Spazmex

Spazmeks - a drug that has spasmolytic and insignificant ganglion blocking effect, which helps reduce the increased activity of detrusor of the bladder.

Its active ingredient is trospium chloride, which relaxes muscles and eliminates problems associated with urination in men and women.

The tablets have a lot of indications, but there are also many contraindications, so it will be useful to get acquainted with them.

Clinical and pharmacological group

A drug that reduces the tone of the smooth muscles of the urinary tract.

Terms of sale from pharmacies

Can buyby prescription.

Price

How much does Spazmex cost in pharmacies? The average price is at the level of660 rubles.

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Composition and form of release

Spazmeks is available in the form of white tablets, for oral use, convex on both sides.

• Each tablet contains 5 mg, 15 mg and 30 mg of active ingredient - Trospium chloride, and also a number of auxiliary components: corn starch, stearic acid, povidone, monohydrate lactose.

Tablets are packed in blisters of 10 pieces, 3-5 blisters each in a cardboard bundle with the attached instructions.

pharmachologic effect

Trospium chloride belongs to the group of ammonium bases, holinoblokatorov. It is an antagonist (an oppositely acting substance) of acetylcholine, which acts in the receptors of membranes of smooth muscles. Trospium chloride has an affinity with cholinergic receptors, reduces the increased activity of detrusor of the bladder, has an antispasmodic effect, shows ganglion-blocking activity.

After oral intake of the maximum concentration of the drug with anticholinergic effect reaches 4-6 hours, binds to plasma proteins up to 80%, not cumulated. In the liver, metabolism occurs before spiroalcohol (formed by the hydrolysis of ester bonds), is excreted for 5-18 hours with urine. The most part is excreted from the body in unchanged form, only 10% is accounted for by the educated metabolite. The drug does not have a central effect.

Indications for use

Indication for the purpose of the drug is:

• enuresis;
• detrusor-sphincter-dissynergy against intermittent catheterism;
• in the complex therapy of cystitis, accompanied by imperative symptoms;
• pollakiuria, nocturia;
• mixed forms of urinary incontinence;
• urinary incontinence and mandatory urge to urinate (with idiopathic hyperreactivity detrusor; with neurogenic hyperactivity (hyperreflexia) detrusor against multiple sclerosis, spinal trauma, congenital and acquired spinal cord diseases, strokes, Parkinsonism).

Contraindications

Before starting therapy, the patient should carefully read the instructions that accompany the drug. Sparex tablets are contraindicated for patients in the following cases:

• renal failure requiring dialysis;
• slow digestion of food and its subsequent movement through the intestine;
• age up to 14 years due to lack of clinical experience;
• lactose intolerance or malabsorption syndrome;
• heart rhythm disturbances;
• glaucoma of the closed type;
• acute urinary retention;
• myasthenia gravis;
• individual intolerance of the drug components.

Relative contraindications (when the drug can be used with caution and under the supervision of a doctor) are:

• Ulcerative colitis (high-dose therapy may increase the risk of developing paralytic intestinal obstruction, intestinal peristalsis depression, as well as to exacerbation / exacerbation of toxic megacolon);
• diseases accompanied by increased intraocular pressure, including. open angle glaucoma (the dosage regimen may need to be changed), age over 40 years (possibility of the presence or development of undiagnosed glaucoma);
• Down's disease (risk of increased heart rate and excessive dilatation of the pupils);
• hyperplasia of the prostate without obstruction of the urinary tract, autonomic neuropathy (risk of increased urinary retention and paralysis accommodation), urinary retention (presence or predisposition to it), as well as diseases accompanied by urinary tract obstruction paths;
• brain diseases in children (risk of increasing effects on the central nervous system);
• chronic lung diseases, especially in children and weakened patients (risk of congestion in the bronchi and thickening of the secret, which is associated with a decrease in bronchial secretion);
• thyrotoxicosis (risk of tachycardia);
• diseases of the digestive system in combination with obstruction, including pyloric stenosis and achalasia (the risk of a decrease in tone and motor skills, which can cause obstruction and retention of the contents stomach);
• reflux esophagitis or hernia of the esophageal opening of the diaphragm in combination with reflux-esophagitis (risk of slowing gastric emptying with increased gastro-esophageal reflux);
• xerostomia (prolonged course may lead to increased severity of symptoms);
• elevated body temperature (may indicate a violation of the activity of sweat glands);
• intestinal atony in weakened patients or elderly patients, paralytic ileus (risk of obstruction);
• diseases of the cardiovascular system, in which it is undesirable to increase the heart rate, including such diseases / conditions: mitral stenosis, ischemic heart disease, tachycardia, atrial fibrillation, chronic heart failure, acute hemorrhage, arterial hypertension;
• myasthenia gravis (risk of deterioration, which is due to inhibition of the action of acetylcholine);
• liver failure;
• kidney failure (increased risk of side effects, which are associated with a decrease in withdrawal Spasmox);
• central paralysis in children (risk of developing the most pronounced response to anticholinergic drugs);
• gestosis (risk of hypertension);
• period of pregnancy and breastfeeding (it is prescribed only after the doctor estimates the ratio of expected benefit with possible complications).

Dosage and route of administration

As indicated in the instructions for use Spazmeks appointed in adults and children over 14 years. Dosing regimen and duration of treatment are set individually depending on the clinical picture and the severity of the disease.

Tablets should be taken before meals, without chewing, with enough water.

• Tablets 5 mg: appoint 2-3 tablets. 3 times / day (30-45 mg) with an interval of 8 hours; at a daily dose of 45 mg is acceptable to take 30 mg in the morning and 15 mg in the evening.
• The tablets covered with a film cover, 15 mg: appoint or nominate on 1 tab. 3 times / day with an interval of 8 hours; daily dose of 45 mg.
• The tablets covered with a film cover, 30 mg: appoint or nominate on 1/2 tab. 3 times / day or 1 tab. in the morning and 1/2 tab. in the evening; daily dose of 45 mg.

In patients with renal insufficiency (CC 10-30 ml / min / 1.73 m2) the daily dose of the drug should not exceed 15 mg.

The average duration of treatment is 2-3 months. If a longer treatment is required, the doctor continues to review the issue of continuing treatment every 3-6 months.

Side effect

The instructions indicate the occurrence of possible side effects during the application of the drug:

• cardiovascular system: infrequently - tachycardia; rarely - hypertensive crisis, fainting, chest pain, tachyarrhythmia;
• digestive system: often - xerostomia, dyspepsia, nausea, constipation, abdominal pain; infrequently - bloating, diarrhea; rarely - gastritis, moderate / insignificant increase in the activity of transaminases;
• allergic reactions: infrequent - skin rash; rarely Stevens-Johnson syndrome, anaphylactic reactions;
• urinary system: infrequent - impaired emptying of the bladder; rarely - urine retention;
• respiratory system: infrequently - dyspnoea;
• musculoskeletal system: rarely - necrosis of skeletal muscles in acute form;
• nervous system: rarely - confusion, hallucinations;
• organ of vision: infrequent - accommodative disorders.

Overdose

In case of an overdose, visual impairment is possible, dry mouth, tachycardia, skin hyperemia.

Treatment: activated charcoal, gastric lavage, if necessary parenteral administration of parasympatomimetics, patients with glaucoma - pilocarpine for topical application.

special instructions

Taking the drug in case of a violation of the internal sphincter function of the urethra or detrusor of the bladder should be accompanied by its complete release by catheterization.

At the beginning of treatment, with an increase in the dose of the drug, the replacement of the drug, as well as in the interaction with alcohol possible deterioration of vision, which should be taken into account when driving and working with moving mechanisms.

In vegetative disorders of the bladder, the cause of dysfunction should be determined before the treatment, organic causes of pollakiuria, nocturia and Urinary incontinence, such as: heart failure, polydipsia, the possibility of urinary tract infection and bladder cancer, because they require etiotropic therapies

Interaction with other drugs

With the simultaneous administration of drugs containing substances such as guar, colestyramine and colestipol, a decrease in the absorption of trospium chloride is possible.

With the simultaneous use of trospium chloride enhances the m-cholinoblocking effect of amantadine, tricyclic antidepressants, quinidine and disopyramide, antihistamines, as well as a positive chronotropic effect beta-adrenomimetics.

Trospium chloride weakens the effect of prokinetics (metoclopramide and cisapride). It affects the motor and secretory functions of the gastrointestinal tract, changing the absorption of concomitantly used drugs.

There was no interaction between trospium chloride and isoenzymes of the cytochrome P450 system (CYP1A2, 2A6, 2C9, 2C19, 2D6, 2E1, 3A4), since trospium chloride is metabolized by them only in a small amount, and hydrolysis of esters is the main route of it metabolism.

Reviews

We offer you to get acquainted with the opinions of people who used the drug Spazmeks:

1. Elizabeth. A nine-year-old son after intense fright began to manifest enuresis at night and even in the daytime. The doctor advised to take courses of psychotherapy, and remove unpleasant symptoms by taking Spazmeks tablets. I read reviews on the drug, and found that it is not suitable for children under 14 years old. I will look for a safe analogue, I do not want to spoil my son's health.
2. Novel. It became easier after three days of taking a dose of 15 mg 3 times a day. Month two lived relatively well. Then gradually worse and worse. Here everything is individual. This drug helped me at least somehow, and the rest of the drugs used in the GAMP did not help at all. I changed 7 urologists and they all treated the prostatitis and thought it was the cause. How I got it. So much money was thrown out on this unnecessary treatment. I do not know how these doctors are taught. As if in addition to prostatitis other diseases in men do not happen.
3. Galina. With age, health began to deteriorate, and urinary incontinence appeared. It was a shame to go to the doctor, but did not want to constantly run to the toilet and use special diapers. The doctor prescribed Spazmex tablets to me. I began to take them on instructions - twice a day. Already for a week, the symptoms are almost gone, but I'll drink even before the next inspection.

Analogues

Structural analogs for the active substance:

• Spasmodic-lithium.

Analogues on the curative effect (means for the treatment of urinary incontinence):

• Adenostop;
• Adiuretin;
• Amizole;
• Amirol;
• Anaphranil;
• Brusniver;
• Vesicar;
• Gopantam;
• Gutron;
• Detruzitol;
• Driptan;
• Clominal;
• Librax;
• Mininin;
• Novitropane;
• Oxybutynin;
• Pantogam;
• Pantogam is an asset;
• Pantokaltsin;
• Pyramids;
• Piracetam;
• Raveron;
• Rolitan;
• Triptysole;
• Urotol;
• Cystrin;
• Enablex;
• Estrokad.

Before buying an analogue, consult your doctor.

Spazmeks or Vesicar - which is better?

The most new drug on the Russian market for the treatment of hyperactive bladder syndrome is Vesicare. Its difference from spasmox is in a single admission per day, the active substance of the drug is solifenacin succinate, relaxing acting on the tone of smooth muscles. Vesicare penetrates into the central nervous system and can cause drowsiness, serious complications, attention disorder. Unlike Spasmox, Vesicare can interact with other drugs without manifesting negative factors.

To achieve a pronounced effect, Vesicare is taken for a month, whereas Spasmox can be used for a long time. The effectiveness of the drugs is different, their appointment should be performed by the attending physician taking into account the severity of the patient's illness, his age, the tolerability of components and other individual characteristics. According to reviews, Spazmex works safer.

Shelf life and storage conditions

Packaging with tablets should be stored out of the reach of children, avoiding direct sunlight. The shelf life of the drug is indicated on the package and is 5 years from the date of manufacture.

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