No-Spa (Drotaverine Hydrochloride)

• Drotaverine Hydrochloride is used to relieve smooth‑muscle spasm in several gastrointestinal and urogenital conditions.
• Abdominal cramps: reduction of painful intestinal spasms and associated discomfort.
• Urogenital colic: alleviation of spasm‑related pain in the urinary and reproductive tracts.
• Smooth muscle spasm: general relaxation of involuntary muscle contractions in various organ systems.

• Drotaverine Hydrochloride selectively inhibits phosphodiesterase‑4 enzymes in smooth‑muscle cells, preventing the breakdown of cyclic adenosine monophosphate (cAMP). Elevated intracellular cAMP leads to reduced calcium influx and diminished contractile activity, resulting in relaxation of smooth muscle fibers in the gastrointestinal, urinary and vascular systems without significant anticholinergic effects. The drug’s action is independent of muscarinic receptors, allowing it to maintain normal autonomic function while providing spasmolysis.

Drotaverine Hydrochloride may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild stomach upset.
• Dizziness: transient light‑headedness.
• Dry mouth: reduced salivation.
• Headache: mild to moderate intensity.
• Blurred vision: temporary visual disturbance.
• Palpitations: awareness of heartbeat.

Serious or Rare Side Effects

• Allergic reaction: rash, itching, swelling, or anaphylaxis.
• Severe hypotension: marked drop in blood pressure causing faintness.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Blood dyscrasias: neutropenia, thrombocytopenia or other hematologic abnormalities.

When prescribing Drotaverine Hydrochloride, clinicians should consider several safety aspects to minimize risk.

• Pregnancy: safety not established; avoid unless clearly needed.
• Breastfeeding: unknown excretion; use with caution.
• Renal impairment: dose adjustment may be required.
• Elderly: monitor for hypotension and dizziness.
• Concomitant medications: review for potential interactions.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Drotaverine Hydrochloride can interact with other medicines; awareness of major and moderate interactions helps ensure safe use.

Major Interactions (Avoid)

• Other phosphodiesterase inhibitors: additive smooth‑muscle relaxation may cause severe hypotension.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase drotaverine plasma levels.

Moderate Interactions (Monitor Closely)

• Antihypertensives: enhanced blood‑pressure‑lowering effect.
• Anticholinergic agents: potential additive antispasmodic effect.
• Diuretics: risk of electrolyte imbalance and hypotension.