Buy No-spa solution intravenously and intramuscularly 40mg/2ml 2ml No. 5 in pharmacies

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.

"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.

No-spalgin® (No-spalgin®)

Paracetamol

after oral administration, it is quickly and completely absorbed from the small intestine.

Maximum plasma concentration is reached after 30-90 minutes and its plasma half-life is 2 hours.

Paracetamol binds weakly to plasma proteins and red blood cells, its distribution is rapid and uniform. Paracetamol is metabolized in the liver, its metabolites are excreted by the kidneys through glomerular filtration. About 85% of the dose taken is excreted in the form of glucuronides, 2% in the form of sulfates, 3% unchanged. Approximately 10% of the dose taken is neutralized in the liver by conjugation with glutathione.

Codeine

after oral administration, it is quickly absorbed from the gastrointestinal tract.

The maximum plasma concentration of codeine is achieved after 1 hour, and its plasma half-life is 2.5-3.5 hours.

Codeine is moderately bound to plasma proteins and is rapidly distributed, accumulating in the kidneys, lungs, liver and skeletal muscles, while brain tissue is not able to accumulate codeine. Codeine crosses the placental barrier and is excreted into breast milk.

In the liver, codeine is metabolized primarily by glucuronidation to codeine-6-glucuronide. A small portion of codeine undergoes O-demethylation, leading to the formation of morphine, and N-demethylation, leading to the formation of norcodeine, with the formation of normorphine after O- and N-demethylation. Morphine and norcodeine are further conjugated with glucuronic acid. Unchanged codeine and its metabolites are excreted mainly by the kidneys within 48 hours (84.4±15.9% of the dose of codeine taken). O-demethylation of codeine to morphine is catalyzed by the cytochrome P450 isoenzyme CYP2D6, which is characterized by genetic polymorphisms that can affect the efficacy and toxicity of codeine.

Genetic polymorphism of the CYP2D6 isoenzyme is manifested by genotypes with ultra-high, high and low activity of the CYP2D6 isoenzyme.

Drotaverine

after oral administration it is quickly and completely absorbed. The maximum plasma concentration is achieved after 45-60 minutes.

Drotaverine entering the systemic circulation is 95-98% bound to plasma proteins, mainly albumins and air globulins.

The plasma half-life is 2.4 hours, the biological half-life is 8-10 hours.

The metabolism of drotaverine occurs in the liver. More than 50% of the dose taken is excreted in the urine, 30% in feces. Drotaverine penetrates the placental barrier.

Combination paracetamol + drotaverine + codeine

A study of the pharmacokinetics of the combination of paracetamol + drotaverine + codeine showed that the equilibrium concentration (Css) of the active ingredients of the drug is established on the 6th day when using one dose per day and on the 3rd day when using two doses per day.

Both with a single dose and with a course of taking the drug, codeine does not affect the pharmacokinetics of paracetamol and drotaverine, and paracetamol does not affect the pharmacokinetics of codeine. Drotaverine and paracetamol do not interact at the level of binding to plasma proteins.

In in vitro

It has been shown that paracetamol (in the therapeutic dose range) nonspecifically inhibits the metabolism of drotaverine, which increases the half-life of the latter by 2-7 times, so it is possible that
in vivo
it can also inhibit the metabolism of drotaverine.

The combination of paracetamol + drotaverine + codeine increases the values ​​of AUC0-24 (area under the concentration-time curve within 24 hours after administration) and Cmax (maximum concentration) of drotaverine, which are in the range of 463.4-830.2 ng*h/ l and 132-171 ng/ml, respectively, that is, the use of the combination increases the relative bioavailability of drotaverine.

A similar phenomenon has also been shown for paracetamol. This combination increases the AUC0-24 values ​​of paracetamol and significantly reduces its clearance. The values ​​of Cmax, AUC0-24 and paracetamol clearance were in the range of 5495-6752 ng/ml, 21760.8-26524.7 ng*h/l, 365-418 ml/min, respectively. This may provide greater pain relief with a slightly longer duration.

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.

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.

Contraindications for use

Contraindications to the use of the drug are the following diseases and features:

• low cardiac output;
• severe kidney and liver diseases (failure);
• hypersensitivity to the active substance (drotaverine) or to other components in the tablet;
• lactase deficiency (metabolism disorders of galactose and glucose).

During pregnancy (any period), the drug is taken with caution; similar recommendations are for children and people with low blood pressure. It is recommended to consult your doctor first.

Indications and contraindications

You should use No-Shpu with arterial hypotension especially carefully. One tablet of No-Shpa contains 104 mg of lactose, so people with lactose intolerance should limit their intake of No-Shpa to avoid problems with the gastrointestinal tract. Those suffering from galactosemia, lactose deficiency or glucose/galactose malabsorption syndrome should avoid taking this medicine.

Side effects from taking No-Shpa tablets

In most cases, no side effects are observed. But with long-term use, as well as due to the individual characteristics of the body and human condition, the following consequences may appear:

• increased heart rate;
• sleep disorders;
• headaches;
• dizziness;
• decreased blood pressure;
• nausea;
• bowel dysfunction (constipation);
• allergic reactions.

If an injection is administered, a local reaction (redness, foreign sensations) may additionally be observed.

Side effects

The body may react adversely to the components of the drug. Possible symptoms include:

• Nervous system: headache, dizziness, sleep disorder, vertigo.
• Cardiovascular system: decreased blood pressure, palpitations.
• Digestive system: nausea, constipation.
• Immune system: allergic reactions (rash, itching, urticaria).

All side effects of the drug are rarely detected: approximately 1 case in 10,000.

An overdose of No-Spa causes cardiac rhythm and conduction problems, which can lead to drug failure and death. In case of an overdose of the drug, you should immediately consult a doctor and subsequently receive symptomatic treatment under his supervision.

Instructions for use "No-Shpa"

Dosage and rules of administration depend on the form of the drug and the age of the person:

1. The daily dosage of the active substance for an adult is in the range of 120-240 mg, which corresponds to 3-6 tablets of the regular drug and 2-3 tablets of the “Forte” variety. In this case, it is allowed to consume no more than 40 mg at a time, i.e. maximum 2 tablets.
2. For children under 11 years of age inclusive, the optimal dose is 80 mg - this amount is taken 2 times a day.
3. For older children, a dose of 160 mg is indicated, divided into 2-4 times.

The general course of therapy (with self-treatment) is no more than 2 days. If during this time your health does not improve, you need to contact a specialist for a possible replacement of the drug and diagnostics. If No-Shpa is used as an additional medication as part of complex therapy, then the course without consulting a specialist can last up to 3 days.

Pregnancy and lactation

Clinical studies have shown that drotaverine does not have a teratogenic or embryotoxic effect, therefore its use during pregnancy is allowed . It is important to be careful and take drotaverine only after weighing the benefits for the mother and the potential risk for the child. There are no preclinical and clinical data on the use of the drug during lactation, therefore, taking No Shpu while breastfeeding is not recommended .

special instructions

No-Shpa contains lactose, so patients with impaired absorption of glucose and galactose should take the tablets with caution and only after the doctor’s approval.

If the solution is administered intravenously, the patient should lie down for several minutes at rest. If you have high blood pressure, use is allowed only in consultation with your doctor.

The injection solution contains sodium metabisulfite, which can cause an allergic reaction. In rare cases (especially in the presence of bronchial asthma, chronic allergies), bronchospasm and the onset of individual signs of anaphylactic shock are possible.

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.

Package

No-Shpa is available in the form of pills and solution for intravenous administration. Tablets of 40 or 80 mg are packaged in plastic blisters of 20 pieces. Each such tablet of medicine, along with instructions, is placed in a cardboard box. The packaging varies depending on the number of tablets inside:

• No. 12: 12 tablets per plate. 1 record per package.
• No. 24: 24 tablets per strip, 1 strip per package.
• No. 60: 60 tablets in a dosing container with protective tape, 1 container per box.
• No. 100: 100 ballet shoes per bottle, 1 bottle per package with a tamper-evident sticker.

The solution for injection is a clear, colorless liquid, which is collected in dark-colored ampoules of 2 ml, which are packed in 5 pieces in a plastic contour package.

Interaction with other drugs

PDE inhibitors like papaverine, which includes drotaverine, which is part of No-Shpa, weaken the antiparkinsonian effect of the substance levodopa (dihydroxyphenylalanine). Therefore, the combination of No Shpa and drugs containing levodopa can lead to increased tremor and rigidity. In combination with other antispasmodic drugs, No Shpa enhances its analgesic effect. Before combining this drug with other medications, you should consult your doctor.