La Spa

Indications

Drotaverine Hydrochloride is used to relieve cramps and spasms of smooth muscle (the muscle in the walls of internal organs), for example:

• colicky pain from gallstones or inflammation of the bile ducts (biliary colic);
• colicky pain from kidney or ureter stones (renal colic) and bladder spasm;
• stomach and bowel cramps, including irritable bowel syndrome;
• painful periods (dysmenorrhoea);
• in hospital, to help with certain spasms during labour and some procedures, as decided by the doctor.

How It Works

Drotaverine is an antispasmodic. It blocks an enzyme called phosphodiesterase 4 (PDE4) inside smooth muscle cells. This raises a messenger substance (cyclic AMP) that makes the muscle relax, so the cramping eases. It works directly on the muscle and does not have the dry mouth and blurred vision effects of some other antispasmodics.

Dosage and Administration

Adults: 40 to 80 mg two or three times a day by mouth. Do not take more than 240 mg in a day.

Children: only as prescribed by a doctor, with lower doses based on age.

Injections are given into a muscle or vein by a doctor or nurse, as prescribed.

Tablets can be taken with or without food. If the pain is severe, keeps coming back, or comes with fever, see a doctor rather than taking more tablets.

Interactions

• Drotaverine can weaken the effect of Levodopa in Parkinson's disease and may make stiffness and tremor worse.
• Other antispasmodics, such as Hyoscine Butylbromide, can add to its effect.
• Medicines that lower blood pressure may cause more dizziness when used together.

Contraindications

Do not use Drotaverine Hydrochloride if you have:

• an allergy to Drotaverine or any ingredient of the product;
• severe liver or kidney disease;
• severe heart failure;
• a serious heart rhythm problem called second or third degree heart block.

Some tablets contain lactose; people with rare inherited problems of galactose intolerance should not use them.

Side Effects

Side effects are uncommon and usually mild: nausea, constipation, headache, dizziness, trouble sleeping, a pounding heartbeat and low blood pressure.

Get urgent medical help if you have:

• swelling of the face, lips or throat, itchy rash or difficulty breathing (allergic reaction);
• fainting or a very slow or irregular heartbeat, especially after an injection;
• severe pain with fever, vomiting, yellow skin or blood in the urine, as these may signal a condition that needs urgent treatment.

Pregnancy and Lactation

Studies have not shown harm, but information is limited. Avoid it in pregnancy unless a doctor advises it. Use during labour is decided by the doctor. It is not known whether it passes into breast milk, so it is not recommended while breastfeeding.

Precautions and Warnings

• Take care if you have low blood pressure.
• It can cause dizziness; do not drive or use machines if affected, especially after an injection.
• Do not use painkillers or antispasmodics to cover up abdominal pain that has not been checked by a doctor.
• Tell your doctor if you have liver, kidney or heart disease.

Overdose

Overdose can cause heart rhythm problems, including heart block and, rarely, cardiac arrest. Get emergency medical help at once.

Therapeutic Class

Antispasmodic; smooth muscle relaxant (phosphodiesterase 4 inhibitor).

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach of children.