No-Spa (Drotaverine Hydrochloride)

Drotaverine is an antispasmodic that acts on smooth muscle to alleviate spasm‑related conditions.

• Smooth muscle spasm: provides rapid relaxation of gastrointestinal, biliary and urinary tract muscles, reducing pain.
• Abdominal pain: eases discomfort caused by intestinal cramping and colic.
• Biliary colic: relieves spasms of the gallbladder and bile ducts, facilitating bile flow.
• Renal colic: diminishes ureteral muscle contraction, helping to alleviate kidney‑stone pain.
• Dysmenorrhea: reduces uterine muscle tone, decreasing menstrual cramps.

• Drotaverine selectively inhibits phosphodiesterase enzymes, leading to an accumulation of intracellular cyclic AMP. Elevated cAMP relaxes smooth muscle by decreasing calcium influx and reducing contractile protein activation, which results in vasodilation and alleviation of spasm in gastrointestinal, biliary, urinary and uterine tissues.

Adverse reactions may occur with drotaverine administration.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Dizziness: transient light‑headedness.
• Headache: occasional throbbing pain.
• Flushing: temporary redness of the skin.
• Hypotension: mild drop in blood pressure.
• Injection site pain: discomfort at the site of IM/IV administration.

Serious or Rare Side Effects

• Anaphylactic reaction: severe allergic response requiring immediate medical attention.
• Severe hypotension: marked blood‑pressure fall that may cause fainting.
• Cardiac arrhythmia: irregular heart rhythm.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Blood dyscrasias: rare blood‑cell abnormalities such as agranulocytosis.
• Stevens‑Johnson syndrome: severe skin and mucous membrane reaction.

Before using No‑Spa, consider the following safety measures.

• Assess cardiovascular status: monitor blood pressure prior to administration.
• Avoid in patients with known hypersensitivity to drotaverine or related compounds.
• Use caution in hepatic impairment: increase monitoring of liver function.
• Concurrent use with other vasodilators: observe for additive hypotensive effects.
• Pregnancy and lactation: evaluate risk–benefit as data are limited.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Drotaverine may interact with other medicines; awareness of the interaction level is essential.

Major Interactions (Avoid)

• Concomitant use with potent vasodilators (e.g., nitroglycerin) may cause severe hypotension.
• Co‑administration with strong CYP3A4 inhibitors may increase plasma concentrations of drotaverine.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): possible enhanced bleeding risk.
• Antihistamines: may augment sedative effects.
• Diuretics: monitor electrolyte balance and blood pressure.