Drotaverine: Difference between revisions

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			{{Short description\|Chemical compound}}
	{{drugbox
			{{distinguish\|doravirine}}

			{{Drugbox
	\| Verifiedfields = changed		\| Verifiedfields = changed
	\| ~~UNII_Ref~~ = ~~{{fdacite\|~~changed~~\|FDA}}~~		\| Watchedfields = changed
			\| verifiedrevid = 443713917
	\| UNII = 98QS4N58TW
			\| IUPAC_name = (''Z'')-1-(3,4-diethoxybenzylidene)-6,7-diethoxy-1,2,3,4-tetrahydroisoquinoline
	\| verifiedrevid = 414437117
			\| image = Drotaverine.svg
	\| IUPAC_name = (''Z'')-1-(3,4-diethoxybenzylidene)-6,7-diethoxy-1,2,3,4-tetrahydroisoquinoline
	\| ~~image~~ = Drotaverine.~~svg~~		\| image2= Drotaverine ball-and-stick.png

			<!--Clinical data-->
			\| tradename = No-Spa, Doverin
			\| Drugs.com = {{drugs.com\|international\|drotaverine}}
			\| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
			\| pregnancy_US = <!-- A / B / C / D / X -->
			\| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
			\| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
			\| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
			\| legal_status = OTC (tablets), Rx-only (solution for injection) <small>(])</small><ref name="PI">{{cite web\|title=Инструкция по применению препарата Но-шпа // No-Spa (tablets) Full Prescribing Information\|url=http://grls.rosminzdrav.ru/InstrImgMZ.aspx?isNew=1&idReg=6198&page=4&isOld=1&t=\|website=National Register of Drugs\|publisher=Chinoin Pharmaceutical and Chemical Works\|pages=3–8\|language=ru}}</ref>
			\| routes_of_administration = Oral, ], ]

			<!--Pharmacokinetic data-->
			\| bioavailability = Highly variable (~65%), peak at 45–60 min
			\| protein_bound = 95–98%
			\| metabolism = ]
			\| elimination_half-life = 7–16 hours
			\| excretion = >50% in urine and ~30% in bile<ref name=PI />

			<!--Identifiers-->
			\| CAS_number_Ref = {{cascite\|changed\|CAS}}
			\| CAS_number = 14009-24-6
			\| ATC_prefix = A03
			\| ATC_suffix = AD02
			\| PubChem = 1712095
			\| DrugBank_Ref = {{drugbankcite\|correct\|drugbank}}
			\| DrugBank = DB06751
	\| ChemSpiderID_Ref = {{chemspidercite\|correct\|chemspider}}		\| ChemSpiderID_Ref = {{chemspidercite\|correct\|chemspider}}
	\| ChemSpiderID = 1361582		\| ChemSpiderID = 1361582
			\| UNII_Ref = {{fdacite\|correct\|FDA}}
	\| InChI = 1/C24H31NO4/c1-5-26-21-10-9-17(14-22(21)27-6-2)13-20-19-16-24(29-8-4)23(28-7-3)15-18(19)11-12-25-20/h9-10,13-16,25H,5-8,11-12H2,1-4H3/b20-13-
			\| UNII = 98QS4N58TW
	\| InChIKey = OMFNSKIUKYOYRG-MOSHPQCFBI
			\| KEGG_Ref = {{keggcite\|correct\|kegg}}
	\| smiles = O(c1ccc(cc1OCC)\C=C3\c2c(cc(OCC)c(OCC)c2)CCN3)CC
			\| KEGG = D07879
	\| ChEMBL_Ref = {{ebicite\|correct\|EBI}}		\| ChEMBL_Ref = {{ebicite\|correct\|EBI}}
	\| ChEMBL = 551978		\| ChEMBL = 551978

			<!--Chemical data-->
			\| C=24 \| H=31 \| N=1 \| O=4
			\| smiles = O(c1ccc(cc1OCC)\C=C3\c2c(cc(OCC)c(OCC)c2)CCN3)CC
	\| StdInChI_Ref = {{stdinchicite\|correct\|chemspider}}		\| StdInChI_Ref = {{stdinchicite\|correct\|chemspider}}
	\| StdInChI = 1S/C24H31NO4/c1-5-26-21-10-9-17(14-22(21)27-6-2)13-20-19-16-24(29-8-4)23(28-7-3)15-18(19)11-12-25-20/h9-10,13-16,25H,5-8,11-12H2,1-4H3/b20-13-		\| StdInChI = 1S/C24H31NO4/c1-5-26-21-10-9-17(14-22(21)27-6-2)13-20-19-16-24(29-8-4)23(28-7-3)15-18(19)11-12-25-20/h9-10,13-16,25H,5-8,11-12H2,1-4H3/b20-13-
	\| StdInChIKey_Ref = {{stdinchicite\|correct\|chemspider}}		\| StdInChIKey_Ref = {{stdinchicite\|correct\|chemspider}}
	\| StdInChIKey = OMFNSKIUKYOYRG-MOSHPQCFSA-N		\| StdInChIKey = OMFNSKIUKYOYRG-MOSHPQCFSA-N
	\| CAS_number = 985-12-6
	\| ATC_prefix = A03
	\| ATC_suffix = AD02
	\| PubChem = 1712095
	\| DrugBank =
	\| KEGG_Ref = {{keggcite\|correct\|kegg}}
	\| KEGG = D07879
	\| C=24\|H=31\|N=1\|O=4
	\| molecular_weight = 397.507 g/mol
	\| bioavailability = Highly variable
	\| protein_bound = 80 to 95%
	\| metabolism = ]
	\| elimination_half-life = 7 to 12 hours
	\| excretion = Fecal and ]
	\| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
	\| pregnancy_US = <!-- A / B / C / D / X -->
	\| pregnancy_category=
	\| legal_AU = <!-- Unscheduled / S2 / S3 / S4 / S5 / S6 / S7 / S8 / S9 -->
	\| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->
	\| legal_UK = <!-- GSL / P / POM / CD / Class A, B, C -->
	\| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
	\| legal_status =
	\| routes_of_administration = Oral, ]
	}}		}}
	'''Drotaverine''' (], also known as '''drotaverin''') is an ] drug, structurally related to ]. Drotaverine is a ], and has no ] effects.{{Citation needed\|date=May 2010}} Drotaverine has been shown to possess dose-dependant analgesic effects in animal models.<ref>{{cite journal \|author=Stepaniuk AG, Stepaniuk NG, Stoliarchuk AA, Stepaniuk GI, Chernobrovyĭ VN \|title= \|language=Russian \|journal=Eksperimental'naia I Klinicheskaia Farmakologiia \|volume=61 \|issue=4 \|pages=17–9 \|year=1998 \|pmid=9783101}}</ref> One small study has shown drotaverine to be eliminated mainly non-renally.<ref>{{cite journal \|doi=10.1007/BF03189716 \|author=Bolaji OO, Onyeji CO, Ogundaini AO, Olugbade TA, Ogunbona FA \|title=Pharmacokinetics and bioavailability of drotaverine in humans \|journal=European Journal of Drug Metabolism and Pharmacokinetics \|volume=21 \|issue=3 \|pages=217–21 \|year=1996 \|pmid=8980918}}</ref>

			'''Drotaverine''' (], also known as '''drotaverin''') is an ] drug, used to enhance ] during ] and to relieve ] ] in the ], ], and ].<ref>{{cite book \|title=Title Textbook of Obstetrics \|vauthors=Padubidri V, Anand E \|date=2006 \|publisher=BI Publications Pvt Ltd \|isbn=9788172252236 \|pages=283}}</ref><ref name="pmid14698825">{{cite journal \| vauthors = Singh KC, Jain P, Goel N, Saxena A \| title = Drotaverine hydrochloride for augmentation of labor \| journal = International Journal of Gynaecology and Obstetrics \| volume = 84 \| issue = 1 \| pages = 17–22 \| date = January 2004 \| pmid = 14698825 \| doi = 10.1016/s0020-7292(03)00276-5 \| s2cid = 43824027 \| url = }}</ref><ref>{{Cite web \|title=DROTAVERINE: Uses, Side Effects and Medicines {{!}} Apollo Pharmacy \|url=https://www.apollopharmacy.in/salt/DROTAVERINE \|access-date=2022-05-24 \|website=www.apollopharmacy.in}}</ref><ref name=":0" />
	A few small 2003 studies found drotaverine to be nearly 80% effective in treating ].<ref>{{cite journal \|author=Romics I, Molnár DL, Timberg G, ''et al.'' \|title=The effect of drotaverine hydrochloride in acute colicky pain caused by renal and ureteric stones \|journal=BJU International \|volume=92 \|issue=1 \|pages=92–6 \|year=2003 \|month=July \|pmid=12823389 \|doi=10.1046/j.1464-410X.2003.04262.x}}</ref><ref>{{cite journal \|author=Garmish OS, Zabashnyĭ SI, Smirnova EV, Kobeliatskiĭ IuIu \|title= \|language=Russian \|journal=Klinichna Khirurhiia \|volume= \|issue=2 \|pages=47–50 \|year=2003 \|month=February \|pmid=12784437}}</ref> It has also been studied in accelerating ] by speeding up cervical dilation, but the results have been conflicting.<ref>{{cite journal \|author=Singh KC, Jain P, Goel N, Saxena A \|title=Drotaverine hydrochloride for augmentation of labor \|journal=International Journal of Gynaecology and Obstetrics \|volume=84 \|issue=1 \|pages=17–22 \|year=2004 \|month=January \|pmid=14698825 \|doi=10.1016/S0020-7292(03)00276-5}}</ref><ref>{{cite journal \|author=Madhu C, Mahavarkar S, Bhave S \|title=A randomised controlled study comparing Drotaverine hydrochloride and Valethamate bromide in the augmentation of labour \|journal=Archives of Gynecology and Obstetrics \|volume= 282\|issue= 1\|pages= 11–5\|year=2009 \|month=July \|pmid=19644697 \|doi=10.1007/s00404-009-1188-8}}</ref><ref>{{cite journal \|author=Gupta B, Nellore V, Mittal S \|title=Drotaverine hydrochloride versus hyoscine-N-butylbromide in augmentation of labor \|journal=International Journal of Gynaecology and Obstetrics \|volume=100 \|issue=3 \|pages=244–7 \|year=2008 \|month=March \|pmid=18031745 \|doi=10.1016/j.ijgo.2007.08.020}}</ref> Drotaverine has been shown to be effective in ] in managing pain during hysteroscopy and endometrial biopsy when administered together with ].<ref>{{cite journal \|author=Sharma JB, Aruna J, Kumar P, Roy KK, Malhotra N, Kumar S \|title=Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy \|journal=Indian Journal of Medical Sciences \|volume=63 \|issue=6 \|pages=244–52 \|year=2009 \|month=June \|pmid=19602758 \|doi=10.4103/0019-5359.53394}}</ref> ] patients presenting with predominant ] are more likely to benefit from ].<ref>{{cite journal \|author=Khalif IL, Quigley EM, Makarchuk PA, Golovenko OV, Podmarenkova LF, Dzhanayev YA \|title=Interactions between symptoms and motor and visceral sensory responses of irritable bowel syndrome patients to spasmolytics (antispasmodics) \|journal=Journal of Gastrointestinal and Liver Diseases \|volume=18 \|issue=1 \|pages=17–22 \|year=2009 \|month=March \|pmid=19337628 \|url=http://www.jgld.ro/12009/12009_2.html}}</ref> Drotaverin has also been tested in combination with ] for antiviral activity against A and B type ].<ref>{{cite journal \|author=Zhilinskaya IN, Konovalova NI, Kiselev OI, Ashmarin IP \|title=No-Spa and Remantadin are the novel complex preparations that inhibit effectively reproduction of the avian influenza viruses \|journal=Doklady Biological Sciences \|volume=414 \|issue= 1\|pages=249–50 \|year=2007 \|pmid=17668635 \|doi=10.1134/S0012496607030234}}</ref> Drotaverin has an adverse effects frequency of 0.9%, side effects being relatively uncommon.<ref>{{cite journal \|author=Tar A, Singer J \|title= \|language=Hungarian \|journal=Orvosi Hetilap \|volume=143 \|issue=11 \|pages=559–62 \|year=2002 \|month=March \|pmid=12583325}}</ref>

			It is structurally related to ], and is a selective ], and has no ] effects.<ref name="drugbank">{{cite web\|title=The DrugBank database: Drotaverine\|url=http://www.drugbank.ca/drugs/DB06751\|website=DrugBank Version 4.1\|publisher=The Metabolomics Innovation Centre\|access-date=9 August 2014}}</ref>
	Drotaverine in sold under brand name No-Spa (Chinoin Pharmaceutical and Chemical Works, Hungary, a member of the ]).{{Citation needed\|date=May 2010}}

			It is available in ],{{Specify \|reason=Which jurisdictions? \|date=October 2019}} ] (Poland,<ref>{{Cite web \|title=No-Spa, 40 mg, tabletki, 20 szt. \|url=https://www.doz.pl/apteka/p6349-No-Spa_40_mg_tabletki_20_szt. \|access-date=2023-01-09 \|website=doz.pl \|language=pl}}</ref> Hungary,<ref>{{Cite web \|title=DROTAVERIN-CHINOIN 40 mg tabletta 24 db - PATIKA24 Gyógyszer \|url=https://www.patika24.hu/drotaverin-chinoin-40-mg-tabletta-24-db.html \|access-date=2023-01-09 \|website=www.patika24.hu \|language=hu}}</ref> Estonia,<ref>{{Cite web \|title=NO-SPA ÕHUKE POLÜMEERKATTEGA TBL 40MG N24 {{!}} BENU Veebiap \|url=https://www.benu.ee:443/products-by-categories/hygiene-ee/no-spa-kaetud-tbl-40mg-n24 \|access-date=2023-01-09 \|website=www.benu.ee \|language=ee}}</ref> Latvia,<ref>{{Cite web \|title=NO-SPA 40 mg tabletes, 24 gab. - Piegāde visā Latvijā {{!}} Mēness aptieka \|url=https://www.e-menessaptieka.lv/no-spa-40-mg-tabletes-24-gab-1142207 \|access-date=2023-01-09 \|website=www.e-menessaptieka.lv \|language=lv}}</ref> Lithuania<ref>{{Cite web \|title=Drotaverine - Vaistai.lt \|url=https://vaistai.lt/grupe/drotaverine.html \|access-date=2023-01-09 \|website=vaistai.lt}}</ref>) under several brand names.<ref>Drotaverine - Drugs.com Page accessed June 28, 2015</ref> A popular brand is ''No-Spa,'' owned by ]). It is distributed by Sanofi as ''Но-Шпа'' (No-shpa) in Russia.<ref>{{Cite web \|title=Но-шпа — инструкция по применению, дозы, побочные действия, отзывы о препарате: таблетки, покрытые пленочной оболочкой,таблетки,раствор для внутривенного и внутримышечного введения, 20 мг/мл, 40 мг, 40 мг \|url=https://www.rlsnet.ru/drugs/no-spa-2216 \|access-date=2023-10-26 \|website=РЛС® \|language=ru}}</ref>

			== Pharmacodynamics ==
			Drotaverine hydrochloride has a ], myotropic, ], ] action.<ref name=":0">{{Cite web \|title=RUE Belmedpreparaty - pharmaceutical enterprise in the Republic of Belarus - DROTAVERINE HYDROCHLORIDE \|url=https://www.belmedpreparaty.com/product/anot.php?anat_id=395&lang_id=2 \|url-status=live \|archive-url=https://archive.today/20220817130104/https://www.belmedpreparaty.com/product/anot.php?anat_id=395&lang_id=2 \|archive-date=2022-08-17 \|access-date=2022-05-24 \|website=RUE Belmedpreparaty - pharmaceutical enterprise in the Republic of Belarus \|language=en}}</ref>

			Drotaverine decreases active ionized calcium supply binding to smooth muscle cells due to inhibition of ] and intracellular accumulation of ]. It has an apparent and prolonged action on smooth muscles of internal organs and blood vessels and it moderately decreases ], increases ] (minute volume of heart), and has some ] potential.<ref name=":0" />

			Drotaverine decreases ] of ] and increases blood-filling. Practically, Drotaverine does not influence the ] and does not penetrate into the ].<ref name=":0" />

			== Side effects ==
			Possible side effects include: heating sensation, dizziness, headache (rarely), insomnia. May be observed: arrhythmia (rarely), hypotension, tachycardia, sweating, nausea.<ref name=":0" />

			Overdose of Drotaverine potentially can cause ], ], paralysis of respiratory system.<ref name=":0" />

			==Counterfeits==

			In ] the product is known under the brand name "No-Spa" by the general public<ref name="study">, Israeli patent and trade mark office, 11 July 2007</ref> which did not receive a permit to be distributed by the ],<ref name="smuggler"> ''NRG'', 11 March 2009</ref> however due to high demand local medical counterfeiters have managed to smuggle No-Spa tablets over the years.<ref name="smuggler"/>

			In 2008, the Israeli health organization warned consumers against counterfeit No-Spa pills after a smuggler had been arrested at the ] with several thousand pills.<ref>{{Cite news \|last=ניב \|first=שי \|date=2008-02-11 \|title=חשש כי תרופה מזויפת בשם NO-SPA הוברחה לישראל ועשויה לגרום לסכנה בריאותית \|language=he \|trans-title=It is feared that a fake drug called NO-SPA has been smuggled into Israel and may cause a health hazard \|work=Globes \|url=https://www.globes.co.il/news/article.aspx?did=1000308494 \|access-date=}}</ref><ref>{{Cite web \|last=Bader \|first=H \|date=11 February 2008 \|title=משרד הבריאות מזהיר משימוש בתרופה לא מאושרת בשם: No-Spa \|trans-title=The Ministry of Health warns against the use of an unapproved medicine called: No-Spa \|url=https://www.inn.co.il/flashes/209104 \|url-status=live \|archive-url=https://web.archive.org/web/20220310114639/https://www.inn.co.il/flashes/209104 \|archive-date=10 March 2022 \|website=Israel National News \|language=he}}</ref>

			In 2011, the Israeli patent and trademark office declined the use of No-SPA.<ref name="study"/>

			== Risks ==
			An article from 2013 described the effects from overdose (in a 19-year-old female) as including vomiting, seizures and fatal cardiac toxicity.<ref>{{cite journal \| url=https://link.springer.com/article/10.1007/s40278-013-7608-3 \| doi=10.1007/s40278-013-7608-3 \| title=Drotaverine overdose \| journal=Reactions Weekly \| date=2013 \| volume=1481 \| page=17 }}</ref>

			In 2016, the young Russian chess player ] died of a massive overdose (or poisoning) of the drug, which was initially thought to be a stroke; the dose detected in his blood was 17 mg/kg.<ref> {{Webarchive\|url=https://web.archive.org/web/20161218132653/http://chess-news.ru/node/21958 \|date=2016-12-18 }} (Russian, Chess-News)</ref>

	==References==		==References==
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Latest revision as of 06:22, 19 August 2024

Chemical compound Not to be confused with doravirine. Pharmaceutical compound

Drotaverine
Clinical data


Trade names	No-Spa, Doverin
AHFS/Drugs.com	International Drug Names
Routes of administration	Oral, intravenous, intramuscular
ATC code	A03AD02 (WHO)
Legal status
Legal status	OTC (tablets), Rx-only (solution for injection) (RU)
Pharmacokinetic data
Bioavailability	Highly variable (~65%), peak at 45–60 min
Protein binding	95–98%
Metabolism	Hepatic
Elimination half-life	7–16 hours
Excretion	>50% in urine and ~30% in bile
Identifiers
IUPAC name (Z)-1-(3,4-diethoxybenzylidene)-6,7-diethoxy-1,2,3,4-tetrahydroisoquinoline
CAS Number	14009-24-6
PubChem CID	1712095
DrugBank	DB06751
ChemSpider	1361582
UNII	98QS4N58TW
KEGG	D07879
ChEMBL	ChEMBL551978
CompTox Dashboard (EPA)	DTXSID60161227
ECHA InfoCard	100.110.916
Chemical and physical data
Formula	C₂₄H₃₁NO₄
Molar mass	397.515 g·mol
3D model (JSmol)	Interactive image
SMILES O(c1ccc(cc1OCC)\C=C3\c2c(cc(OCC)c(OCC)c2)CCN3)CC
InChI InChI=1S/C24H31NO4/c1-5-26-21-10-9-17(14-22(21)27-6-2)13-20-19-16-24(29-8-4)23(28-7-3)15-18(19)11-12-25-20/h9-10,13-16,25H,5-8,11-12H2,1-4H3/b20-13- Key:OMFNSKIUKYOYRG-MOSHPQCFSA-N
(what is this?) (verify)

Drotaverine (INN, also known as drotaverin) is an antispasmodic drug, used to enhance cervical dilation during childbirth and to relieve smooth muscle spasms in the gastrointestinal tract, urinary system, and gall bladder.

It is structurally related to papaverine, and is a selective inhibitor of phosphodiesterase-4, and has no anticholinergic effects.

It is available in Asia, Central and Eastern Europe (Poland, Hungary, Estonia, Latvia, Lithuania) under several brand names. A popular brand is No-Spa, owned by Sanofi). It is distributed by Sanofi as Но-Шпа (No-shpa) in Russia.

Pharmacodynamics

Drotaverine hydrochloride has a spasmolytic, myotropic, vasodilation, hypotensive action.

Drotaverine decreases active ionized calcium supply binding to smooth muscle cells due to inhibition of phosphodiesterase and intracellular accumulation of cAMP. It has an apparent and prolonged action on smooth muscles of internal organs and blood vessels and it moderately decreases arterial blood pressure, increases cardiac output (minute volume of heart), and has some antiarrhythmic potential.

Drotaverine decreases vascular tone of cerebral blood vessels and increases blood-filling. Practically, Drotaverine does not influence the autonomic nervous system and does not penetrate into the central nervous system.

Side effects

Possible side effects include: heating sensation, dizziness, headache (rarely), insomnia. May be observed: arrhythmia (rarely), hypotension, tachycardia, sweating, nausea.

Overdose of Drotaverine potentially can cause atrioventricular (AV) block, cardiac arrest, paralysis of respiratory system.

Counterfeits

In Israel the product is known under the brand name "No-Spa" by the general public which did not receive a permit to be distributed by the health ministry, however due to high demand local medical counterfeiters have managed to smuggle No-Spa tablets over the years.

In 2008, the Israeli health organization warned consumers against counterfeit No-Spa pills after a smuggler had been arrested at the Ben Gurion Airport with several thousand pills.

In 2011, the Israeli patent and trademark office declined the use of No-SPA.

Risks

An article from 2013 described the effects from overdose (in a 19-year-old female) as including vomiting, seizures and fatal cardiac toxicity.

In 2016, the young Russian chess player Ivan Bukavshin died of a massive overdose (or poisoning) of the drug, which was initially thought to be a stroke; the dose detected in his blood was 17 mg/kg.

References

^ "Инструкция по применению препарата Но-шпа // No-Spa (tablets) Full Prescribing Information". National Register of Drugs (in Russian). Chinoin Pharmaceutical and Chemical Works. pp. 3–8.
Padubidri V, Anand E (2006). Title Textbook of Obstetrics. BI Publications Pvt Ltd. p. 283. ISBN 9788172252236.
Singh KC, Jain P, Goel N, Saxena A (January 2004). "Drotaverine hydrochloride for augmentation of labor". International Journal of Gynaecology and Obstetrics. 84 (1): 17–22. doi:10.1016/s0020-7292(03)00276-5. PMID 14698825. S2CID 43824027.
"DROTAVERINE: Uses, Side Effects and Medicines | Apollo Pharmacy". www.apollopharmacy.in. Retrieved 2022-05-24.
^ "RUE Belmedpreparaty - pharmaceutical enterprise in the Republic of Belarus - DROTAVERINE HYDROCHLORIDE". RUE Belmedpreparaty - pharmaceutical enterprise in the Republic of Belarus. Archived from the original on 2022-08-17. Retrieved 2022-05-24.
"The DrugBank database: Drotaverine". DrugBank Version 4.1. The Metabolomics Innovation Centre. Retrieved 9 August 2014.
"No-Spa, 40 mg, tabletki, 20 szt". doz.pl (in Polish). Retrieved 2023-01-09.
"DROTAVERIN-CHINOIN 40 mg tabletta 24 db - PATIKA24 Gyógyszer". www.patika24.hu (in Hungarian). Retrieved 2023-01-09.
"NO-SPA ÕHUKE POLÜMEERKATTEGA TBL 40MG N24 | BENU Veebiap". www.benu.ee (in Ewe). Retrieved 2023-01-09.
"NO-SPA 40 mg tabletes, 24 gab. - Piegāde visā Latvijā | Mēness aptieka". www.e-menessaptieka.lv (in Latvian). Retrieved 2023-01-09.
"Drotaverine - Vaistai.lt". vaistai.lt. Retrieved 2023-01-09.
Drotaverine - Drugs.com Drugs.com international listings for drotaverine Page accessed June 28, 2015
"Но-шпа — инструкция по применению, дозы, побочные действия, отзывы о препарате: таблетки, покрытые пленочной оболочкой,таблетки,раствор для внутривенного и внутримышечного введения, 20 мг/мл, 40 мг, 40 мг". РЛС® (in Russian). Retrieved 2023-10-26.
^ NO-SPA (also pronounced as No-SHPA) trade mark registration decision 202248, Israeli patent and trade mark office, 11 July 2007
^ Health Ministry: Fake drug had been smuggled NRG, 11 March 2009
ניב, שי (2008-02-11). "חשש כי תרופה מזויפת בשם NO-SPA הוברחה לישראל ועשויה לגרום לסכנה בריאותית" [It is feared that a fake drug called NO-SPA has been smuggled into Israel and may cause a health hazard]. Globes (in Hebrew).
Bader, H (11 February 2008). "משרד הבריאות מזהיר משימוש בתרופה לא מאושרת בשם: No-Spa" [The Ministry of Health warns against the use of an unapproved medicine called: No-Spa]. Israel National News (in Hebrew). Archived from the original on 10 March 2022.
"Drotaverine overdose". Reactions Weekly. 1481: 17. 2013. doi:10.1007/s40278-013-7608-3.
Silence, lack of will, indifference Archived 2016-12-18 at the Wayback Machine (Russian, Chess-News)

Drugs for functional gastrointestinal disorders (A03)

Drugs for
functional
bowel
disorders

Antimuscarinics

Tertiary amino group	Camylofin Dicycloverine Difemerine Dihexyverine Mebeverine Oxyphencyclimine Piperidolate Rociverine Trimebutine
Quaternary ammonium compounds	Benzilone Bevonium Diphemanil Fenpiverinium Glycopyrronium Hexocyclium Isopropamide Mepenzolate Methantheline Otilonium Oxyphenonium Penthienate Pipenzolate Poldine Prifinium Propantheline Tiemonium Timepidium Tridihexethyl

Phosphodiesterase
inhibitors

Acting on
serotonin receptors

Other

Belladonna
and derivatives
(antimuscarinics)

Tertiary amines: Atropine
Hyoscyamine

Propulsives

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