ACTIVE-SPASS TAB

• Drotaverine inhibits phosphodiesterase-4 in smooth muscle, relaxing spasm in the gut, biliary tree, urinary tract and uterus.
• Because it acts directly on smooth muscle rather than through anticholinergic blockade, drotaverine avoids the dry mouth, blurred vision and urinary hesitancy of atropine-type antispasmodics.
• Aceclofenac reduces the prostaglandin production that drives both the pain and, in dysmenorrhoea, the excessive uterine contraction itself.
• The two actions are complementary in period pain, where prostaglandin-mediated cramping is the underlying mechanism.
• Useful in renal and biliary colic, where relieving the spasm is central to relieving the pain.

Not everyone gets these. Most are mild and settle as the course finishes.

• Contraindicated in severe hepatic, renal or cardiac impairment, and in known hypersensitivity to either component.
• Contraindicated in active peptic ulcer disease and in NSAID hypersensitivity including aspirin-sensitive asthma.
• Use with care in hypotension — drotaverine can lower blood pressure further.
• Colic must be diagnosed before it is treated: do not use to mask undiagnosed acute abdominal pain, which may need surgical assessment.
• Avoid in the third trimester of pregnancy; use earlier in pregnancy and while breastfeeding only on medical advice.
• May cause dizziness. Warn the patient before driving.
• Avoid alcohol during the course.