Круглые двояковыпуклые таблетки желтого с зеленоватым или оранжеватым оттенком цвета, с
гравировкой spa на одной стороне.
Фармакологические свойства
Дротаверин представляет собой производное изохинолина, которое проявляет мощное
спазмолитическое действие на гладкую мускулатуру за счет ингибирования фермента
фосфодиэстеразы IV типа (ФДЭ IV). Ингибирование фермента ФДЭ IV приводит к повышению
концентрации цАМФ, инактивации киназы легкой цепи миозина, что в дальнейшем вызывает
расслабление гладкой мускулатуры.
Снижающий концентрацию ионов Ca2+ эффект дротаверина через цАМФ объясняет
антагонистический эффект дротаверина по отношению к ионам Ca2+
In vitro дротаверин ингибирует фермент ФДЭ IV без ингибирования ферментов ФДЭ III и ФДЭ V.
Поэтому эффективность дротаверина зависит от концентраций ФДЭ IV в разных тканях. ФДЭ IV
наиболее важна для подавления сократительной активности гладкой мускулатуры, в связи с чем
селективное ингибирование ФДЭ IV может быть полезным для лечения гиперкинетических
дискинезий и различных заболеваний, сопровождающихся спастическим состоянием желудочнокишечного тракта.
Гидролиз цАМФ в миокарде и гладкой мускулатуре сосудов происходит, главным образом, с
помощью фермента ФДЭ III, чем объясняется тот факт, что при высокой спазмолитической
активности у дротаверина отсутствуют серьезные побочные эффекты со стороны сердца и сосудов
и выраженные эффекты в отношении сердечно-сосудистой системы.
Дротаверин эффективен при спазмах гладкой мускулатуры как нейрогенного, так и мышечного
происхождения. Независимо от типа вегетативной иннервации, дротаверин расслабляет гладкую
мускулатуру желудочно-кишечного тракта, желчевыводящих путей, мочеполовой системы.
Вследствие своего сосудорасширяющего действия дротаверин улучшает кровоснабжение тканей.
Таким образом, вышеописанные механизмы действия дротаверина устраняют спазм гладкой
мускулатуры, что приводит к уменьшению боли.
Показания к применению
Спазмы гладкой мускулатуры при заболеваниях желчевыводящих путей: холецистолитиаз,
При спазмах гладкой мускулатуры желудочно-кишечного тракта: язвенная болезнь желудка
и двенадцатиперстной кишки, гастрит, спазмы кардии и привратника, энтерит, колит,
спастический колит с запором, синдром раздраженного кишечника с метеоризмом.
При головных болях напряжения.
При дисменорее (менструальных болях).
Противопоказания
Повышенная чувствительность к действующему веществу или к любому из
Период грудного вскармливания (отсутствие клинических данных).
Наследственная непереносимость галактозы, дефицит лактазы и синдром мальабсорбции
глюкозы-галактозы (из-за присутствия в составе препарата лактозы моногидрата).
С осторожностью
При артериальной гипотензии.
У детей (недостаточность клинического опыта применения).
У беременных женщин (см. раздел «Применение при беременности и в период грудного
вскрмливания»)
Применение при беременности и в период грудного вскармливания
В проведенных исследованиях не выявлено тератогенного и эмбриотоксического действия
дротаверина, а также неблагоприятного воздействия на течение беременности. Однако, при
необходимости применения препарата Но-шпа® во время беременности, следует соблюдать
осторожность, и назначать препарат только после оценки соотношения потенциальной
пользы для матери и возможного риска для плода.
В связи с отсутствием исследований на животных и клинических данных, назначать
дротаверин в период грудного вскармливания не рекомендуется.
Способ применения и дозы
Взрослые
По 1-2 таблетки на один прием 2-3 раза в день. Максимальная суточная доза – 6 таблеток (что
соответствует 240 мг).
Дети
Клинические исследования по применению дротаверина у детей не проводились.
В случае назначения дротаверина детям:
от 6 до 12 лет: по 1 таблетке на один прием 1-2 раза в день. Максимальная суточная доза - 2
таблетки (что соответствует 80 мг);
старше 12 лет: по 1 таблетке на один прием 1-4 раза в день или по 2 таблетки на один прием 1-2
раза в день. Максимальная суточная доза - 4 таблетки (что соответствует 160 мг).
При приеме препарата без консультации с врачом рекомендованная продолжительность приема
препарата обычно составляет 1-2 дня. В случаях, когда дротаверин применяется в качестве
вспомогательной терапии, продолжительность лечения без консультации с врачом может быть
больше (2-3 дня). Если болевой синдром сохраняется, пациенту следует обратиться к врачу.
При использовании флакона с полиэтиленовой пробкой, снабженной штучным дозатором:
перед использованием удалить защитную полоску с верхней части флакона и наклейку со дна
флакона. Расположить флакон в ладони таким образом, чтобы дозирующее отверстие на донышке
не упиралось в ладонь. Затем надавить на верхнюю часть флакона, в результате чего одна таблетка
выпадет из дозирующего отверстия на донышке.
Побочное действие
Ниже представлены неблагоприятные реакции, наблюдавшиеся в клинических исследованиях,
разделенные по системам органов с указанием частоты их возникновения в соответствии со
следующими градациями, рекомендованными Всемирной Организацией Здравоохранения: очень
часто (≥10 %); часто (≥1 %, <10 %); нечасто (≥0,1 %, <1 %); редко (≥0,01 %, <0,1 %); очень редко,
включая отдельные сообщения (<0,01 %); частота неизвестна (по имеющимся данным частоту
определить нельзя).
Со стороны нервной системы
Редкие: головная боль, головокружение, бессонница.
Со стороны сердечно-сосудистой системы
Редкие: ощущение сердцебиения, снижение артериального давления.
Со стороны желудочно-кишечного тракта
Редкие: тошнота, запор.
Со стороны иммунной системы
Редкие: аллергические реакции (ангионевротический отек, крапивница, сыпь, зуд) (см. раздел
«Противопоказания»).
Передозировка
Передозировка дротаверина ассоциировалась с нарушениями сердечного ритма и проводимости,
включая полную блокаду ножек пучка Гиса и остановку сердца, которая может быть фатальной.
В случае передозировки пациенты должны находиться под медицинским наблюдением, и при
необходимости, им должно проводиться симптоматическое и направленное на поддержание
основных функций организма лечение, включая искусственное вызывание рвоты или промывание
желудка.
Взаимодействие с другими лекарственными средствами
С леводопой
Ингибиторы фосфодиэстеразы, подобные папаверину, снижают антипаркинсоническое действие
леводопы. При назначении дротаверина одновременно с леводопой возможно усиление
ригидности и тремора.
С другими спазмолитическими средствами, включая м-холиноблокаторы
Взаимное усиление спазмолитического действия.
Особые указания
Каждая таблетка препарата Но-шпа® 40 мг содержит 52 мг лактозы моногидрата. Это может
вызывать желудочно-кишечные жалобы у пациентов с непереносимостью лактозы. Данная форма
неприемлема для пациентов с дефицитом лактазы, галактоземией или синдромом нарушенной
абсорбции глюкозы/галактозы (см. раздел «Противопоказания»).
Условия хранения
Для таблеток в блистерах Алюминий/Алюминий: 5 лет.
Для таблеток в блистерах ПВХ/Алюминий: 3 года.
Для таблеток во флаконах: 5 лет.
Не применять препарат после истечения срока годности, указанного на упаковке.
Срок годности
Для таблеток в блистерах Алюминий/Алюминий: хранить при температуре не выше 30 °С.
Для таблеток в блистерах ПВХ/Алюминий: хранить при температуре не выше 25 °С.
Для таблеток во флаконах: хранить в оригинальной упаковке при температуре от 15 С до 25 С.
Хранить в недоступном для детей месте
Условия отпуска
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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1 таблетке содержится:\u003cbr /\u003e\nдействующее вещество: дротаверина гидрохлорид – 40 мг;\u003cbr /\u003e\nвспомогательные вещества: магния стеарат – 3 мг, тальк – 4 мг, повидон – 6 мг, крахмал\nкукурузный – 35 мг, лактозы моногидрат – 52 мг."}}]},{"id":2,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Круглые двояковыпуклые таблетки желтого с зеленоватым или оранжеватым оттенком цвета, с\nгравировкой spa на одной стороне."}}]},{"id":3,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Дротаверин представляет собой производное изохинолина, которое проявляет мощное\nспазмолитическое действие на гладкую мускулатуру за счет ингибирования фермента\nфосфодиэстеразы IV типа (ФДЭ IV). Ингибирование фермента ФДЭ IV приводит к повышению\nконцентрации цАМФ, инактивации киназы легкой цепи миозина, что в дальнейшем вызывает\nрасслабление гладкой мускулатуры.\u003cbr /\u003e\nСнижающий концентрацию ионов Ca2+ эффект дротаверина через цАМФ объясняет\nантагонистический эффект дротаверина по отношению к ионам Ca2+\nIn vitro дротаверин ингибирует фермент ФДЭ IV без ингибирования ферментов ФДЭ III и ФДЭ V.\nПоэтому эффективность дротаверина зависит от концентраций ФДЭ IV в разных тканях. ФДЭ IV\nнаиболее важна для подавления сократительной активности гладкой мускулатуры, в связи с чем\nселективное ингибирование ФДЭ IV может быть полезным для лечения гиперкинетических \nдискинезий и различных заболеваний, сопровождающихся спастическим состоянием желудочнокишечного тракта.\nГидролиз цАМФ в миокарде и гладкой мускулатуре сосудов происходит, главным образом, с\nпомощью фермента ФДЭ III, чем объясняется тот факт, что при высокой спазмолитической\nактивности у дротаверина отсутствуют серьезные побочные эффекты со стороны сердца и сосудов\nи выраженные эффекты в отношении сердечно-сосудистой системы.\u003cbr /\u003e\nДротаверин эффективен при спазмах гладкой мускулатуры как нейрогенного, так и мышечного\nпроисхождения. Независимо от типа вегетативной иннервации, дротаверин расслабляет гладкую\nмускулатуру желудочно-кишечного тракта, желчевыводящих путей, мочеполовой системы.\u003cbr /\u003e\nВследствие своего сосудорасширяющего действия дротаверин улучшает кровоснабжение тканей.\nТаким образом, вышеописанные механизмы действия дротаверина устраняют спазм гладкой\nмускулатуры, что приводит к уменьшению боли."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Спазмы гладкой мускулатуры при заболеваниях желчевыводящих путей: холецистолитиаз,"]}},{"type":"paragraph","data":{"text":"холангиолитиаз, холецистит, перихолецистит, холангит, папиллит.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Спазмы гладкой мускулатуры мочевыводящих путей: нефролитиаз, уретролитиаз, пиелит,"]}},{"type":"paragraph","data":{"text":"цистит, спазмы мочевого пузыря.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При спазмах гладкой мускулатуры желудочно-кишечного тракта: язвенная болезнь желудка"]}},{"type":"paragraph","data":{"text":"и двенадцатиперстной кишки, гастрит, спазмы кардии и привратника, энтерит, колит,\nспастический колит с запором, синдром раздраженного кишечника с метеоризмом.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При головных болях напряжения.\u003cbr /\u003e","При дисменорее (менструальных болях).\u003cbr /\u003e"]}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Повышенная чувствительность к действующему веществу или к любому из"]}},{"type":"paragraph","data":{"text":"вспомогательных веществ препарата.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Тяжелая печеночная или почечная недостаточность.\u003cbr /\u003e","Тяжелая сердечная недостаточность (синдром низкого сердечного выброса).\u003cbr /\u003e","Детский возраст до 6 лет.\u003cbr /\u003e","Период грудного вскармливания (отсутствие клинических данных).\u003cbr /\u003e","Наследственная непереносимость галактозы, дефицит лактазы и синдром мальабсорбции"]}},{"type":"paragraph","data":{"text":"глюкозы-галактозы (из-за присутствия в составе препарата лактозы моногидрата).\u003cbr /\u003e\nС осторожностью\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При артериальной гипотензии.\u003cbr /\u003e","У детей (недостаточность клинического опыта применения).\u003cbr /\u003e","У беременных женщин (см. раздел «Применение при беременности и в период грудного"]}},{"type":"paragraph","data":{"text":"вскрмливания»)"}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["В проведенных исследованиях не выявлено тератогенного и эмбриотоксического действия"]}},{"type":"paragraph","data":{"text":"дротаверина, а также неблагоприятного воздействия на течение беременности. Однако, при\nнеобходимости применения препарата Но-шпа® во время беременности, следует соблюдать\nосторожность, и назначать препарат только после оценки соотношения потенциальной\nпользы для матери и возможного риска для плода.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["В связи с отсутствием исследований на животных и клинических данных, назначать"]}},{"type":"paragraph","data":{"text":"дротаверин в период грудного вскармливания не рекомендуется."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Взрослые\u003cbr /\u003e\nПо 1-2 таблетки на один прием 2-3 раза в день. Максимальная суточная доза – 6 таблеток (что\nсоответствует 240 мг).\u003cbr /\u003e\nДети\u003cbr /\u003e\nКлинические исследования по применению дротаверина у детей не проводились.\u003cbr /\u003e\nВ случае назначения дротаверина детям:\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["от 6 до 12 лет: по 1 таблетке на один прием 1-2 раза в день. Максимальная суточная доза - 2"]}},{"type":"paragraph","data":{"text":"таблетки (что соответствует 80 мг);\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["старше 12 лет: по 1 таблетке на один прием 1-4 раза в день или по 2 таблетки на один прием 1-2"]}},{"type":"paragraph","data":{"text":"раза в день. Максимальная суточная доза - 4 таблетки (что соответствует 160 мг).\u003cbr /\u003e\nПри приеме препарата без консультации с врачом рекомендованная продолжительность приема\nпрепарата обычно составляет 1-2 дня. В случаях, когда дротаверин применяется в качестве\nвспомогательной терапии, продолжительность лечения без консультации с врачом может быть\nбольше (2-3 дня). Если болевой синдром сохраняется, пациенту следует обратиться к врачу.\u003cbr /\u003e\nПри использовании флакона с полиэтиленовой пробкой, снабженной штучным дозатором:\u003cbr /\u003e\nперед использованием удалить защитную полоску с верхней части флакона и наклейку со дна\nфлакона. Расположить флакон в ладони таким образом, чтобы дозирующее отверстие на донышке\nне упиралось в ладонь. Затем надавить на верхнюю часть флакона, в результате чего одна таблетка\nвыпадет из дозирующего отверстия на донышке."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ниже представлены неблагоприятные реакции, наблюдавшиеся в клинических исследованиях,\nразделенные по системам органов с указанием частоты их возникновения в соответствии со\nследующими градациями, рекомендованными Всемирной Организацией Здравоохранения: очень\nчасто (≥10 %); часто (≥1 %, \u003c10 %); нечасто (≥0,1 %, \u003c1 %); редко (≥0,01 %, \u003c0,1 %); очень редко, \nвключая отдельные сообщения (\u003c0,01 %); частота неизвестна (по имеющимся данным частоту\nопределить нельзя).\u003cbr /\u003e\nСо стороны нервной системы\u003cbr /\u003e\nРедкие: головная боль, головокружение, бессонница.\u003cbr /\u003e\nСо стороны сердечно-сосудистой системы\u003cbr /\u003e\nРедкие: ощущение сердцебиения, снижение артериального давления.\u003cbr /\u003e\nСо стороны желудочно-кишечного тракта\u003cbr /\u003e\nРедкие: тошнота, запор.\u003cbr /\u003e\nСо стороны иммунной системы\u003cbr /\u003e\nРедкие: аллергические реакции (ангионевротический отек, крапивница, сыпь, зуд) (см. раздел\n«Противопоказания»)."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Передозировка дротаверина ассоциировалась с нарушениями сердечного ритма и проводимости,\nвключая полную блокаду ножек пучка Гиса и остановку сердца, которая может быть фатальной.\nВ случае передозировки пациенты должны находиться под медицинским наблюдением, и при\nнеобходимости, им должно проводиться симптоматическое и направленное на поддержание\nосновных функций организма лечение, включая искусственное вызывание рвоты или промывание\nжелудка."}}]},{"id":10,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"С леводопой\u003cbr /\u003e\nИнгибиторы фосфодиэстеразы, подобные папаверину, снижают антипаркинсоническое действие\nлеводопы. При назначении дротаверина одновременно с леводопой возможно усиление\nригидности и тремора.\u003cbr /\u003e\nС другими спазмолитическими средствами, включая м-холиноблокаторы\nВзаимное усиление спазмолитического действия."}}]},{"id":11,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Каждая таблетка препарата Но-шпа® 40 мг содержит 52 мг лактозы моногидрата. Это может\nвызывать желудочно-кишечные жалобы у пациентов с непереносимостью лактозы. Данная форма\nнеприемлема для пациентов с дефицитом лактазы, галактоземией или синдромом нарушенной\nабсорбции глюкозы/галактозы (см. раздел «Противопоказания»)."}}]},{"id":12,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для таблеток в блистерах Алюминий/Алюминий: 5 лет.\u003cbr /\u003e\nДля таблеток в блистерах ПВХ/Алюминий: 3 года.\u003cbr /\u003e\nДля таблеток во флаконах: 5 лет.\u003cbr /\u003e\nНе применять препарат после истечения срока годности, указанного на упаковке."}}]},{"id":13,"name":"Срок годности","slug":"expiry_date","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для таблеток в блистерах Алюминий/Алюминий: хранить при температуре не выше 30 °С.\u003cbr /\u003e\nДля таблеток в блистерах ПВХ/Алюминий: хранить при температуре не выше 25 °С.\u003cbr /\u003e\nДля таблеток во флаконах: хранить в оригинальной упаковке при температуре от 15 С до 25 С.\u003cbr /\u003e\nХранить в недоступном для детей месте"}}]},{"id":14,"name":"Условия отпуска","slug":"release_condition","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Без рецепта"}}]}],"source":null},"description_toggle":false,"short_description":"Дротаверин представляет собой производное изохинолина, которое проявляет мощное спазмолитическое действие на гладкую мускулатуру за счет ингибирования фермента фосфодиэстеразы IV типа (ФДЭ IV). 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