Drotaverine

Drotaverine
Clinical data
Trade namesNo-Spa, Doverin
AHFS/Drugs.comInternational Drug Names
Routes of
administration		Oral, intravenous, intramuscular
ATC code
Legal status
Legal status
  • OTC (tablets), ℞-only (solution for injection) (RU)[1]
Pharmacokinetic data
BioavailabilityHighly variable (~65%), peak at 45–60 min
Protein binding95–98%
MetabolismHepatic
Elimination half-life7–16 hours
Excretion>50% in urine and ~30% in bile[1]
Identifiers
IUPAC name
  • (Z)-1-(3,4-diethoxybenzylidene)-6,7-diethoxy-1,2,3,4-tetrahydroisoquinoline
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.110.916
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Chemical and physical data
FormulaC24H31NO4
Molar mass397.515 g·mol−1
3D model (JSmol)
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- checkY
  • Key:OMFNSKIUKYOYRG-MOSHPQCFSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Drotaverine (INN, also known as drotaverin) is an antispasmodic drug, used to enhance cervical dilation during childbirth.[2]: 283 [3]

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

It is available in Asian and Central and Eastern European countries under several brand names.[5] Most known brand is No-Spa by Hungarian plant Chinoin (owned by Sanofi).

An article from 2013 described the effects from overdose (in a 19-year-old woman) as including vomiting, seizures and fatal cardiac toxicity.[6]

In 2016, the young Russian chess player Ivan Bukavshin died of a massive overdose (or poisoning) of the drug, which was originally thought to be a stroke.[7] His doses was 17 mg/kg in the blood stream.

Counterfeits

In Israel the product is known under the brand name "No-Spa" by the general public[8] which did not receive a permit to be distributed by the health ministry,[9] however due to high demand local medical counterfeiters have managed to smuggle No-Spa tablets over the years.[9]

In 2008 the Israeli health organization warned consumers from counterfeit No-SPA pills after a smuggler had been arrested at the Ben Gurion Airport with several thousand pills.[10][11]

In 2011 Israeli patent and trade mark office declined the use of the No-SPA.[8]

References

  1. 1 2 "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.
  2. ↑ Padubidri V, Anand E (2006). Title Textbook of Obstetrics. BI Publications Pvt Ltd. ISBN 9788172252236.
  3. ↑ 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.
  4. ↑ "The DrugBank database: Drotaverine". DrugBank Version 4.1. The Metabolomics Innovation Centre. Retrieved 9 August 2014.
  5. ↑ Drotaverine - Drugs.com Drugs.com international listings for drotaverine Page accessed June 28, 2015
  6. ↑ Drotaverine overdose (case report) Reactions Weekly, Volume 1481 (1), page 17.
  7. ↑ Silence, lack of will, indifference (Russian, Chess-News)
  8. 1 2 NO-SPA (also pronounced as No-SHPA) trade mark registration decision 202248, Israeli patent and trade mark office,11 July 2007
  9. 1 2 Health Ministry: Fake drug had been smuggled NRG, 11 March 2009
  10. ↑ Health Ministry: Counterfeit NO-SPA pills had been smuggled and are considered a health risk, Globes
  11. ↑ "משרד הבריאות מזהיר משימוש בתרופה לא מאושרת בשם: No-Spa".
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