Not only extremely unpleasant, but also very alarming for every pregnant woman, the feeling of nagging pain in the lower abdomen can become a harbinger of extremely undesirable events, the most dangerous of which are spontaneous abortion or premature birth.
As most expectant mothers testify, such pain can appear for absolutely no reason. And although women take great care of their pregnancy, try not to be nervous or physically tense, any pregnant woman can be at risk.
In case of uterine hypertonicity, pregnant women may be prescribed Drotaverine, a drug unknown in Western countries and used in the CIS countries since Soviet times.
When doctors prescribe this medicine, they are not at all afraid for the condition of the fetus - in fact, thanks to Drotaverine, the fetus gets a chance to be born. The medicine, tested over the years and the experience of generations, has never failed either doctors or mothers in labor. But is it as safe as they say it is?
Our answer No-Shpe
If we talk about analogues of Drotaverine and offer the famous drug No-Shpa as a safer one, then the proposal will turn out to be somewhat untrue. Why? No-Shpa is no safer; it is completely identical to Drotaverine both in composition and in effectiveness.
It’s just that the Hungarian brand is more popular, it is known in both Eastern and Western European countries. And Drotaverine remains our original product, “restricted to travel” outside the CIS; the drug is used exclusively by our doctors to save exclusively our future citizens.
The drug is very effective and several times cheaper than its Hungarian counterpart. It is surprising that even in the post-Soviet space it is not well known and expensive foreign drugs are bought to relieve spasmodic pain.
Description of the drug
Drotaverine helps well with muscle spasms of internal organs. Indications for use are as follows:
- renal or hepatic colic;
- exacerbation of peptic ulcer;
- headache due to vascular spasm
- menstrual pain;
- threat of miscarriage or premature birth;
- spasm of the uterine pharynx during childbirth;
- afterpains.
The active ingredient of the drug is drotaverine hydrochloride. One form of release of the drug is tablets weighing 140 milligrams. Each tablet contains 40 milligrams of drotaverine hydrochloride. They also contain excipients, including lactose monohydrate and magnesium stearate.
Available in the form of a solution for injection, in ampoules of 2 milliliters. Each ampoule contains 40 milligrams of the active substance.
Composition and pharmacokinetics
Drotaverine is available in two forms:
- tableted;
- injection.
The active ingredient of the drug is drotaverine hydrochloride. The action of the drug is based on blocking phosphodiesterase IV, a special enzyme on which the state of human smooth muscles depends (tension or relaxation). The effect of Drotaverine causes the elimination of spasm.
The substance of the drug is distributed very evenly throughout the tissues and quickly penetrates into smooth muscle cells. 98% bound to plasma proteins, excreted by the kidneys in the urine and partially in the bile.
The onset of action of Drotaverine is 15-20 minutes after taking the tablet and 5-10 minutes after the injection.
Indications for use
- Prevention and treatment of spasm of smooth muscles of the gastrointestinal tract (inflammation of the gallbladder and cholelithiasis, intestinal colic, stomach and duodenal ulcers), urinary system (inflammation of the bladder, urolithiasis, inflammation of the pelvis);
- In complex therapy to combat high blood pressure;
- When conducting various diagnostic studies where it is necessary to relax muscle tissue;
- To eliminate headaches caused by vasospasm;
- In obstetrics to relieve pain during childbirth and improve cervical dilatation, with threatened miscarriage and premature birth;
- In gynecology for painful menstruation.
Indications during pregnancy
Drotaverine is prescribed for spasm-like pain of various types; for pregnant women, the most relevant prescriptions are for:
- threat of miscarriage;
- difficulty opening the uterus during childbirth;
- postpartum contractions.
In addition, pregnant women often have problems with the functioning of the intestines (colic, constipation), stomach, urinary system (various types of inflammation), and circulatory system (vasoconstriction causing high blood pressure). For all these misfortunes, doctors will recommend or prescribe taking Drotaverine if the result of a study of the pregnant woman’s general history does not raise any suspicions or questions from the attending physician.
What can be replaced
There are two types of substitutes for Drotaverine: synonymous and analogue agents. The synonyms contain the same active ingredient - drotaverine hydrochloride. Analogue drugs contain a different active substance, but have a similar therapeutic effect, that is, they are antispasmodics.
Table: No-shpa and other synonyms and analogues of Drotaverine
| Name | Release form | Active substance | Indications | Contraindications | Features of application | approximate cost |
| Drotaverine hydrochloride |
|
| From 30 rubles | ||
| Pills |
|
| With caution in the first trimester | From 79 rubles | ||
|
|
| According to the doctor's indications | From 56 rubles | ||
| Papaverine hydrochloride |
|
| Security not established | From 36 rubles |
Photo gallery: No-spa and other antispasmodics prescribed in different trimesters of pregnancy
Spasmol - an antispasmodic, approved for use from the second trimester of pregnancy Papaverine - an antispasmodic drug used to reduce the tone and reduce the contractile activity of smooth muscles
No-spa is a medicine designed to effectively eliminate spasms
Spasmonet is an antispasmodic, similar in chemical structure and pharmacological properties to Drotaverine
The choice of medication during pregnancy is a complex and controversial issue. On the one hand, even at this time treatment is necessary. On the other hand, it is much easier to do harm with some drugs than to help. But there are still conditions when the expectant mother cannot do without medication.
Contraindications and dangers of self-medication
Even if Drotaverine is the most effective and thrice safe (which is questionable) drug in the world, it cannot be used independently. Taking any of the antispasmodic drugs can negatively affect the overall clinical picture of pregnancy and cause discrepancies between the real condition of the pregnant woman and her complaints. Simply - to confuse the doctor.
This is the reason why doctors call on pregnant women, and indeed all patients, not to treat themselves.
Main contraindications to the use of Drotaverine:
- low blood pressure;
- heart failure;
- impaired cardiac conduction;
- kidney and liver diseases;
- individual intolerance.
Possible side effects include:
- disorders of the gastrointestinal tract (vomiting, nausea, diarrhea, changes in appetite);
- nervous system disorders (insomnia, dizziness, headache);
- disorders of the cardiovascular system (low blood pressure, irregular pulse rhythm, fever);
- respiratory system disorders (swelling of the nasal mucosa, breathing problems);
- allergic reactions.
How to use?
How to use Drotaverine for uterine tone? The dosage of the active substance in this drug during treatment is prescribed individually. They depend on the indications for admission, the presence or absence of pregnancy, and other factors that indicate the patient’s health. In addition, the regimen and frequency of administration, its duration, depend on the dosage form in which the drug was prescribed. These can be tablets or injections.
There is no significant difference between these dosage forms, however, it is believed that when administered by injection, the drug is absorbed faster and begins to act more effectively. On the other hand, the tablet form is well absorbed and does not have a negative effect on the gastrointestinal tract. Therefore, most often, the choice between two dosage forms depends on the ability of the patient’s family members to give injections.
In tablets
The drug is prescribed in individual dosages, but there are limits that apply to all patients. Adults should take 1-2 tablets of the drug 2-3 times a day, depending on the dosage in the tablets, as well as on the initial state of health and indications. Children aged 12 to 18 years should take 1 tablet 2-3 times a day (with the same caveats). The medicine cannot be used under 12 years of age.
The duration of the course depends on the indications and health status of the patient.
In injections
Injection is not used as often. Dosages are calculated depending on the concentration of the solution and the presence or absence of excipients. Injections can be given intravenously or intramuscularly. Injections are given strictly in a lying position, as there is a risk of collapse. It is recommended to carry out treatment strictly in a hospital setting.
Drotaverine for uterine hypertonicity
For many women, a desired pregnancy can be very difficult to maintain. The most terrible diagnosis for a future mother who places all her hopes on this child may be uterine hypertonicity.
With hypertonicity, there is most often a risk of oxygen starvation of the fetus, which leads to the death of the child’s brain cells. With timely medical intervention, the situation can be corrected and the woman will give birth to a healthy baby on time, without any abnormalities.
If treatment is delayed, the consequences can be very tragic: from the birth of a handicapped person to the death of a child.
Drotaverine has a powerful relaxing effect and is prescribed for hypertonicity of the uterus in women at the final stage of pregnancy, as a warning against premature birth.
Side effect
Drotaverine may have the following side effects:
- hypotension;
- tachycardia;
- nausea and vomiting;
- sleep disturbance, dizziness;
- difficulty breathing;
- allergic reactions (itching or hives).
Drotaverine by trimester
1st trimester
The most controversial period for taking Drotverin. Some doctors claim that the drug does not contain any substances harmful to the embryo, and practice prescribing the drug in the early stages of pregnancy. Others, based on the fact that the effect of the active substance of the drug on the fetus has not been studied, themselves refrain from such prescriptions in the first trimester and advise their colleagues to do the same.
The practice of maintaining pregnancy in the early stages still shows the effectiveness of Drotaverine, but medical caution clearly demonstrates the appropriateness of using the drug only if its benefits greatly outweigh the risks.
2nd trimester
In the second trimester, the use of Drotaverine is considered safe, since its inability to penetrate the placental barrier has been proven. In the middle of pregnancy, Drotaverine in tablet form copes well with uterine tone and spasmodic pain; injections are prescribed only in exceptional cases.
Drotaverine and pregnancy
Drotaverine is a drug whose use is not recommended during pregnancy. This remedy can only be used if it is prescribed by the treating gynecologist after confirming the diagnosis. However, when prescribing drotaverine, you can be sure that the benefits of taking this drug will be much higher than the risk of various complications for the developing fetus.
In some countries, drotaverine is prohibited for use during pregnancy and is not even registered. Various studies have been conducted on the effects of this drug on the developing fetus during pregnancy.
Based on the results of the studies, we can safely say that drotaverine is a safe drug:
- does not have a teratogenic effect on the fetus, that is, injuries and mutations do not occur after treatment with its use;
- does not cause the development of any anomalies in the unborn baby.
It turns out that drotaverine is similar in composition to another drug, Duspatalin, which has been used in Western countries for many years. The conducted studies allow us to confidently assert that drotaverine is one of the safe drugs that can be used during pregnancy. At the same time, despite these facts, one cannot speak of its complete harmlessness.
Reviews from women
Regarding the reviews of women who took Drotaverine, they can be divided into two groups: the drug helped some, but did not have the expected effect on others.
Here's what they say about it:
Oksana, 27 years old:
“I had uterine tone at the beginning of pregnancy. The doctor warned about the threat of miscarriage and prescribed Drotaverine. I heard that it can have unpleasant side effects, and in Europe they don’t use it at all.
I was very worried that the medicine would not harm the baby. But the doctor assured me that hypertension and oxygen deprivation are much worse for him, and many people use the drug, and there is no harm.
When I finally started taking Drotaverine, it really helped put my uterus in order, and my son was eventually born strong and healthy.”
Liana, 23 years old
“A year ago, when I was pregnant with my daughter, the doctor prescribed Drotaverine for my uterine tone. She said that the drug should help with pain in the lower abdomen.
But when I started drinking it, the effect was not observed either after 5 minutes or after 30, as indicated in the instructions. I took another pill - again zero. The spasms were terrible.
Possible analogues
No-shpa has a number of analogues with other drugs that have antispasmodic and analgesic effects. At the same time, independent selection of such funds is strictly prohibited. The active substances of medications with similar compositions have different effects on the body of the mother and the developing fetus.
Among the effective analogues are:
- Drotaverine.
- Biospa.
- Spasmol.
- Spasmonet.
The active substance of all these drugs is drotaverine. Before starting treatment, a doctor's consultation is necessary.
An available analogue is Papaverine. It is contraindicated for people with renal failure and is more often used in surgical practice. Duspatalin and Nispan effectively relieve spasms. Drugs are prescribed to treat intestinal diseases.
Taking No-shpa when uterine tone occurs is completely safe for the health of the mother and the unborn baby, if the treatment is prescribed by a doctor and is carried out under his supervision. It is prohibited to take the drug on your own; this can cause not only side effects, but also provoke the threat of miscarriage.
Precautionary measures
Before you start taking any drug, you must read the instructions; detailed instructions are in the drug packaging. It is necessary to carefully study not only the recommendations for use, but also familiarize yourself with the list of contraindications given in the instructions. Taking drotaverine is prohibited in the following cases:
- with lactose intolerance;
- with detected insufficiency of liver and kidney functions;
- if you are intolerant to any components included in the product;
- with clinical low cardiac output syndrome.
Thus, the instructions do not indicate that the drug should not be taken during pregnancy. However, this does not mean that it can be taken without a doctor's recommendation. In the first weeks, you can take the drug only if there is a threat of miscarriage; taking drotaverine as an anesthetic during this period is prohibited.
Side effects
Negative side effects are more often observed when using the drug in injection form. You may experience such unpleasant phenomena as:
- sleep disturbances, difficulty falling asleep;
- dizziness, migraine-like pain;
- nausea, less often vomiting;
- increased heart rate;
- decreased blood pressure;
- increased sweating;
- periodic feeling of heat.
Another unpleasant moment may be the appearance of constipation caused by relaxation of the intestinal muscles provoked by the drug.
So, drotaverine has been used during pregnancy for quite a long time. If necessary, it can be prescribed in the first weeks to relieve uterine tone. This drug is also used during childbirth to facilitate the process. But the use of drotaverine is possible only on the recommendation and under the supervision of a doctor. Self-medication during pregnancy is strictly prohibited.
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