Spasmalgon

Spasmalgon is a combination medication that contains three active ingredients: sodium metamizole, pitophenone, and fenpiverinium bromide. Here is brief information about each of these components and their possible effects:

1. Metamizole sodium: It is an analgesic (pain reliever) and antipyretic often used to relieve pain and fever in headache, toothache, muscle pain, migraine and other conditions. It exerts its action by blocking the synthesis of prostaglandins, substances responsible for causing pain and inflammation.
2. Pitofenone: It is a muscle relaxant that helps reduce cramps and tension in the muscles. It is used to relieve pain and discomfort associated with cramps and spasms of internal organs such as the stomach and intestines.
3. Fenpiverinium bromide: It is an anticholinergic agent that blocks the action of acetylcholine on receptors in the smooth muscles of the digestive organs. This helps to reduce spasms and contractile activity of the intestines, reducing pain and discomfort in various gastrointestinal disorders.

Spasmalgon is commonly used to relieve pain and cramps in various diseases and conditions such as stomach and intestinal cramps, menstrual contractions, postnatal uterine contractions, urinary tract cramps and others. It can also be used to relieve pain and discomfort after surgical procedures.

Indications Spasmalgon

1. Gastrointestinal Spasms: Spasmalgon may be prescribed to relieve spasms and pain from colic of the stomach, intestines, gallbladder and bile ducts.
2. Menstrual pain: The drug may help with lower abdominal pain that occurs during menstruation in women.
3. Urinary tract spasms: Spasmalgon can be used to relieve pain and spasms in diseases of the urinary system, such as cystitis, urethritis, urolithiasis and others.
4. Pain syndrome in renal colic: The drug may help relieve intense pain in renal colic caused by blockage of the ureter by a stone.
5. Migraine: Spasmalgon may be used to relieve headache and associated spasms in migraine.
6. Postoperative pain: The drug may be prescribed to relieve pain after abdominal or pelvic surgery.
7. Other pain syndromes: Spasmalgon can be used to relieve pain and spasms in various other conditions such as muscle spasms, back pain, acute pancreatitis, etc.

Release form

1. Pills

• Description: Solid oral form, convenient for taking. Spazmalgon tablets are usually packaged in blisters.
• Use: Take orally, drinking sufficient water.

2. Solution for injection

• Description: Liquid form of Spasmalgon for intramuscular or intravenous administration, usually supplied in ampoules.
• Use: Used when rapid pain relief is needed or when oral administration is not possible.

Pharmacodynamics

1. Metamizole sodium: It is an anti-inflammatory, antipyretic and analgesic. It has the ability to block the synthesis of prostaglandins, which helps reduce pain and inflammation.
2. Pitofenone: This ingredient is a myorelaxant, it reduces muscle contraction, which helps relax the smooth muscles of the abdominal organs, which can reduce spasms and pain.
3. Fenpiverinium bromide: This ingredient is an antispasmodic that also reduces the contractile activity of the smooth muscles of the abdominal organs, which helps to reduce cramps and pain.

Pharmacokinetics

1. Metamizole sodium:

   • Absorption: Metamizole sodium is generally well absorbed from the gastrointestinal tract.
   • Distribution: It is distributed in organs and tissues of the body, including sites of inflammation.
   • Metabolism: Metamizole sodium is metabolized in the liver to form active metabolites, including aminopyrine and methylaminoantipyrine.
   • Excretion: Mainly excreted from the body through the kidneys in the form of metabolites.

2. Pitofenone:

   • Absorption: Pitofenone is also well absorbed from the gastrointestinal tract.
   • Distribution: It is also distributed throughout the tissues of the body.
   • Metabolism: Pitofenone is metabolized in the liver.
   • Excretion: It is eliminated from the body mainly through the kidneys as metabolites.

3. Fenpiverinium bromide:

   • Absorption: Fenpiverinium bromide is rapidly absorbed from the gastrointestinal tract.
   • Distribution: It is distributed in the tissues of the body.
   • Metabolism: Fenpiverinium bromide is metabolized in the liver.
   • Excretion: Mainly excreted through the kidneys.

Interactions between the components of Spasmalgon may be minimal as their pharmacokinetic profiles differ.

Dosing and administration

1. Pills

• Adults: It is generally recommended to take 1-2 tablets 2-3 times a day. Do not exceed 6 tablets per day.
• Children over 15 years of age: The recommended dose is 1 tablet 2-3 times a day. Do not exceed 3 tablets per day.

Tablets should be taken after a meal, drinking enough water. Do not chew.

2. Solution for injection

• Adults: Usually 2-5 ml intramuscularly or intravenously 2-3 times a day. The maximum daily dose should not exceed 10 ml.
• Children: The drug in the form of injections is generally not recommended for children under 15 years of age, except in special clinical cases and strictly as prescribed by a physician.

The injections can be given intramuscularly or intravenously. Intravenous administration should be done slowly, for at least 2-3 minutes, to minimize the risks of side effects.

General recommendations

• The drug is intended for short-term use. If symptoms persist for more than a few days, a doctor should be consulted.
• Spasmalgon is not recommended in the presence of certain diseases such as asthma, glaucoma, severe liver or kidney dysfunction, and in case of hypersensitivity to any of the components.
• Use of the drug may mask symptoms of other serious conditions; therefore, it is important to consult your doctor before starting the drug.
• Avoid drinking alcohol during treatment with Spasmalgon as it may increase the chance of side effects.

Use Spasmalgon during pregnancy

Spasmalgon is not recommended for use during pregnancy, especially in the first and third trimesters, if other methods of treatment can be effective and safe. Components of the drug may have a negative effect on the developing fetus.

1. Metamizole sodium: Use of metamizole in the first trimester of pregnancy is associated with an increased risk of defects in the baby.
2. Pitofenone and fenpiverinium bromide: There is limited data on the safety of these ingredients during pregnancy. Toxic effects on the fetus have been found in animal studies.

Contraindications

1. Hypersensitivity: People with known hypersensitivity to metamizole sodium, pithophenone, fenpiverinium bromide or other components of the drug should avoid its use.
2. Pregnancy and lactation: Use of the drug during pregnancy or lactation should be under medical supervision, as the safety of its use in these cases may be limited.
3. Bone marrow lesions: The drug may be contraindicated in the presence of bone marrow lesions, as sodium metamizole may affect blood composition.
4. Liver and kidney damage: People with liver or kidney disease should consult a doctor before using Spasmalgon, as it may affect liver and kidney function.
5. Bronchial asthma: Metamizole sodium may cause allergic reactions, therefore the drug may be contraindicated for people with bronchial asthma or other allergic diseases.
6. Glaucoma: Fenpiverinium bromide may increase the symptoms of glaucoma, therefore the use of the drug may be contraindicated in people with glaucoma.
7. Myasthenia gravis: Pitofenone may increase the symptoms of myasthenia gravis, so use of the drug may be contraindicated in people with this condition.

Side effects Spasmalgon

1. Metamizole sodium:

   • Potentially serious side effects: rare may include agranulocytosis (severe decrease in white blood cell count), thrombocytopenia (decrease in platelet count), aplastic anemia (decrease in the number of all types of hematopoietic cells in the bone marrow), and allergic reactions, including anaphylaxis (a systemic allergic response that can be life-threatening).
   • More common side effects: may include dyspeptic symptoms such as nausea, vomiting, and diarrhea, and rarely, skin rash and itching.

2. Pitofenone:

   • Common side effects: may include drowsiness, dizziness, fatigue and rarely, gastrointestinal disturbances such as constipation or dry mouth.

3. Fenpiverinium bromide:

   • Side effects: may include dry mouth, visual disturbances, constipation, urinary disturbances and rarely, allergic reactions such as skin rash or itching.

Overdose

Symptoms of overdose may include:

1. Nausea and vomiting: Excess of the drug may cause vomiting, which may lead to further loss of fluids and electrolytes.
2. Headache and dizziness: Increasedheadache and sensation of dizziness may result from overdose.
3. Hypotension: Overdose can cause a drop in blood pressure, which can lead to dizziness, weakness, and even fainting.
4. Stomach and Intestinal Disorders: This may include diarrhea, stomach cramps, and abdominal discomfort.
5. Heart rhythm disorders: Arrhythmias may occur, especially in mixed intoxication.

Interactions with other drugs

1. Drugs that increase central nervous system depressant effects: Combining metamizole sodium, pithophenone and fenpiverinium bromide with other drugs such as sedative drugs, sleeping pills, alcohol or benzodiazepines may increase their depressant effects on the central nervous system.
2. Hypotensive drugs: The combination may increase thehypotensive effects of drugs such as antihypertensives, which may lead to a dangerous drop in blood pressure.
3. Drugs that increase the risk of bleeding: Metamizole sodium may increase the anticoagulant effects of acetylsalicylic acid or other drugs that increase the risk of bleeding.
4. Drugs affecting hepatic or renal function: Combination with drugs affecting hepatic or renal function may increase their toxic effects.
5. Drugs metabolized via cytochrome P450: Metabolism of some drugs may be altered by metamizole sodium, which may result in strengthening or weakening of their effects.
6. Intestinal drugs: Fenpiverinium bromide may increase the effects of intestinal drugs such as anticholinergic agents, which may lead to increased side effects.