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5 amp.

Mechanism of action

Drotaverine is an isoquinoline derivative that exhibits a spasmolytic effect on a smooth one by suppressing the enzyme phosphodiesterase IV (PDE IV). Inhibition of the phosphodiesterase IV enzyme leads to an increased concentration of cAMP, which inactivates the myosin kinase light chain (MLCK), which, in turn, leads to the relaxation of smooth muscles. Drotaverine inhibits the phosphodiesterase (PDE) IV enzyme in vitro without inhibiting the PDE III and PDE V isoenzymes V. Apparently, PDE IV is functionally very important for reducing the contractility of smooth muscles, which suggests that selective PDE IV inhibitors can be useful in treatment hyperkinetic diseases and various diseases associated with spastic states of the gastrointestinal tract.
The enzyme hydrolyzing cAMP in myocardial and vascular smooth muscle cells is mainly PDE III isoenzyme, which explains that drotaverine is an effective antispasmodic agent without serious cardiovascular side effects and strong cardiovascular therapeutic activity.
The drug is effective in spasms of smooth muscles of both nervous and muscular etiology.Regardless of the type of vegetative innervation, drotaverine acts on smooth muscles found in the gastrointestinal, biliary, urogenital and vascular systems.

Indications and usage

  • smooth muscle spasms associated with diseases of the biliary tract: cholecystolithiasis, cholangiolithiasis, cholecystitis, pericholecystitis, cholangitis, papillitis.
  • spasms of smooth muscles of the urinary tract: nephrolithiasis, urethrolithiasis, pyelitis, cystitis, tenesmus of the bladder.
  • During the period of stretching during physiological labor, shortening of the cervical dilatation phase and thereby reducing the total duration of labor.


  • Hypersensitivity to the active substance or to any of the excipients of the drug No-spa (especially to sodium metabisulfite)
  • Severe hepatic or renal failure
  • Severe heart failure (low cardiac output syndrome).

Pregnancy and Breastfeeding

As shown by experiments on animal reproduction and retrospective studies of clinical data, the use of drotaverine during pregnancy does not lead to teratogenic or embryotoxic effects. However, the use of the drug is recommended only after carefully weighing the ratio of benefits and risks.
In the absence of the necessary clinical data in the period of lactation is not recommended.

Adverse reactions

Gastrointestinal disturbances (rarely - nausea, constipation); disorders of the nervous system (rarely - headache, dizziness, insomnia); cardiovascular disorders (rarely - rapid heartbeat, very rarely - hypotension); immune system disorders (very rarely - allergic reactions, especially in patients with hypersensitivity to bisulphites).

Drug Interactions

It is necessary to be careful at combined use of No-Shpy with levodopa as the antiparkinson effect of the latter decreases and an increase in tremor and rigidity is observed.

Storage conditions

Store in a dark place at a temperature of 15-25 ° C.

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