No-SPA 40 mg / 2 ml Injection – Box of 25 Ampoules (Drotaverine Antispasmodic)

Description

No-SPA injection (drotaverine hydrochloride) is a potent antispasmodic (smooth muscle relaxant) used to relieve spasms in organs like the gastrointestinal tract, biliary tract, and urinary system. The injectable form enables rapid action in acute colicky pain, muscle spasm, or smooth-muscle disorders. 

Ingredients

• Active ingredient: Drotaverine hydrochloride — 40 mg per 2 ml ampoule 

• Excipients / inactives: May include sodium metabisulfite, ethanol, water for injection, buffer salts (depending on manufacturer) 

Drug Class

Antispasmodic / Myotropic Smooth Muscle Relaxant 

Dosage Form

Sterile injectable solution in ampoule — 2 ml per ampoule containing 40 mg drotaverine. 

Uses (Indications)

No-SPA injection is indicated for:

• Relief of smooth muscle spasm (colic pain) in biliary tract (gallbladder, bile ducts) 

• Ureteric colic, renal colic (urinary tract spasm) 

• Gastrointestinal smooth muscle spasms (intestinal, pyloric, enteric colic) 

• Gynecological spasm (e.g., dysmenorrhea, uterine spasm) in some settings 

Dosage

• For adults, typical doses range from one ampoule (40 mg / 2 ml) by intramuscular (IM) or slow intravenous (IV) injection, depending on severity. 

• In acute colic, 1 or 2 ampoules may be given via slow IV injection (in some protocols)

• Doses may be repeated depending on response and physician direction, but not exceeding safe limits (e.g. 1-3 injections daily)

• Pediatric use: Safety and dosage in children are less well established; only under specialist supervision. 

In Case of Overdose

• Overdose may lead to hypotension, cardiac arrhythmias, bradycardia, respiratory depression, or circulatory collapse. 

• Management: supportive care, cardiovascular monitoring, intravenous fluids, symptomatic and intensive care as needed.

• There is no specific antidote; treatment is supportive.

Missed Dose

• Typically, as injectable medication is administered by healthcare providers, “missed dose” is less relevant.

• Follow the prescribing physician’s plan; do not self-administer or double dose.

How to Use / Administration

• Administer intramuscular (IM) or **slow intravenous (IV) injection. 

• IV administration should be done slowly to avoid sudden vasodilation or hypotension.

• Use aseptic technique; ensure correct dilution (if required) and monitoring during and after injection.

• Monitor vital signs, especially blood pressure and cardiac rhythm.

When Not to Use (Contraindications)

• Known hypersensitivity to drotaverine or any component of the formulation (e.g. metabisulfite)

• Severe cardiac conditions or significant hypotension risk

• Severe hepatic or renal impairment (use with caution)

• Pregnancy and breastfeeding: only if benefit outweighs risk (consult specialist)

• Patients with known sulfite sensitivity (some formulations contain sodium metabisulfite) 

• Caution or avoid in conditions where vasodilation or drop in blood pressure can be dangerous

Side Effects

Common / Less serious:

• Headache, dizziness

• Flushing or warmth sensation

• Hypotension, palpitation 

• Local reactions at injection site (pain, redness, swelling) 

• Nausea, gastrointestinal discomfort

Rare / Serious:

• Allergic reactions (rash, itching, swelling, anaphylaxis) 

• Severe hypotension, syncope

• Cardiac arrhythmias in predisposed patients

• Respiratory depression in overdose cases

Precautions & Warnings

• Monitor blood pressure and cardiovascular status in at-risk patients

• Use with caution in patients with liver or kidney disease

• Avoid co-administration with other vasodilators without careful monitoring

• May impair ability to perform tasks requiring alertness (e.g. driving) if side effects occur

• Inform healthcare providers about therapy before surgical/dental procedures

• In formulations containing sulfites, caution in patients with asthma or sulfite sensitivity

Drug Interactions

• Risk of additive hypotensive effect with other vasodilators or antihypertensives

• Drugs that affect cardiac conduction or rhythm may interact in susceptible patients

• Other smooth muscle relaxants may potentiate effects

• Because drotaverine acts via phosphodiesterase inhibition, caution with other PDE inhibitors (though specific interactions are less well documented) 

Storage / Disposal

• Store below 30 °C in a dry place, protected from light. 

• Do not freeze

• Use before expiry date

• Dispose unused or expired ampoules per medical / pharmaceutical waste regulation

Control Drug Status

• Not a narcotic or controlled substance, but prescription-only and must be administered under medical supervision

Quick Tips

• Administer slowly by IV when needed, especially in colic pain

• Monitor blood pressure before and after administration

• Avoid combining with other potent vasodilators without supervision

• Be cautious in patients with cardiovascular disease

• In patients with sulfite sensitivity, check formulation ingredients