Medicine Duspatalin - indications for use and analogues

pharmachologic effect

Relaxes spasmodic smooth fibers. When taking the medicine, peristalsis is normalized. Compared to papaverine, it has a 20 times more pronounced effect on the gallbladder sphincter.

The mechanism of action is based on double blocking of ion channels: at the first stage, the drug slows down the transport of sodium ions, blocking fast channels. Then the process of calcium ion uptake is inhibited. The result is long-term relaxation of smooth muscles, without atony of the small or large intestine.

Duspatalin for gastritis with high acidity and other types of this disease effectively copes with the main symptom - pain and cramps, which significantly worsen the quality of life if they are ignored. Each Duspatalin capsule contains the active pharmaceutical substance mebeverine. Mebeverine acts on the muscles of the digestive tract and helps relieve spasm caused by their contraction. As a result, peristalsis is normalized and adverse symptoms are alleviated.

Duspatalin for gastritis begins to relieve spasms half an hour after taking the capsule. The effect lasts about 10 hours. Metabolism of Duspatalin occurs in the liver. The medication is excreted by the kidneys in the form of waste metabolites.

Operating principle

What is Duspatalin? What does this drug help with? This medication is a myotropic antispasmodic. The analgesic effect of this medicine is based on the suppression of spasms and relaxation of the smooth muscles of the intestines. At the same time, the drug does not affect peristaltic contractions in any way, due to which it ensures complete elimination of pain in the abdomen without slowing down the movement of food masses.

What does Duspatalin help with: indications for use

The advantages of Duspatalin are that the drug does not suppress peristaltic movements, but only acts on enhanced motility. After elimination of smooth muscle activity, normal intestinal motility remains. Indications for use of the drug are the following conditions:

1. Biliary colic, when a stone interferes with the flow of bile from the liver or gallbladder.
2. Intestinal colic is severe pain that occurs due to any changes in the colon.
3. Dysfunction of the gallbladder when its contractility is impaired.
4. Spasms of the gastrointestinal tract caused by diseases of the intestinal tract, for example, pancreatitis or cholecystitis.
5. Irritable bowel syndrome: abdominal pain, diarrhea, constipation.

Reviews from doctors

Practitioners leave mostly positive reviews about Duspatalin. Moreover, excellent results were noted in the gynecological field by specialists who manage pregnancy, as well as therapists involved in the treatment of pathologies of the gastrointestinal tract. Gynecologists also talk about the noticeable effect of the drug in the fight against colic and spasms in pregnant women that arise due to dietary errors, increased emotional impressions, severe anxiety, etc.

General practitioners claim in reviews of Duspatalin that it is a proven drug in the fight against functional colic and spasms, for example, due to severe anxiety or dietary errors. In addition, doctors highly appreciate the effectiveness of the drug in the prevention and treatment of cholecystitis and pancreatitis. The medication is especially good as a preventive measure to avoid exacerbations of these diseases. However, for the treatment of pancreatitis, the use of one medication has little effect, and its inclusion in complex therapy helps to significantly enhance its effectiveness. What other reviews about Duspatalin are there?

Release form of the medicine

Duspatalin is produced in the form of capsules and tablets. Capsules contain more active ingredient than tablets. Their effect is more pronounced and lasts longer. Both capsules and tablets contain chemically produced mebeverine, as well as magnesium stearate, ethyl acrylate copolymer, triacetin and talc, shellac, gelatin, titanium dioxide, soy lecithin, antifoam and other components. The content of complementary substances in capsules and tablets is slightly different.

The medicine, produced in the form of capsules, has a prolonged effect, and the word “Retard” is always added to the name on the packaging. This term means a long duration of exposure to the body. The name may be supplemented with the amount of active substance expressed in numbers, for example, the name of the drug may be indicated as Duspatalin 200.

The tablets are round in shape, white in color, and the package can contain from 10 to 120 pieces. The capsules have a dense gelatin shell, their color is white and opaque. The contents of the capsules are multi-colored granules. The package can contain from 10 to 90 capsules.

Taking capsules

Duspatalin capsules should be swallowed 20 minutes before meals. Swallow the drug whole, without chewing or spilling the filler. Drink 0.5 cups of clean water. Take the medicine one capsule twice a day - in the mornings and evenings.

The timing of taking the drug is determined depending on the speed with which the tone of smooth muscle cells in the digestive organs returns to normal. Taking capsules can be continued until the patient says goodbye to discomfort. When improvement is achieved, the medicine should be gradually discontinued.

Discontinuation of treatment with Duspatalin is a gradual reduction in the dose of the drug, designed for one dose. For 7-14 days, the patient will take a capsule per day - before breakfast. Then the use of the drug is stopped. Take the drug one capsule at a time for a week, then take a break and carefully evaluate the changes in how you feel.

Contraindications

The drug has a number of significant contraindications, which are recommended to be strictly adhered to. Duspatalin should not be used in patients under twelve years of age. During pregnancy and the postpartum period, it is preferable to take the drug exclusively in capsule form. This is due to the peculiarities of the physiological state of the female body. At the same time, contraindications include individual intolerance to individual components of the composition. It is prohibited to carry out complex treatment with the parallel consumption of drinks containing alcohol.

Contraindicated in pregnant women

Duspatalin – when is it prescribed?

The medication Duspatalin, due to its effect on the body, which helps eliminate spasms and pain in the gastrointestinal tract, is used to improve the functioning of the body in the following conditions:

• Intestinal colic;
• Abdominal pain is spasmodic;
• Colon irritation (the drug is used to relieve the severity of intestinal disorders and discomfort in the area where the intestines are located;
• Gallbladder dysfunction or biliary colic;
• Postoperative recovery if the gallbladder is removed;
• Spasms of the gastrointestinal tract are secondary, caused by diseases of other systems and organs (in the case of pancreatitis, cholecystitis);
• Problems with the function of the organs of the digestive system, in which there are clearly defined pains and discomfort in the abdominal area;
• It is used as a symptomatic drug to reduce pain, discomfort, and spasms in the intestines.

Patient reviews

Patients respond mostly positively to the drug, although there are cases when the desired effect is not achieved. However, you need to understand that the drug may not always act quickly. If the disease is in an advanced state, it will take at least two days to eliminate its acute manifestations. When treating stomach ulcers or gastritis, it helps eliminate spasms and pain, but does not affect the cause of the pathology. We reviewed patient reviews of Duspatalin and the instructions for the drug.

How to be treated using medication

The optimal regimen for using the drug should be considered separately for each form. They not only have different intensities of action, but there are also certain nuances of use.

Duspatalin tablets should be taken approximately thirty minutes before meals. The tablet should be swallowed whole, without biting or chewing. Then take the tablet with clean water, drink at least half a glass.

One tablet per dose, a total of three doses per day - before breakfast, lunch, dinner. Continue the course until the spastic pain goes away. When the desired effect is obtained, the medication is gradually tapered off. The process may take approximately 3-4 weeks. It goes something like this:

• Week 1. Before each lunch and breakfast, the patient takes a whole tablet of the drug, and before each dinner another half;
• Week 2. Take the medicine twice a day, before breakfast and dinner, a whole tablet;
• Week 3: Swallow a whole tablet before breakfast, then take another half before dinner;
• Week 4. Take a whole tablet per day before breakfast.

This scheme for gradual drug withdrawal represents recommendations developed by specialists from leading clinics in the country. These organizations specialize in therapeutic work with diseases of the digestive system, including the development of drugs for the treatment of gastritis.

Depending on the patient’s health characteristics, the scheme can be lengthened or shortened. In cases where withdrawal is tolerated calmly, the dosage is reduced not by a whole tablet per day, but by 0.5. Then the cancellation process will take no more than a couple of weeks. If, when reducing the amount of medication, you feel unwell, the reduction should be carried out by half a tablet per day. After reducing the dose of the medication, the condition is assessed in about a couple of days.

Doctors involved in the treatment of gastrointestinal diseases and gastritis recommend starting to reduce the dose of the medicine, removing half a tablet at a time. If you want things to go faster, after two days, eliminate another tablet entirely. Wait a couple of days again, taking the medicine in this amount.

If no deterioration is noted, continue withdrawal with the same regimen. If you experience any discomfort, return to the first option for taking the medication. Start this way every week following the start of drug withdrawal. Monitor your health when switching to a new regimen in the first two days.

Use for children

Duspatalin can be used by children only from the age of 12. The drug is prescribed to relieve spasms and pain in the gastrointestinal tract.

According to numerous studies, capsules are suitable for eliminating discomfort, heaviness and pain that arise after using low-quality and harmful food products or against the background of psycho-emotional stress.

Children can develop irritable bowel syndrome from foods. All unwanted manifestations are relieved by using capsules or tablets.

For use in adolescents, capsules are suitable, which are taken twice a day. The main advantages of release in capsules: it has a long-lasting effect. The dosage is identical to the dosage for adults; the doctor does not make any adjustments.

For psycho-emotional disorders, experts recommend using one capsule per day. Before dinner, another one is taken. If the pain has passed and the spasm has been relieved, there is no need to use capsules at all. If the pain remains, then take two capsules in the morning and evening, every 24 hours.

Interesting! Indications and contraindications for the drug Itomed - nuances of use

For children over 12 years of age (no younger) the drug is prescribed only as needed. For emotional spasms, there is no need to use capsules as a course.

If the doctor notes a violation of the outflow of bile, then take the capsules for a long time with the same single dose, as given in the instructions above. No special dosing is required.

Important! How to take Duspatalin for adolescents is prescribed by the attending physician, based on the clinical manifestations and causes of the pathology.

The effectiveness of the drug in treatment with its use

Based on the characteristics of their action, Duspataltin and many analogues are classified as myotropic antispasmodics. Myotropy provides the ability to relax the smooth muscles of the intestine, eliminates pain and spasms associated with severe tension.

Smooth muscle cells are mostly found in the large intestine, so the effect of the drug is most pronounced in this part of the body. With a decrease in smooth muscle tone, peristaltic activity does not change. The movement of food through the intestines and digestion of food does not become slower, there are no disruptions to the process.

The drug, in addition, has a relaxing effect on the sphincter of Oddi, due to which the outflow of bile improves and pain is reduced. The pain is usually associated with biliary colic. Particular convenience when using Duspatalin lies in the rapid improvement of motor skills, while peristalsis is not completely suppressed.

This helps maintain normal intestinal motility after excessive smooth muscle activity has been eliminated. In this case, there is no need to fear reflex hypotension for the intestines.

When Duspatalin enters the intestines, the substances pass into the blood and then enter the liver. There, biochemical transformations occur with them, resulting in the breakdown of metabolites. The drug is excreted in the form of metabolites, with the main amount being excreted in the urine.

When Retard capsules are used for treatment, the main substance is released at a low speed. Therefore, you can expect that after taking the medication, the effect will last approximately 16 hours.

Instructions for use

Duspatalin is produced by the Dutch pharmaceutical company ABBOTT HEALTHCARE PRODUCTS, BV. In pharmacies you can find a drug produced in France. The company offers medicine in the form of tablets and capsules. There is no tablet product in Russia, but we will introduce the reader to its features.

The drug is considered prolonged, which means it is slowly eliminated from the body and has a prolonged effect, and “retard” is added to the name.

Compound

Dosage forms differ in quantitative composition, auxiliary components, and duration of action.

The active substance of Duspatalin is mebeverine. Its weight in a tablet is 135 mg, in a capsule - 200 mg. The auxiliary components form a protective capsule and therefore differ from tablets. The company produces round white tablets of Duspatalin in different packaging from 10 to 120 pieces.

The capsules (antiquity lovers call them “pills”) are covered with an opaque gelatin shell. Inside there is an active substance in granules. You can buy packages of 10, 20, 30, 50, 60 or 90 pieces.

Pharmacological properties of the drug

To explain the mechanism of action of Duspatalin, you will have to remember the anatomy. The body distinguishes between striated and smooth muscle fibers. The former dominate the skeletal muscles and provide human movement. The second ones are located in the internal organs, forming the tone of the sphincters of the stomach, intestines, urinary and gall bladder. Maintain shape, regulate the elasticity of blood vessels and hollow formations.

A negative feature of smooth muscle cells in terms of therapeutic effects is the ability to independently excite in response to various stimuli (hormonal fluctuations, stretching, growth of prostaglandins during inflammation, changes in metabolism). In addition, they have the automatic ability to maintain their contraction. For skeletal muscles, this requires special nerve impulses.

The mediator acetylcholine is involved in fiber contraction. It stimulates muscarinic receptors in the cell membranes of smooth fibers. As a result, channels open for Na to enter the cell. To prevent spasm, drugs that block receptor sites (anticholinergics) are used. This is a well-known group of Atropine (No-shpa, Spazmalgon, Platyfillin, Papaverine). Their disadvantage is an undesirable effect on vision, pronounced palpitations, urinary retention, and dry mouth.

Mebeverine acts specifically on the cell membrane: it reduces its permeability to Na and does not block receptors. Therefore, there are no unpleasant side effects during clinical use. The substance prevents persistent atony by slightly removing K ions from the cell and preventing prolonged hyperpolarization of the membrane.

The pharmacological effect provides a reduction in the force of contraction without suppressing peristalsis. Thanks to the gradual dissolution of the capsule shell, the medication is evenly distributed throughout the intestines, including the lower sections. It passes through the wall and is absorbed into the bloodstream. Metabolized in the liver (the state of the organ matters in the use of the drug) and is excreted in the urine a day after taking one dose. The drug concentration remains in the blood for 16 hours.

Mebeverine does not have anticholinergic properties and therefore does not cause atropine-like effects. Can be prescribed for glaucoma, enlarged prostate gland in men, when other antispasmodics are contraindicated.

The use of Duspatalin in the treatment of diseases of the biliary system and pancreas is associated with relaxation of the sphincter of Oddi, elimination of biliary colic, and normalization of bile outflow.

The drug is allowed to be used indefinitely. There are no classical courses of treatment. It helps some patients from the first or second day, while others have to take it for a long time. The clinical outcome depends on identifying the cause of abdominal pain and targeted treatment.

After eliminating the pain, you cannot immediately stop taking Duspatalin; the dosage is reduced gradually.

Duspatalin is an antibiotic?

The medicine does not have an anti-inflammatory effect and does not affect the growth and reproduction of pathogenic microorganisms. Therefore, it cannot belong to the class of antibiotics. The need for pain relief arises for various diseases. Mebeverine combines well with antibacterial drugs.

Does duspatalin cure or only relieve pain?

Sometimes patients who have not studied the instructions tend to attribute non-existent properties to the drug. Perhaps future research will reveal something more useful.

Doctors warn that Duspatalin is a symptomatic drug. It is intended to alleviate the patient's condition and relieve pain. The medicine does not fight the immediate cause of the pathology. This requires a full examination and complex therapy.

Contraindications to the use of the drug

The use of Duspatalin is very effective, and it has practically no contraindications. The medication is not prescribed if the patient has sensitivity to certain components, manifested by an allergic reaction. The medicine is contraindicated for children under 14 years of age: clinical trials have not been conducted in this age group, so there are no exact indications about how Duspatalin affects the immature body of a child.

Elderly age

Taking the drug is permitted using the dosage regimen.

For liver dysfunction

Application permitted.

For impaired renal function

Treatment is carried out under the supervision of doctors, and if necessary, the dose of the medication is adjusted.

Analogues of the drug Duspatalin

There are cheaper analogues of Duspatalin used to treat irritated gastrointestinal tract - these are Trigan, Niaspam, Sparex. In the group of antispasmodics, analogues of the drug are “Papaverine”, “Dicetel”, “Drotaverine hydrochloride”, “No-shpa”. These drugs are similar in therapeutic effect, but have different active ingredients.

Use during pregnancy and lactation

Taking the drug is completely safe for pregnant women, since it affects only the smooth muscles of the digestive organs and does not affect the blood vessels and uterus. In addition, the medicine has a positive effect on the release of bile and juice in the pancreas into the duodenum and relaxes the sphincter of Oddi. Does not affect fetal development. Prescribe Duspatalin only with the consent of the doctor, having assessed the ratio of possible risks and benefits for the mother and fetus.

Pregnant women are prescribed only capsules. They cannot be combined with various antispasmodics such as No-shpa, Papaverine or Drotaverine hydrochloride. Prescribe two capsules twice a day. The duration of treatment is carried out until the pain symptoms disappear and the patient’s condition normalizes. The withdrawal of the drug is carried out according to the usual scheme for adults and gradually.

During this period of a woman’s life, when the whole body is undergoing a restructuring and is getting used to a new state, sometimes there is a need to take antispasmodics. In most cases, no-shpa or papaverine is prescribed, but if pain appears in the area of ​​the digestive organs, Duspatalin may also be prescribed.

Duspatalin relieves the increased tone of the muscles of the digestive organs, while leaving the normal tone of the uterus. Duspatalin suppresses spasm of the sphincter of Oddi muscle, quite selectively. These properties of the drug are successfully used in the treatment of digestive disorders in pregnant women.

The manufacturers of Duspatalin did not conduct clinical trials on this group of patients, but if we take into account the results of studies conducted on animals, it must be taken into account that after treatment that includes this drug, no negative effects on the fetus were found. Therefore, Duspatalin is approved for the treatment of pregnant women, but it should be prescribed only for precise and clear indications, the woman should be under the supervision of a doctor.

This drug does not suppress intestinal motility and does not increase constipation, which is so characteristic of pregnancy. This, undoubtedly, is one of the advantages of Duspatalin, since many women, at this period of life, suffer from constipation, which complicates the course of pregnancy. Duspatalin can be prescribed not only for problems with the gastrointestinal tract, but also when dysfunction of the sphincter of Oddi is detected.

With this disorder, pain of unknown origin appears in the abdomen, and sometimes disturbances in functional liver tests occur. This condition can occur as a result of removal of the gallbladder, and with chronic pancreatitis. During pregnancy, manifestations of sphincter of Oddi dysfunction may intensify, therefore, the doctor may prescribe Duspatalin.

Pregnant women should not take this drug together with other antispasmodics.

For uterine hypertonicity, no-spa and papaverine are prescribed, despite the fact that Duspatalin also has a similar effect, but in this case it is not suitable. When taking this antispasmodic, there are practically no side effects, which is a big plus for treatment during pregnancy.

The only thing is that an allergic reaction may occur, which is possible when taking any medicine and is simply a feature of the patient’s body. An allergy can be expressed in the appearance of hives, swelling, which is dangerous because it seizes the vocal cords and causes breathing problems.

At the slightest suspicion of an allergy, the drug should be discontinued immediately. Less likely to occur are symptoms such as nausea, dizziness, headache, loss of coordination.

In case of overdose, overexcitation of the central nervous system will occur.

It is important that during pregnancy, every woman remembers that any medicine, be it just an antispasmodic or otherwise, should only be prescribed by a doctor, and in no case should you take medicine without consulting a doctor.

You cannot self-medicate and listen to the advice of those who “had the same thing”, remember that everyone’s body is different, the symptoms may simply be similar, and after listening to such incompetent advice, never try it in practice, as the consequences can be very disastrous both for the pregnant woman and for the child.

The principle of correct reception

The occurrence of discomfort in the stomach and intestines is provoked by an increase in the tone of the so-called smooth muscles, which are located on the walls of the organ. Such disorders are most often accompanied by painful spasms of varying intensity. At the same time, the sufferer experiences a negative change in the process of digesting food.

Pain in the stomach

Pain syndrome can be detected in any part of the internal organ; their gradual spread to neighboring areas is not excluded. The pain occurs suddenly and develops sharply. It is characterized by attacks and lasts for a short period of time. In such a situation, the gastroenterologist prescribes the patient a course of Duspatalin, tangible results from taking which are visible after just a few days.

Duspatalin capsules are recommended to be taken orally no later than 20 minutes before a meal. The drug is taken with a large volume of water. The duration of therapy and dosage are determined individually by the treating doctor. At the final stage, it is better to gradually reduce the dosage of the medication. The approximate duration of completion of treatment is several weeks; abrupt cessation of treatment is unacceptable.

If the drug is used in the form of capsules, chewing them is prohibited. This is due to the fact that the prolonged action is ensured by the shell. If the regular use of the drug Duspatalin is not observed, compensation by increasing the dosage is prohibited. In the case of carrying out therapeutic measures with the help of tablets, it is recommended to refrain from driving cars, as well as from those activities that require the utmost attention of a person. There are no such restrictions at the time of treatment with capsules.

If discomfort occurs in the body of a teenage patient, it is recommended to take the complex immediately after the appearance of unpleasant symptoms. Subsequent use is carried out before the evening meal. If after a couple of days the disease does not bother the patient, then Duspatalin therapy is stopped. If discomfort signs persist, treatment continues, taking into account the rules for its completion.

No-shpa

Patients during pregnancy deserve special attention. This is due to the fact that the body undergoes significant restructuring. Often, when spasms and pain occur, No-shpa or Papaverine is prescribed, but doctors prefer Duspatalin. The drug allows you to cope with tone in the uterine area and sphincter spasm. Despite the fact that therapy with this complex is permitted during pregnancy and breastfeeding, treatment should be carried out under the supervision of a medical specialist and following all prescribed recommendations. The use of the drug simultaneously with other antispasmodic agents is strictly prohibited.

Side effects of Duspatalin

Duspatalin capsules are well tolerated and have virtually no side effects other than allergic reactions. Tablets can cause an allergic reaction, nausea, headache, dizziness.

During the period of taking pills, it is advisable to refrain from driving a car or other vehicle, and also try not to perform those types of work that require increased concentration and coordination of movements.

Although Duspatalin has very few contraindications, it should still be taken only as prescribed by a doctor; self-medication is highly not recommended.

One or more side symptoms may develop:

• general weakness, dizziness;
• headache;
• constipation or diarrhea;
• feeling of discomfort and bloating in the abdominal area;
• pain during bowel movements;
• nausea;
• swelling;
• allergic reactions: skin itching, burning, dermatitis or urticaria.

Side effects

Duspatalin in capsule form is very well tolerated by patients, in rare cases it can cause adverse reactions (allergic reactions are common). The tablet form can cause nausea, headaches and dizziness.

The drug should be taken with caution in patients who have high blood pressure, chronic pathology, diseases of the cardiovascular system and the pathways responsible for excreting urine from the body. If the recommendations are not followed, the patient may experience a slow heart rate and insufficient oxygen supply to all internal organs.

When treating ailments in the intestinal area, it is recommended to entrust the choice of a suitable drug to a doctor; it is extremely prohibited to carry out therapy on your own.

Duspatalin is the most powerful antispasmodic that helps the body cope with bloating, pain, stool problems and flatulence. Despite the increased cost, it confirms its effectiveness. Many patients report visible results even after a single use.

Analogs

There are medications that act similarly to Duspatalin. They have the same active ingredient (mebeverine), but the set of auxiliary components is different. The decision to prescribe another drug for treatment can only be made by the attending physician. You should not change the drug to another one on your own.

Not all analogues of the drug are better in action. But in some cases, replacement is still required - for example, due to poor tolerance of the auxiliary components. You can consult your doctor to find out which is better – Trimedat or Duspatalin. Both of them have a pronounced antispasmodic effect and help regulate the tone of the smooth muscles of the organs that make up the gastrointestinal tract.

But Trimedat has a slightly wider spectrum of action. Therefore, Duspatalin is chosen in cases where it is necessary to treat or prevent exacerbations of pancreatitis, cholecystitis, and is suitable for the treatment of gastritis. To cure diseases that are somewhat more severe, it is more convenient to use Trimedat.

It is worth considering that the division of medicines should be considered conditional. Duspatalin or Trimedat - the decision must be made depending on the patient’s condition.

Price in pharmacies for Duspatalin

Depending on the region, the cost of the drug may vary between 50-1328 rubles .

For example, in Moscow the price for Duspatalin is as follows:

1. If you purchase capsules, you need to prepare 550 rubles .
2. Buying tablets will cost 650 rubles .

Duspatalin - contraindications

In addition to information about what Duspatalin helps with, it is important for patients to know that there are some restrictions on its use. The drug Duspatalin is prohibited for use in the following cases:

• children under 12 years of age;
• pregnancy (only in exceptional cases with the permission of a doctor);
• breastfeeding period;
• hypersensitivity to the components of the drug.

Duspatalin in the treatment of functional diseases of the intestine and biliary tract

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The first international classification of functional diseases of the gastrointestinal tract was presented at the XIII Gastroenterological Congress in 1988 in Rome.
It was then that the term irritable bowel syndrome was first officially approved and clinical criteria for its diagnosis were given. Irritable bowel syndrome (IBS) code K 58. according to the International Classification of Diseases (ICD X) - disorders of the motor and secretory function of the intestines, characterized by the presence of pain or abdominal discomfort for 12, not necessarily consecutive weeks over the last 12 months in combination with two of the following three signs: stop after defecation;
associated with changes in stool frequency; associated with changes in the shape of feces . This includes: IBS with diarrhea (code K 58.0), IBS without diarrhea (code K 58.9) and IBS with constipation (code K 59.0). Despite the heterogeneity of IBS, previous acute intestinal infections with the development of intestinal dysbiosis play a significant role in its occurrence.

And the greatest interest, especially in surgical clinics, is in conditions after cholecystectomy, accompanied by a violation of the functional state of the biliary tract. Over the past decades, the incidence of calculous cholecystitis has acquired a steady upward trend. Cholecystectomy has become the most common operation after appendectomy. More than 110 thousand operations are performed per year in Russia. According to various authors, 20–40% of patients who have undergone cholecystectomy still have complaints related to pain and dyspeptic disorders, which are usually regarded as postcholecystectomy syndrome: code K 91.5. according to the International Classification of Diseases (ICD X).

It should be noted that postcholecystectomy syndrome

is a collective concept that unites various pathological conditions and associated clinical manifestations observed in patients after removal of the gallbladder. Most authors who have studied this problem consider the term used to be not entirely successful. The term postcholecystectomy syndrome is currently used to designate dysfunction of the sphincter of Oddi (SDO) that develops after surgery, caused by a violation of the tone of the sphincter of the common bile duct, pancreatic duct or common sphincter, preventing the normal outflow of bile and pancreatic secretions into the duodenum in the obligatory absence of organic obstacles. In this regard, correct interpretation of pathophysiological disorders in the functioning of the sphincter apparatus of the biliary tract is important for making a diagnosis.

Despite intensive research and the search for new pharmacological groups of drugs for the treatment of irritable bowel syndrome and dysfunctional diseases of the biliary tract, the leading role in the treatment of abdominal pain in these diseases belongs to myotropic antispasmodics

. Numerous clinical studies have proven the effectiveness and good tolerability of myotropic antispasmodics for functional diseases of the intestine and biliary tract. However, the pharmacological group of myotropic antispasmodics is heterogeneous, and when choosing a drug, its mechanism of action should be taken into account, since abdominal pain is very often combined with other clinical symptoms, primarily flatulence, constipation and diarrhea.

Duspatalin (mebeverine hydrochloride) turned out to be the drug of choice in the treatment of these functional disorders.

. The main clinical advantage of Duspatalin is that it is indicated for patients with abdominal pain of functional origin, which is accompanied by both constipation and diarrhea, since the drug has a normalizing effect on intestinal function.

Mebeverine is a drug with an antispastic effect that has affinity for muscle tissue. It is used for the symptomatic treatment of abdominal pain, distress and discomfort associated with irritable bowel syndrome and sphincter of Oddi dysfunction. Mebeverine is also used to relieve spasms in various parts of the gastrointestinal tract due to its organic lesions.

The drug was first registered in 1965. Since then, it has been prescribed to (on average) 6.5 million patients per year worldwide. Mebeverine is currently sold in 74 countries under the trade names Colafac®, Duspatal®, Duspatalin®, Colospa®, Colotal® or Rudakol®.

It is widely recognized that double-blind, placebo-controlled clinical trials are absolutely essential when evaluating treatments for IBS and sphincter of Oddi dysfunction, given the high response rates to placebo (Cann, 1989). Over the past thirty-odd years, the effects of mebeverine have been studied in several double-blind, placebo-controlled clinical trials, including Connell (1965), Tasman-Jones (1973), Berthelot & Centonze (1981) and Prout (1983). The drug was also evaluated in comparison with standard drugs such as alverine citrate (Tudor, 1986), fenoverine (Salandre & Mignon, 1989) and dicycloverine (Grillage et al., 1990).

Mebeverine was statistically more effective than placebo in relieving abdominal pain and bowel dysfunction. Mebeverine has also proven effective in comparison with other antispastic agents.

Data on the safety and tolerability of the drug were obtained from clinical studies involving more than 3,500 patients taking mebeverine. The drug was always well tolerated by patients, even when using doses exceeding therapeutic ones. Most authors reported literally no side effects with treatment. The autonomic nervous system is not involved in the mechanism of action of mebeverine, therefore the drug in therapeutic doses does not have typical anticholinergic side effects. This makes it possible to use the drug in patients with concomitant diseases such as prostatic hypertrophy, urinary retention or glaucoma.

The most common drug in Russia is Duspatalin.

. A special feature of the drug is that smooth muscle contractions are not completely suppressed by mebeverine, which indicates the preservation of normal peristalsis after suppression of hypermotility. Indeed, there is no known dose of mebeverine that completely inhibits peristaltic movements, i.e. would cause hypotension.

Experimental studies show that mebeverine has two effects. First, the drug has an antispastic effect, reducing the permeability of smooth muscle cells to Na+. Secondly, it indirectly reduces the outflow of K+ and, accordingly, does not cause hypotension.

Contraction of smooth muscles of the gastrointestinal tract occurs when acetylcholine stimulates muscarinic receptors on the surface of the muscle cell. This causes sodium channels in the membrane to open, allowing Na+ to enter the cell. The resulting depolarization of the cell, in turn, promotes the opening of calcium channels and the entry of Ca2+ into the cell. The increased intracellular Ca2+ level leads to phosphorylation of myosin and, accordingly, to muscle contraction.

At therapeutic doses, mebeverine has a direct blocking effect on sodium channels, which limits the influx of Na+ and prevents the sequence of events leading to muscle spasm.

In addition to muscarinic receptors, smooth muscle cells in the wall of the gastrointestinal tract also have α1-adrenergic receptors associated with Ca2+ stores. This depot, located on the cell membrane, constantly restores the level of Ca2+ from the extracellular environment. Stimulation of the receptor by norepinephrine leads to the mobilization of Ca2+ from this depot into the intracellular space - a process that causes the opening of the channel for K+, which leads to hyperpolarization and decreased tone.

Mebeverine blocks the filling of the depot with extracellular Ca2+. Thus, if the a1-adrenergic receptor is activated in the presence of the drug, the depot is emptied, but cannot be filled again. Accordingly, the outflow of K+ is short-lived and permanent relaxation or hypotension does not occur.

Research into the effectiveness of Duspatalin in the treatment of functional bowel disorders has been conducted almost since its entry into the market. Data on the most authoritative studies are shown in Table 1.

The general conclusion of many authors after the study can be briefly summarized as follows: “The results obtained with mebeverine treatment are statistically significantly superior to the results obtained with placebo (p < 0.05)” (Tasman-Jones, 1973) or “In only 30 days, mebeverine resulted in to almost complete remission of abdominal pain and flatulence" (Secco et al., 1983). The results are presented in Figure 1.

Rice. 1. Evaluation of the effectiveness of mebeverine in the treatment of irritable bowel syndrome compared with placebo

The high effectiveness of mebeverine in the treatment of irritable bowel syndrome and sphincter of Oddia dysfunction has been noted in a number of other studies; the effectiveness of the drug in reducing pain and flatulence is presented in Figure 2.

Rice. 2. Efficacy of mebeverine in the treatment of IBS and sphincter of Oddi dysfunction

All research data on the effectiveness of mebeverine and comparing its effectiveness with placebo are statistically reliable, which proves
the need to choose Duspatalin for the treatment of spastic conditions and functional disorders of the gastrointestinal tract
.

A very important positive property of the drug is its low toxicity. Safety and tolerability data were obtained from clinical studies involving more than 3,500 patients treated with mebeverine.

In all studies, mebeverine was well tolerated by patients. Hematological and biochemical parameters remained unchanged throughout the course of treatment. Since the drug's introduction in 1965, no serious side effects have been reported. In an analysis of studies of drugs commonly used in the treatment of IBS and DSO, mebeverine ranked first in the absence of side effects (Poynard et al., 1994).

In most clinical studies of mebeverine, there was no mention of competitive symptoms occurring. This gives the drug a significant advantage over standard anticholinergic drugs, which, to obtain a therapeutic effect, must be prescribed in doses that act not only on the target organ, but also on other parts of the body.

Tasman-Jones (1973) noted that “the absence of anticholinergic properties is clearly an advantage; not only because the patient does not have unpleasant side effects, such as dry mouth, visual disturbances and constipation, but also because mebeverine is not contraindicated in patients with glaucoma and prostatic hypertrophy.”

Studies that used higher than standard doses also do not report a significant increase in side effects. Available data from the use of mebeverine at doses of 800 mg, 810 mg or 600 mg per day confirm that there were no clinically significant changes in safety parameters (Kastein, 1988; Van Outryve et al., 1996). Most patients tolerated these doses without experiencing noticeable side effects.

Thus, given the numerous studies on the use of mebeverine, some researchers suggest monotherapy with Duspatalin for such serious conditions as sphincter of Oddi dysfunction after cholecystectomy

(Ilchenko A.A., 2002). It was shown that after 2 weeks of Duspatalin therapy in patients who underwent cholecystectomy and have dysfunctional disorders of the sphincter apparatus of the biliary tract, there was a positive trend in pain relief, as well as normalization of both laboratory and ultrasound parameters.

The results obtained allow us to recommend Duspatalin to patients with various types of sphincter of Oddi dysfunction, both as monotherapy and in combination with other drugs. If necessary, it can be combined with antibacterial, enzyme preparations, as well as prokinetics. The undoubted advantage of the drug is the fact that it has a direct, almost selective antispastic effect on the smooth muscle tissue of the gastrointestinal tract. The exception is patients with organic lesions: choledocholithiasis; not eliminated or newly emerged stenosis of the large duodenal papilla and the distal part of the common bile duct.

A significant improvement in the condition is observed when treating irritable bowel syndrome with Duspatalin (Minushkin O.N., 2001), expressed in the disappearance or reduction of pain in patients by the 7th day of therapy. By day 14, pain was completely relieved in 60% of patients and significantly decreased in intensity and duration in 26.6% of patients. Abdominal bloating disappeared by day 7 of treatment. After 2 weeks, a clear trend toward normalization of stool frequency and consistency during diarrhea was noted. Heaviness in the right hypochondrium and discomfort in the epigastrium, noted in 16 patients, disappeared in 90% of patients.

After 2 weeks of treatment with Duspatalin, colon motility normalized in 50% of patients, and a tendency toward a decrease in increased motor activity appeared. In patients with diarrhea, the passage time through the gastrointestinal tract increased. The time of the carbolene test before treatment was 17.5 hours, after 2 weeks of treatment – ​​28.0 hours.

Thus, Duspatalin is a highly effective drug

in the treatment of irritable bowel syndrome and sphincter of Oddi dysfunction.

conclusions

1. The drug Duspatalin effectively relieves symptoms associated with impaired motor function of the intestines and biliary tract.

2. Duspatalin can be actively used to influence the main symptoms of functional disorders of the gastrointestinal tract, pain and spasm, flatulence, as a violation of the tone of the intestinal wall, and disturbances in the frequency and consistency of stool.
Literature:
1. Grigoriev P.Ya. Recommendations (protocols) for the diagnosis and treatment of patients with diseases of the digestive system. Practicing physician today. Gastroenterology series. 2002, No. 1, p. 3 – 34.

2. Dadvani S.A., Vetshev P.S., Shuludko A.M., “Cholelithiasis,” M., 2000, pp. 114–115.

3. Ilchenko A.A. Dysfunctional disorders of the biliary tract // Consilium medicum. (Appendix. Gastroenterology.) 2002. No. 1. pp. 20–23.

4. Kolesnikov L.L. Human sphincter apparatus. St. Petersburg, 2000. P. 99.

5. Minushkin O.N., Elizavetina G.A., Ardatskaya M.D. Treatment of functional disorders of the intestines and biliary system, occurring with abdominal pain and flatulence // Klin. Pharmacol. and ter. 2002. No. 1. P. 1–3.

6. Nozdrachev A.D., Bazhenov Yu.I., Barannikova I.A., Batuev A.S. – Beginnings of Physiology – St. Petersburg, Lan.2001.

7. Evans P., Bak., Kellow J. Mebeverine alters small bowel motility in irritable bowel syndrome // Aliment. Pharmacol. Ther. 1996. No. 10. R. 773.

Reviews about the drug

We have already established what duspatalin helps with, reviews from doctors and patients confirm this.

• Sergey Astafiev, gastroenterologist : “In my practice, I often had to prescribe duspatalin or its analogues when treating patients with chronic pancreatitis. The medicine is not the main one in the course of therapy, but in combination with medication it is very, very effective. The tool really makes it possible to quickly achieve positive dynamics of treatment. The patients themselves claim that they immediately feel an improvement in their condition.”
• Ekaterina Safronova, gynecologist : “During clinical trials, it was not established for certain whether the drug could have any negative effect on the development of the fetus and child during breastfeeding. No human subjects were involved in the studies. However, theoretical data and clinical studies on animals give the right to believe that the drug can still be prescribed in short courses during the gestational and lactation periods. I have had occasion to prescribe duspatalin to women with various acute-chronic gastrointestinal dysfunctions. No pathologies were identified in the children. But some of my colleagues offer this drug to many of their patients as the most effective in the fight against constipation, diarrhea, intestinal colic and spasms. Practice proves them right.”
• Anna Popkova, 33 years old : “The baby had severe stomach colic. The pediatrician recommended giving me a little duspatalin. Although the instructions say that this medicine should not be given to infants, I still accepted this recommendation at my own peril and risk. Everything went right the first time. My son became calm and stopped being capricious. After a while we were examined - the medicine did not leave any consequences.”
• Alexander Kovrigin, 41 years old : “I had the opportunity to become acquainted with this antispasmodic during the period of recovery of the body after a long course of taking antibiotics. The aggressiveness of antibiotics is known to everyone. I developed severe cramps and cramps in my stomach. I did not expect such an effect: literally after fifteen minutes no pain was felt, the drug retains its effect for a long time.”
• Kristina Yakovleva, 57 years old : “Frequent constipation, bloating, problems with stool, pain in the stomach after every meal. It is not customary to talk about such problems out loud. But they cause so much trouble. All you think about all day is: when will you be able to go to the toilet normally! I read about duspatalin on the Internet and decided to try it, although I knew that the drug should be prescribed by a doctor. I followed the course and dosage exactly. There were no side effects. I completed the procedure without any consequences. Even halfway through the journey, significant improvements occurred: gas formation decreased, stools finally returned to normal, and the pain in the stomach went away.”

There are also negative reviews, but against the general background there are only a few of them. Most likely, these people either took the pills incorrectly or expected something more from them. Therefore, to summarize, I would like to clarify once again: duspatalin is not the main medicine in the treatment of various diseases of the gastrointestinal tract. The product has an antispasmodic effect, relieving symptoms, and helps improve overall well-being. And in relation to the disease, it supports the positive dynamics of treatment.

Duspatalin for gastritis

The main indication for the use of this drug is diseases of the gastrointestinal tract, which are based on functional disorders. The medicine is used for gastroduodenal reflux, gastritis, duodenitis, gastroduodenitis, pancreatitis. For stomach or duodenal ulcers, Duspatalin is taken only as prescribed by a doctor. It is usually recommended after the acute process has subsided.

According to doctors, the use of this medicine for diseases of the gastrointestinal tract can achieve the following effects:

• eliminate abdominal pain of varying severity;
• reduce nausea, vomiting, belching;
• restore motor function of the gastrointestinal tract.

Also, Duspatalin tablets help eliminate the accompanying symptoms of digestive disorders: bitterness in the mouth, nausea, flatulence, loss of appetite. The pain syndrome after taking Duspatalin is relieved already on the third day of treatment. After a week of use of the drug, the motor activity of the gastrointestinal tract is restored. It is important that even long-term use of Duspatalin does not cause any significant side effects. Therefore, it is often recommended for long courses for gastrointestinal diseases.

The usual dosage of Duspatalin is 0.2 g, one capsule twice a day.

How to take Duspatalin for gastritis

How many days to drink and how to take Duspalizan for gastritis? According to the official instructions for use, it is recommended to take this medicine before meals. The interval between taking the capsule and eating should not exceed 20 minutes. You need to take the medicine with a sufficient amount of water, at least 100-150 ml per day.