Продолговатые двояковыпуклые таблетки желтого с зеленоватым или оранжевым
оттенком цвета, с гравировкой «NOSPA» на одной стороне и линией разлома на другой
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.
Эффект дротаверина по снижению цитозольной концентрации ионов Ca2+ через цАМФ
объясняет его антагонистический эффект 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 желудочно-кишечного 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, сосудов.
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:
пиелит, цистит, спазмы мочевого пузыря.
В качестве вспомогательной терапии
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
вспомогательных веществ препарата.
Период грудного вскармливания (см. раздел «Применение при беременности и в
период грудного вскармливания»).
Детский возраст.
Наследственная непереносимость галактозы, дефицит лактазы, и синдром
мальабсорбции глюкозы-галактозы (из-за присутствия в составе препарата лактозы
моногидрата) (см. «Особые указания»).
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® форте 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
Препарат принимается внутрь. Линия разлома на таблетке предназначена исключительно
для деления с целью облегчения проглатывания.
По 1 таблетке на один прием 1-3 раза в сутки.
Максимальная суточная доза составляет 3 таблетки (что соответствует 240 мг),
максимальная разовая доза - 1 таблетка (что соответствует 80 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 дольше (2 - 3 дня). Если болевой синдром сохраняется, пациенту
следует обратиться к врачу.
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
Симптомы передозировки
Передозировка дротаверина ассоциировалась с нарушениями сердечного ритма и
проводимости, включая полную блокаду ножек пучка Гиса и остановку сердца, которая может
быть фатальной.
Лечение
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
При одновременном применении дротаверин может ослабить противопаркинсонический
эффект леводопы, то есть, усилить ригидность и тремор.
С папаверином, бендазолом и другими спазмолитиками (в том числе, с мхолиноблокаторами)
Усиление спазмолитического действия.
С морфином
Уменьшение спазмогенной активности морфина.
С фенобарбиталом
Усиление спазмолитического действия дротаверина.
Особые указания
Применение препарата при артериальной гипотензии требует повышенной осторожности.
В каждой таблетке Но-шпа® форте содержится 104 мг лактозы. Прием препарата согласно
рекомендованному режиму дозирования может вызывать у больных, страдающих
непереносимостью лактозы, нарушения со стороны желудочно-кишечного тракта. Данная
форма препарата неприемлема для больных, страдающих дефицитом лактазы, галактоземией
или синдромом мальабсорбции глюкозы/галактозы.
Условия хранения
Для таблеток в блистерах из алюминиевой фольги/алюминиевой фольги, ламинированной
полимером: 5 лет.
Для таблеток в блистерах из ПВХ / алюминиевой фольги: 3 года.
Не применять препарат после истечения срока годности, указанного на упаковке.
Срок годности
Хранить при температуре не выше 25 ºС.
Хранить в недоступном для детей месте.
Условия отпуска
Без рецепта.
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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1 таблетке содержится:\u003cbr /\u003e\nдействующее вещество: дротаверина гидрохлорид – 80 мг;\nвспомогательные вещества: магния стеарат, тальк, повидон, крахмал кукурузный,\nлактозы моногидрат."}}]},{"id":2,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Продолговатые двояковыпуклые таблетки желтого с зеленоватым или оранжевым\nоттенком цвета, с гравировкой «NOSPA» на одной стороне и линией разлома на другой\nстороне."}}]},{"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\nповышению концентрации цАМФ, инактивации киназы легкой цепи миозина, что в\nдальнейшем вызывает расслабление гладкой мускулатуры.\u003cbr /\u003e\nЭффект дротаверина по снижению цитозольной концентрации ионов Ca2+ через цАМФ\nобъясняет его антагонистический эффект по отношению к ионам Ca2+.\u003cbr /\u003e\nIn vitro дротаверин ингибирует фермент ФДЭ IV без ингибирования ферментов ФДЭ III и\nФДЭ V. Поэтому эффективность дротаверина зависит от концентраций ФДЭ IV в разных\nтканях. ФДЭ IV наиболее важна для подавления сократительной активности гладкой\nмускулатуры, в связи с чем селективное ингибирование ФДЭ IV может быть полезным для\nлечения гиперкинетических дискинезий и различных заболеваний, сопровождающихся\nспастическим состоянием желудочно-кишечного тракта.\u003cbr /\u003e\nГидролиз цАМФ в миокарде и гладкой мускулатуре сосудов происходит, главным\nобразом, с помощью фермента ФДЭ III, чем объясняется тот факт, что при высокой\nспазмолитической активности у дротаверина отсутствуют серьезные побочные эффекты\nсо стороны сердца и сосудов и выраженные эффекты в отношении сердечно-сосудистой\nсистемы.\u003cbr /\u003e\nДротаверин эффективен при спазмах гладкой мускулатуры как нейрогенного, так и\nмышечного происхождения. Независимо от типа вегетативной иннервации, дротаверин\nрасслабляет гладкую мускулатуру желудочно-кишечного тракта, желчевыводящих путей,\nмочеполовой системы, сосудов.\u003cbr /\u003e\nВследствие своего сосудорасширяющего действия дротаверин улучшает кровоснабжение\nтканей.\u003cbr /\u003e\nТаким образом, вышеописанные механизмы действия дротаверина устраняют спазм\nгладкой мускулатуры, 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:\u003cbr /\u003e"]}},{"type":"paragraph","data":{"text":"холецистолитиаз, холангиолитиаз, холецистит, перихолецистит, холангит, папиллит.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Спазмы гладкой мускулатуры мочевыводящих путей: нефролитиаз, уретролитиаз,"]}},{"type":"paragraph","data":{"text":"пиелит, цистит, спазмы мочевого пузыря.\u003cbr /\u003e\nВ качестве вспомогательной терапии\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При спазмах гладкой мускулатуры желудочно-кишечного тракта: язвенная болезнь"]}},{"type":"paragraph","data":{"text":"желудка и двенадцатиперстной кишки, гастрит, спазмы кардии и привратника,\nэнтерит, колит, спастический колит с запором, синдром раздраженного кишечника с\nметеоризмом.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При головных болях напряжения.\u003cbr /\u003e","При дисменорее (менструальных болях)."]}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к действующему веществу или к любому из\nвспомогательных 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","Период грудного вскармливания (см. раздел «Применение при беременности и в"]}},{"type":"paragraph","data":{"text":"период грудного вскармливания»).\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Детский возраст.\u003cbr /\u003e","Наследственная непереносимость галактозы, дефицит лактазы, и синдром"]}},{"type":"paragraph","data":{"text":"мальабсорбции глюкозы-галактозы (из-за присутствия в составе препарата лактозы\nмоногидрата) (см. «Особые указания»)."}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В проведенных исследованиях не выявлено тератогенного и эмбриотоксического действия\nдротаверина, а также неблагоприятного воздействия на течение беременности. Однако,\nпри необходимости применения препарата Но-шпа® форте во время беременности,\nследует соблюдать осторожность, и назначать препарат только после оценки соотношения\nпотенциальной пользы для матери и возможного риска для плода.\u003cbr /\u003e\nВ связи с отсутствием исследований на животных и клинических данных, назначать\nдротаверин в период грудного вскармливания не рекомендуется."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат принимается внутрь. Линия разлома на таблетке предназначена исключительно\nдля деления с целью облегчения проглатывания.\u003cbr /\u003e\nПо 1 таблетке на один прием 1-3 раза в сутки.\u003cbr /\u003e\nМаксимальная суточная доза составляет 3 таблетки (что соответствует 240 мг),\nмаксимальная разовая доза - 1 таблетка (что соответствует 80 мг).\u003cbr /\u003e\nПри приеме препарата без консультации с врачом рекомендованная продолжительность\nприема препарата обычно составляет 1 - 2 дня. В случаях, когда дротаверин применяется в\nкачестве вспомогательной терапии, продолжительность лечения без консультации с\nврачом может быть дольше (2 - 3 дня). Если болевой синдром сохраняется, пациенту\nследует обратиться к врачу."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ниже представлены неблагоприятные реакции, наблюдавшиеся в клинических\nисследованиях, разделенные по системам органов с указанием частоты их возникновения\nв соответствии со следующими градациями, рекомендованными Всемирной Организацией\nЗдравоохранения: очень часто (≥10 %); часто (≥1 %, \u003c10 %); нечасто (≥0,1 %, \u003c1 %); редко\n(≥0,01 %, \u003c0,1 %); очень редко, включая отдельные сообщения (\u003c0,01 %); частота\nнеизвестна (по имеющимся данным частоту определить 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.\nраздел «Противопоказания»)."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы передозировки\u003cbr /\u003e\nПередозировка дротаверина ассоциировалась с нарушениями сердечного ритма и\nпроводимости, включая полную блокаду ножек пучка Гиса и остановку сердца, которая может\nбыть фатальной.\u003cbr /\u003e\nЛечение\u003cbr /\u003e\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\nпромывание желудка."}}]},{"id":10,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"С леводопой\u003cbr /\u003e\nПри одновременном применении дротаверин может ослабить противопаркинсонический\nэффект леводопы, то есть, усилить ригидность и тремор.\u003cbr /\u003e\nС папаверином, бендазолом и другими спазмолитиками (в том числе, с мхолиноблокаторами)\nУсиление спазмолитического действия.\u003cbr /\u003e\nС морфином\u003cbr /\u003e\nУменьшение спазмогенной активности морфина.\u003cbr /\u003e\nС фенобарбиталом\u003cbr /\u003e\nУсиление спазмолитического действия дротаверина."}}]},{"id":11,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата при артериальной гипотензии требует повышенной осторожности.\nВ каждой таблетке Но-шпа® форте содержится 104 мг лактозы. Прием препарата согласно\nрекомендованному режиму дозирования может вызывать у больных, страдающих\nнепереносимостью лактозы, нарушения со стороны желудочно-кишечного тракта. Данная\nформа препарата неприемлема для больных, страдающих дефицитом лактазы, галактоземией\nили синдромом мальабсорбции глюкозы/галактозы."}}]},{"id":12,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Для таблеток в блистерах из алюминиевой фольги/алюминиевой фольги, ламинированной\nполимером: 5 лет.\u003cbr /\u003e\nДля таблеток в блистерах из ПВХ / алюминиевой фольги: 3 года.\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":"Хранить при температуре не выше 25 ºС.\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). Ингибирование фермента ФДЭ IV приводит к повышению концентрации цАМФ, инактивации киназы легкой цепи миозина, что в дальнейшем вызывает расслабление гладкой мускулатуры. Эффект дротаверина по снижению цитозольной концентрации ионов Ca2+ через цАМФ объясняет его антагонистический эффект 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 желудочно-кишечного тракта. 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