shpa
Level 4 ATC code matches:
Spasmol
Drotaverine Hydrochloride
Papaverine
Drotaverine
The most famous Russian analogue of No-Shpa is Drotaverin . Other generics of the drug: Vero-Drotaverine , Bioshpa , Nosh-Bra , Ple-Spa , Spasmonet , Spasmol , Spazoverine , Spakovin .
Which is better: Drotaverine or No-Shpa?
drotaverine hydrochloride as an active substance . Based on this, we can conclude that Drotaverine is essentially No-Shpa.
The only significant difference between the drugs is the price: Drotaverine is several times cheaper than its imported counterpart.
No-Shpa for children
According to the annotation, there are no restrictions on the use of the solution for IM and IV administration in pediatrics. 40 mg tablets are prescribed to children from the age of six. Clinical studies of the safety and effectiveness of Forte tablets in children have not been conducted.
Indications for use in pediatric practice
It is advisable to give medicine to children for cystitis and nephrolithiasis , sudden spasms of the duodenum or stomach, gastritis, enteritis, colitis, flatulence, constipation, spasm of peripheral arteries, high fever and severe headaches .
Contraindications for children
In children, the use of No-Shpa is contraindicated in case of cardiac, renal or liver failure , individual intolerance to the components of the drug, low blood pressure, impaired absorption of galactose/lactose, angle-closure glaucoma , bronchial asthma , atherosclerosis of the coronary arteries .
The use of tablets is strictly contraindicated in children under 12 months, but it is considered safest to give the drug from the age of six. Very young children are given such a powerful antispasmodic only in cases where there is no alternative.
To improve the taste of the tablet, it can be crushed into powder and mixed with sweet syrup.
Dosage of No-Shpa for children
For children from one to six years of age, a single oral dose is 0.5-1 tablet. You should take the medicine 2 or 3 times a day. A school-age child is given No-Shpu from 2 to 5 r/day. a whole tablet.
Dosage for children with fever
For fever in children, No-Shpa is used as one of the components of the so-called “triad”.
In addition to the antispasmodic, such a mixture may include:
- Analgin and Diphenhydramine ;
- Analgin and Paracetamol ;
- Suprastin and Analgin ;
- Paracetamol and Suprastin .
To bring down the temperature, you can also use a simple combination “No-Spa + Analgin ”.
The dosage of each drug is calculated depending on the age of the child. So, for example, for a 2-year-old child, ⅓ Analgin tablet and ⅓ No-Shpa tablet are enough.
Buy No-spa solution intravenously and intramuscularly 40mg/2ml 2ml No. 5 in pharmacies
Instructions for use No-spa solution IV and IM 40 mg/2 ml 2 ml No. 5
Dosage forms injection solution 20mg/ml 2ml
Synonyms Droverin Nosh-bra Spazmol Spazmonet Group Antispasmodics - isoquinoline derivatives International nonproprietary name Drotaverine Composition Active substance - Drotaverine. Manufacturers Hinoin (Hungary), Hinoin Pharmaceutical and Chemical Products Plant A.O. (Hungary), Hinoin Pharmaceutical and Chemical Products Plant CJSC (Hungary) Pharmacological action Antispasmodic, myotropic, vasodilator, hypotensive. Quickly and completely absorbed into the gastrointestinal tract. It is evenly distributed throughout the tissues and penetrates smooth muscle cells. Excreted by the kidneys. Pronouncedly and for a long time expands the smooth muscles of internal organs and blood vessels, reduces blood pressure, and increases cardiac output. It has virtually no effect on the autonomic nervous system and does not penetrate the central nervous system. Side effects: Feeling of heat, dizziness, arrhythmias, hypotension, palpitations, sweating (more often with parenteral administration), allergic dermatitis. Indications for use Spasm of smooth muscles of internal organs (cardio- and pylorospasm), chronic gastroduodenitis, peptic ulcer of the stomach and duodenum, cholelithiasis (hepatic colic), chronic cholecystitis, postcholecystectomy syndrome, hypermotor dyskinesia of the biliary tract, spastic intestinal dyskinesia, intestinal colic due to gas retention after surgery, colitis, proctitis, tenesmus, flatulence, urolithiasis (renal colic), pyelitis, spasm of cerebral vessels, coronary and peripheral arteries, the need to weaken uterine contractions and relieve cervical spasm during childbirth, smooth muscle spasm during childbirth time of instrumental interventions Contraindications Hypersensitivity, glaucoma. Overdose AV blockade, cardiac arrest, paralysis of the respiratory center. Interaction Enhances (especially with intravenous administration) the effect of other antispasmodics (including m-anticholinergics), hypotension caused by tricyclic antidepressants, quinidine, novocainamide. Phenobarbital increases the reliability of eliminating spasms. Reduces the spasmogenic activity of morphine and the antiparkinsonian properties of levodopa. Special instructions Restrictions on use. Prostate adenoma, severe atherosclerosis of the coronary arteries. Storage conditions List B. In a place protected from light at room temperature.
No-Shpa during pregnancy and breastfeeding
Drotaverine has a relaxing effect on all smooth muscle structures of the body, while provoking dilation of blood vessels and helping to increase blood flow to various organs.
During pregnancy , the remedy is used mainly for uterine tone in the early stages. It is not prescribed before childbirth, this is due to the fact that taking No-Shpa before childbirth will help relax and dilate the cervix.
Taking the drug during childbirth helps to normalize the contractile activity of the uterine muscles and reduce pain, reduces the risk of injury, and also reduces the period of labor. Despite this, in many European countries, the administration of No-Shpa during childbirth is considered a relic of the old school.
No-Shpa is considered a safe drug for pregnant women. Clinical experience with the use of the drug in pregnant women, as well as the results of reproductive studies conducted on animals, show that drotaverine has neither embryotoxic nor teratogenic effects.
However, during pregnancy it is necessary to balance the potential benefits for a woman with the possible risks for her unborn child.
Dosage of No-Shpa during pregnancy
For pregnant women, the form of the drug and the daily dose are selected individually. With increased uterine muscle tone in early pregnancy, the recommended dose varies from 80 to 240 mg/day.
No-Spa in ampoules is usually used to prepare for childbirth. Injections of drotaverine accelerate the process of dilation of the cervix. The medicine is injected into the muscle at a dose of 40 mg. After a few hours, the injection is repeated if necessary.
Women who took the drug during pregnancy - the reviews are confirmation of this - claim that No-Shpa not only copes well with severe cramps in the first months of pregnancy, but also greatly facilitates the course of childbirth.
No-Shpa during breastfeeding
Due to the fact that there are few necessary clinical data on the use of No-Shpa during lactation , it is not recommended to prescribe the drug during breastfeeding.
Reviews about No-Shpe
Reviews about No-Spe vary: for some, the drug literally saves them (especially during pregnancy), while others consider it completely ineffective.
The main advantages of the drug are:
- high safety profile, which is confirmed by the results of a large number of clinical and post-marketing studies;
- the ability to reliably prevent smooth muscle spasm and reduce its severity;
- availability of 2 dosage forms;
- absence of side effects that are typical for certain antispasmodics with anticholinergic effects ;
- the ability to eliminate spasms of various origins (No-Spa is effective for spasms caused by urological and gynecological diseases , gastrointestinal and obstetric diseases; the drug is a first-line drug when it comes to providing emergency care).
Another important feature of No-Shpa is that it does not mask the symptoms of an “acute abdomen”.
Pharmacological properties of the drug No-shpa
Pharmacodynamics. Drotaverine is an isoquinoline derivative that has an antispasmodic effect on smooth muscles by inhibiting the action of the PDE IV enzyme, causing an increase in the concentration of cAMP and, due to the inactivation of myosin light chain kinase (MLCK), leads to relaxation of smooth muscles. In vitro, drotaverine inhibits the action of the PDE IV enzyme and does not affect the action of the PDE III and PDE V isoenzymes. PDE IV is of great functional importance for reducing the contractile activity of smooth muscles, therefore selective inhibitors of this enzyme may be useful for the treatment of diseases that are accompanied by motor hyperfunction, as well as various diseases during which gastrointestinal spasms occur. In the smooth muscle cells of the myocardium and blood vessels, cAMP is hydrolyzed to a greater extent by the PDE III isoenzyme, therefore drotaverine is an effective antispasmodic agent that does not have significant side effects on the cardiovascular system and a strong therapeutic effect on this system. Drotaverine is effective for smooth muscle spasms of both nervous and muscular origin. Drotaverine acts on the smooth muscles of the gastrointestinal, biliary, genitourinary and cardiovascular systems, regardless of the type of innervation. Increases blood circulation in tissues due to its ability to dilate blood vessels. The action of drotaverine is more effective than that of papaverine, absorption is faster and more complete, it binds less to blood plasma proteins. The advantage of drotaverine, in contrast to papaverine, is that after its parenteral administration there is no such side effect as stimulation of respiration. Pharmacokinetics. Drotaverine is quickly and completely absorbed after parenteral and oral administration. It binds to a high degree (95-98%) with blood plasma proteins, especially with albumin, gamma and beta globulins. After primary metabolism, 65% of the administered dose enters the blood circulation unchanged. Metabolized in the liver. The half-life is 8–10 hours. Within 72 hours, drotaverine is almost completely eliminated from the body, more than 50% is excreted in the urine and approximately 30% in feces. Drotaverine is mainly excreted in the form of metabolites and is not found in unchanged form in the urine.
How much does No-Shpa cost?
The price of No-Shpa in 40 mg tablets in Russian pharmacies is from 55 rubles (cost 6 pieces). You can buy 24 tablets of 40 mg for an average of 110 rubles, and 24 tablets of 80 mg for 160-200 rubles. The price of No-Shpa in ampoules is from 98 to 447 rubles. (depending on the number of ampoules in the package).
The price of No-Shpa in tablets in Ukraine is from 50 UAH (24 tablets of 40 mg). Injections in Kharkov or Kyiv can be bought for 245-260 UAH (25 ampoules of 2 ml). Price No-Shpa Forte - from 100 UAH.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- No-spa forte - tablets 10 pcs. Chinoin
69 rub. order - No-spa tablets 64 pcs. Quinoin Pharmaceutical and Chemical Products Plant CJSC
RUB 176 order
- No-shpa forte tab. 80 mg №24Chinoin
150 rub. order
- No-spa tablets 40mg 100 pcsChinoin Pharmaceutical and Chemical Products Plant CJSC
RUB 226 order
- No-shpa - p.p.o. tablets 24 pcs. Hinoin Pharmaceutical and Chemical Products Plant CJSC
123 RUR order
Pharmacy Dialogue
- No-spa (amp. 20 mg/ml 2 ml No. 25) Chinoin
RUR 446 order
- No-spa forte for abdominal pain tablets 80 mg No. 10Chinoin
73 rub. order
- No-spa forte for abdominal pain tablets 80 mg No. 24Chinoin
RUB 158 order
- No-spa for abdominal pain tablets 40 mg No. 24Chinoin
103 rub. order
- No-spa (amp. 20 mg/ml 2 ml No. 5) Chinoin
90 rub. order
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Pharmacy24
- No-spa forte 80 mg N24 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
96 UAH.order - No-spa 40 mg N60 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
110 UAH order
- No-spa 40 mg No. 100 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
175 UAH order
- No-spa 40 mg N24 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
51 UAH order
- No-spa Comfort 40 mg No. 24 tablets Quinoin Pharmaceutical and Chemical Products Plant Private Co. Ltd., Ugorshchina
55 UAH order
PaniPharmacy
- No-shpa tablets No-shpa tablets. 40 mg No. 60 (dosing container) Hungary, Chinoin
118 UAH order
- No-shpa tablets No-shpa tablets. 40 mg No. 100 Hungary, Chinoin
191 UAH order
- No-Spa comfort tablets No-Spa Comfort tablets 40 mg No. 24 Hungary, Chinoin
68 UAH order
- No-shpa tablets No-shpa tablets. 40 mg No. 24 Hungary, Chinoin
54 UAH order
- No-spa ampoule No-spa solution for injection 40 mg ampoules 2 ml No. 25 Hungary, Chinoin
296 UAH. order
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"No-Shpa": composition and other characteristics
The drug belongs to the category of antispasmodics. Available in the form of tablets (6, 10, 24 pieces in one package) or in the form of injections (25 ampoules of 2 ml each).
The active ingredient is drotavertin (represented as hydrochloride). Each tablet contains 40 mg, each ampoule solution contains 20 mg. In the No-Shpa Forte variety (dosage doubled - 80 mg).
The tablets may have a yellowish, greenish or orange color. The shape of the tablets is round, both surfaces are convex. On one side there is a fault line in the middle, on the other there is a monolithic surface with the inscription “NOSPA”. The solution in the ampoules is also colored in shades of yellow and green.
The shelf life depends on the form of release. Tablets can be stored for 5 years, and ampoules - 3 years from the date of release. The drug is protected from light and stored at room temperature in the range from 15 to 25 degrees.
Attention!
Tablets can be purchased without a doctor's prescription, but injections can only be purchased with a prescription.
