Spasmalgon is a combination medicine. It contains several active components. This guarantees high efficiency in relieving pain of moderate intensity. In addition, the drug has weak antipyretic and anti-inflammatory properties. When taken, it is possible to eliminate the discomfort associated with pain in a short time. Spasmalgon is often prescribed in the postoperative period, as well as after diagnosis.
Active ingredients of the drug
“Spazmalgon” is a product that contains three active components in different proportions to provide antispasmodic and analgesic effects.
- metamizole sodium or analgin – provides an anti-inflammatory effect, as well as reducing fever and relieving pain;
- pitofenone – antispasmodic property on the cells of smooth muscle structures;
- fenpiverinium is a gangliobacterium and anticholinergic agent that has an inhibitory effect on nerve impulses.
The combination of three active components allows Spazmalgon to become a potent and effective remedy. The drug is available in pharmacies without a prescription and is affordable.
Release form "Spazmalgona"
The product is produced in two forms: tablets and injections. Tablet forms begin to act 20 - 30 minutes after administration, and a solution administered intramuscularly after 10 - 15 minutes. The solution is chosen according to the need for urgent pain relief.
These tablets have an analgesic effect and act quickly
Spazmalgon effect, 30 pcs., film-coated tablets
Paracetamol
It is characterized by high and rapid absorption from the gastrointestinal tract, mainly in the small intestine. The time to reach maximum concentration in blood plasma (TCmax) is 0.5-1.5 hours after oral administration. The maximum concentration in blood plasma (Cmax) is 5-20 mcg/ml. The connection with plasma proteins is insignificant - 15%. Paracetamol is evenly distributed and penetrates the blood-brain barrier, as well as into most body tissues. The estimated volume of distribution is 0.95 l/kg. Metabolized in the liver (90-95%): 80% enters into conjugation reactions with glucuronic acid and sulfates to form inactive metabolites; 17% undergoes hydroxylation to form 8 active metabolites, which conjugate with glutathione to form inactive metabolites. With a lack of glutathione, these metabolites can block the enzyme systems of hepatocytes and cause their necrosis. The CYP2E1 isoenzyme is also involved in the metabolism of the drug. The half-life (T1/2) is 1.5-2.5 hours. Excreted by the kidneys in the form of metabolites, mainly conjugates, only 3% unchanged. In elderly patients, drug clearance decreases and T1/2 increases.
Naproxen
Absorption from the gastrointestinal tract of naproxen is rapid and complete. Bioavailability - 95%. Food intake has virtually no effect on either the completeness or the rate of absorption. TCmax - 1-2 hours. Plasma protein binding is more than 99%. Equilibrium concentration is achieved after taking 4-5 doses of the drug (2-3 days). Metabolized in the liver to dimethylnaproxen with the participation of the CYP2C9 isoenzyme. T1/2 - 12-15 hours. Clearance - 0.13 ml/min/kg. Excreted by the kidneys (98%), 10% of which are unchanged; 0.5-2.5% of the dose taken is excreted in bile. In case of renal failure, accumulation of metabolites is possible.
Caffeine
Caffeine, which is part of the drug, is almost completely and quickly absorbed, the maximum concentration in the blood plasma is reached after 1 hour. Quickly passes through the blood-brain and placental barriers, enters breast milk, and is excreted (including in the form of metabolites) mainly by the kidneys, about 65-80%. The main metabolites are 1-methylxanthine, 1-methyluric acid and acetylated uracil derivatives; a small amount of caffeine is converted to theophylline and theobromine. T1/2 - 3.5 hours.
Drotaverine
When taken orally, absorption of drotaverine is high and rapid. Bioavailability - 100%. After first-pass metabolism, 65% of the administered dose of drotaverine enters the systemic circulation. The time to reach Cmax in the blood is 45-60 minutes. Plasma protein binding is 95-97%, mainly with albumin, gamma and beta globulins, as well as high-density lipoproteins. Evenly distributed in tissues, penetrates smooth muscle cells. Does not penetrate the blood-brain barrier. Drotaverine and/or its metabolites may slightly penetrate the placental barrier. T1/2 - 8-10 hours. Almost completely metabolized in the liver by O-desethylation. Metabolites quickly conjugate with glucuronic acid. The main metabolite is 4′-desethyldrotaverine, other metabolites are 6-desethyldrotaverine and 4′-desethyldrotaveraldine. T1/2 - 8-10 hours. Within 72 hours it is almost completely eliminated from the body. Basically (more than 50% of drotaverine) is excreted by the kidneys, mainly in the form of metabolites, to a lesser extent (about 30%) - with bile. Unchanged drotaverine is not detected in urine.
Pheniramine
The maximum concentration of pheniramine in blood plasma is achieved after approximately 1-2.5 hours. T1/2 - 16-19 hours. 70-83% of the dose taken is excreted from the body through the kidneys in the form of metabolites or unchanged.
When is the remedy prescribed?
“Spazmalgon” is effective for non-systematic pain, as well as for migraines, toothaches, and algodismenorrhea. "Spazmalgon" is sometimes prescribed after surgical interventions or before them, before performing diagnostic procedures.
The drug is prescribed by specialists for:
- when a stone passes through the urethra;
- intestinal colic caused by spasm;
- dyskinesias of the gallbladder and cholelithiasis;
- diseases of the gastrointestinal tract;
- algodismenorrhea.
How does the drug affect blood pressure: does it increase or decrease?
The action of the drug is aimed at relieving smooth muscle spasms. Since large arteries have muscle balls, they also relax under the influence of Spasmalgon. Vasodilation occurs after taking the drug, which helps restore full blood circulation and reduces the load on the myocardium.
Doctors are unanimous in their opinion that since Spazmalgon affects the smooth muscle structure, as a result of which it relaxes and relieves spasms, the pressure will decrease
The drug relieves headaches and can help with migraines. If these pathological conditions are accompanied by a reflex increase in pressure, then the remedy can be taken and it will be effective.
If a patient is diagnosed with hypertension and the severity level is set, then the person needs systematic influence on the body. "Spazmalgon" is not used for such purposes. If the pressure periodically tends to decrease, then you should stop using the drug and choose another remedy to relieve pain.
What does the medicine help with?
Spasmalgon, the instructions for use confirm this, has a wide range of uses. The drug effectively relieves moderate pain of various etiologies.
The medicine has proven its effectiveness against toothache. Its important feature is associated with the properties of smooth muscle relaxation, which eliminates the irradiation of pain in the ear and cheek area, which is practically impossible to endure stoically.
Medicine is prescribed to reduce joint pain in the development of various pathologies. In addition, it is used in the complex treatment of neuralgia and myalgia. After surgical operations, spasmalgon is prescribed as an adjuvant. It is permissible to prescribe medications to reduce fever when treating colds.
With the help of spasmalgon, you can relieve headaches if they are not associated with increased arterial or intracranial pressure, and are also not provoked by cerebrovascular accident. The effectiveness of the drug for migraine, which is characterized by an additional symptom – stomach spasm, has been proven. Thanks to its pronounced antispasmodic properties, spasmalgon successfully copes with this problem.
In addition, the drug effectively copes with headaches caused by sudden changes in weather. This means that it is indispensable for weather-sensitive people.
Spasmalgon copes with pain in organs located in the abdominal cavity. It is recommended to use the medicine for women who suffer from menstrual pain. The drug is considered highly effective for eliminating intestinal, renal, hepatic or biliary colic.
Often among the reviews regarding what spazlmalgon helps with, there are recommendations for using the product for headaches caused by a hangover. But to get a positive result, you need to completely cleanse your body of alcohol. This can be done, for example, with the help of diuretics.
Is it possible to lower blood pressure with the drug?
It is not recommended to regularly reduce blood pressure with Spazmalgon. Tablets or injections are designed to relieve pain caused by muscle spasms. The recommended period of taking the drug should not exceed three to five days. If a patient has diagnosed arterial hypertension, then he needs constant pressure reduction and maintenance therapy.
“Spazmalgon” sometimes helps to reduce blood pressure by 5–7 points if it has increased due to vasospasm. In other cases, with renal hypertension or other pathologies, the drug cannot be taken systematically.
Contraindications and side effects
A direct contraindication to taking spasmalgon is hypersensitivity to all components of the drug. The product should not be used during pregnancy and lactation, as well as for children under 6 years of age. Other contraindications are indicated in the instructions for use of the medicine
Side effects with a single dose are rare. This may include nausea, dizziness and increased blood pressure. With prolonged use of the drug, the risks of disruptions in the urinary and hematopoietic systems increase. An overdose of the drug can provoke dangerous allergic reactions. If this happens, it is necessary to rinse the stomach, induce vomiting, and take absorbents.
Use of "Spazmalgon" for hypotension
"Spazmalgon" for pain relief can be taken once for hypotension. Especially if the patient has physiological hypotension, that is, the pressure is constantly moderately reduced, which is associated with the constitution of the body and metabolic processes. If the pressure has dropped, began to differ from the “working” indicators, and a headache has occurred with low blood pressure, then the drug “Spazmalgon” will be ineffective. It does not relieve headache attacks and can cause unpleasant side effects and increase pain.
It is advisable for hypotensive patients to stop taking the medication so as not to provoke a worsening of their condition.
Spasmalgon®
When treating children and patients receiving cytostatic drugs, treatment with the drug should be carried out only under the supervision of a physician.
An increased risk of developing hypersensitivity reactions to metamizole sodium, which is part of the drug, is caused by the following conditions:
- bronchial asthma, especially in combination with polypous rhinosinusitis;
- chronic urticaria;
- alcohol intolerance (increased sensitivity to alcohol), against the background of which, even when taking a small amount of certain alcoholic beverages, patients experience sneezing, lacrimation and severe redness of the face. Alcohol intolerance may indicate previously unidentified aspirin asthma syndrome;
- intolerance or hypersensitivity to dyes (for example, tartrazine) or preservatives (for example, benzoate).
Before using the drug, it is necessary to conduct a thorough interview with the patient. If a risk of developing an anaphylactoid reaction is detected, use of the drug is possible only after a full assessment of the risk/benefit ratio.
If the drug is used in such patients, strict medical monitoring of their condition is necessary and the availability of means to provide them with emergency assistance in the event of the development of anaphylactic/anaphylactoid reactions is required.
Predisposed patients may experience anaphylactic shock, so patients with asthma or atopy should use the drug with caution.
Life-threatening skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been described with the use of metamizole sodium. If symptoms of these diseases appear (such as a progressive skin rash, often with blisters or lesions of the mucous membrane), treatment with the drug should be stopped immediately and should not be restarted.
During therapy with metamizole-containing drugs, agranulocytosis may develop. It lasts at least a week, does not depend on the dose, can be severe, life-threatening and even lead to the death of the patient. In this regard, if symptoms possibly associated with neutropenia appear (fever, chills, sore throat, difficulty swallowing, stomatitis, erosive and ulcerative lesions of the oral cavity, vaginitis or proctitis, a decrease in the number of neutrophils in peripheral blood - less than 1500/mm3), it is necessary to stop treatment and consult a doctor.
If the patient receives antibiotic therapy, then the typical manifestations of agranulocytosis may be minimally expressed. The erythrocyte sedimentation rate is significantly increased, while lymph node enlargement is mild or absent.
Typical symptoms of thrombocytopenia are an increased tendency to bleeding and the appearance of petechiae on the skin and mucous membranes.
In case of pancytopenia, treatment should be stopped immediately; complete blood count parameters should be monitored until they return to normal.
All patients should be aware that if symptoms of a pathological change in the blood (for example, general malaise, infection, persistent fever, bruising, bleeding, pale skin) appear while using the drug, they should immediately consult a doctor.
Administration of a metamizole-containing drug may cause individual hypotensive reactions. These reactions may be dose dependent and occur more often after parenteral administration.
To avoid the development of severe hypotensive reactions, you should adhere to the following recommendations:
- blood pressure, heart rate and breathing should be monitored;
- patients with existing hypotension, decreased circulating blood volume, dehydration, hemodynamic instability or with the initial stage of circulatory failure require normalization of hemodynamics;
- Caution should be used when treating patients with high body temperature.
In patients who should avoid lowering blood pressure (for example, with severe ischemic heart disease or cerebral stenosis), therapy should be carried out only with careful hemodynamic monitoring.
During treatment with the drug you should refrain from drinking alcohol.
It is unacceptable to use the drug to relieve acute abdominal pain (until the cause is determined).
In patients with impaired liver or kidney function, it is recommended to avoid the use of the drug in high doses due to a decrease in the rate of elimination of the drug.
How is the drug prescribed?
It is advisable to first agree on the dosage with your doctor. It depends on the age of the patient. The maximum daily dose for an adult should not exceed six tablets of the drug. Depending on the intensity of the pain, you can take one or two tablets as a single dose, after meals.
Do not crush the tablet before taking it. It is important to drink the product with plenty of water. It is recommended to take breaks between using Spazmalgon for four hours. For children over 12 years of age, the maximum daily dose is 4 tablets; it is recommended to take one tablet at a time. The drug can be used from 8 years of age, in which case the maximum daily dose is 3 tablets.
