No-Spa and No-Spa Forte Tablets (Drotaverine)
Hoechst Pakistan LimitedDRAP reg. 006168
We dispense the Forte 80 mg on prescription, our own policy; it is prescription-only in Switzerland. We dispense the 40 mg without one, also our own policy.
Same day or next day in Karachi, Lahore, Islamabad, Rawalpindi for orders confirmed before 6pm. Tracked courier, 2 to 4 working days everywhere else. Delivery Rs 250 in Rawalpindi and Islamabad, Rs 300 everywhere else, cash on delivery. Delivery details
Prices in PKR, checked 16 October 2026.
What No-Spa is
A tablet containing drotaverine, an antispasmodic: it relaxes smooth muscle, such as the muscle of the gut wall. It is not an antibiotic, and its labels class it as an antispasmodic rather than a painkiller.
- It has never been approved in the United States: the FDA’s database of approved drugs, Drugs@FDA, has no entry for drotaverine. That is not the same as being withdrawn. It is authorised in Switzerland, in Hungary and in several other European countries.
- Registered with DRAP under number 006168. No-Spa Forte is registered separately (DRAP reg. 029431). DRAP’s registry records the 40 mg tablet as “Drotaverine hydrochloride…0.040g” and the Forte as 80 mg. We sell the 40 mg in packs of 24 and the Forte in packs of 30 (3 strips of 10).
- DRAP records the maker as Hoechst Pakistan Limited, which describes itself on its own website as “formerly Sanofi aventis Pakistan Limited”, so your carton may show either name depending on when it was printed.
- Prices: DRAP’s approved price for the 24-tablet pack of No-Spa 40 mg is Rs 247, and that is our price. DRAP’s price index has no entry for No-Spa (searched 16 October 2026), and the registry shows no price for the Forte packs (its pricing type reads “As per SRO”); our Forte price is the one printed on the carton.
- We sell the 40 mg without asking for a prescription. We dispense No-Spa Forte 80 mg on prescription: our own policy. In Switzerland the 80 mg is prescription-only. We found no Pakistani regulator document that states its status. We sell the tablets only, not the injection.
What it is approved for, what Switzerland did not approve, and what the maker claims
The approved uses differ by country. The one they share, and the only one we list it for, is gut pain and cramps in adults. In Pakistan, the maker claims uses that Switzerland did not approve. Hungary approves them, but some only as an add-on treatment, a qualifier the maker’s page leaves out.
| Source | What it says |
|---|---|
| Pakistan, Hoechst’s product page (maker’s claim, not an approval) | “No-Spa® (Drotaverine HCI) is used as an antispasmodic in the management of biliary-tract, urinary-tract, and gastrointestinal spasm. No-Spa® is indicated in the management of irritable bowel syndrome, renal colic, biliary colic, and the management of severe pain during menstruation.” |
| Switzerland, Spaverin (Swissmedic, 2023) | Approved only “Symptomatic treatment of gastrointestinal complaints (pain, cramps) in the context of functional disorders of the gastrointestinal tract”, in adults. The company had asked for spasms of the bile ducts and gallbladder and of the urinary tract; and, as add-on uses, gut spasm in listed gut diseases (ulcers, gastritis, enteritis, colitis, irritable colon), tension headache and period pain. Swissmedic approved only the narrower functional-disorder wording above, and none of the bile-duct, urinary, headache or period-pain uses; its report gives no reasons. |
| Hungary, No-Spa (June 2025) | Approved for spasms of the bile ducts and gallbladder, and of the urinary tract. As an add-on treatment: gut spasms, period pain and tension headache. |
| Estonia, No-Spa (July 2023) | Approved for smooth muscle spasms of the gut, bile ducts and urinary tract. |
| Poland, No-Spa (April 2024) | Approved for spasms of the bile ducts and urinary tract; as an add-on, gut spasms and period pain. |
Hoechst’s Pakistani product page claims “the management of severe pain during menstruation”. Switzerland was asked to approve it, as an add-on treatment, and did not. Hungary and Poland list it only as an add-on treatment, and we found no placebo-controlled trial of drotaverine for period pain.
How often, and for how long without a doctor
For adults, the labels split the daily amount into two or three doses. How much is for your prescriber or pharmacist and the pack.
| Label | What it says |
|---|---|
| Swiss product information (Spaverin) | Adults: “verteilt auf 2-3 Gaben” (split into 2 to 3 doses a day). Without a prescription, the 40 mg “soll … nicht länger als 3 Tage angewendet werden” (should not be used for longer than 3 days); if symptoms persist or get worse, see a doctor to find the cause. |
| Hungary, No-Spa 40 mg | Adults: “2-3 részletben” (in 2 to 3 doses a day). |
| Poland, No-Spa 40 mg patient leaflet | If there is no improvement after 10 days, or you feel worse, contact a doctor. |
| Poland, No-Spa Max 80 mg (non-prescription) | Without consulting a doctor, for a maximum of 7 days. |
The labels disagree on how long to use it without a doctor: 3 days in Switzerland, 7 or 10 days in Poland. Our own advice: if gut pain or cramps don’t settle within a few days, or are severe or getting worse, see a doctor.
What the Swiss approval actually is
Swissmedic approved drotaverine as Spaverin in January 2023, by a simplified procedure. It did not evaluate the clinical evidence itself.
- Swissmedic’s assessment report (1 March 2023): “Swissmedic has not assessed the primary data relating to clinical aspects of this application and is taking over the results of the assessment of the foreign reference authority in Hungary.”
- The Swiss product information (Spaverin) opens: “Die Wirksamkeit und Sicherheit von Spaverin wurden von Swissmedic nur summarisch geprüft” (Swissmedic examined the efficacy and safety of Spaverin only in summary). Under clinical efficacy it says: “Keine Angaben” (no information).
- Its public summary (April 2023): Swissmedic “did not conduct its own comprehensive scientific review” of efficacy and safety.
- An approval does not always mean a regulator has evaluated the evidence. Here, one deferred to another.
The evidence behind it
Drotaverine has been used for decades: Hungary first authorised it in 1963.
- Placebo-controlled trials we found: two in irritable bowel syndrome (2014 and 2017), one in children with recurrent stomach pain (2015), one in kidney stone pain given by injection (2003), and a few in labour. The bowel, children’s stomach pain and kidney stone trials found benefit; for labour, see below.
- In our search of PubMed we found none for period pain or for bile duct and gallbladder spasm.
- Switzerland took over Hungary’s assessment rather than reviewing the clinical data itself.
Pregnancy, labour and breastfeeding
Labour is an approved use in none of the countries we checked, and the labels point in different directions.
| Source | What it says |
|---|---|
| Poland, No-Spa (April 2024), 4.6 | “W badaniu klinicznym stwierdzono zwiększone ryzyko krwotoku poporodowego u pacjentek otrzymujących drotawerynę w trakcie porodu. Dlatego też nie należy stosować drotaweryny w okresie porodu.” (A clinical study found an increased risk of postpartum haemorrhage in patients given drotaverine during labour. Therefore drotaverine should not be used during labour.) In pregnancy, only where the benefit outweighs the risk; it crosses the placenta. |
| Hungary, No-Spa injection | “Szülésnél történő alkalmazása tilos” (use during childbirth is prohibited). |
| Estonia, No-Spa injection | “Drotaveriini ei tohi kasutada tuhude ajal” (drotaverine must not be used during labour). |
| Swiss product information (Spaverin) | Pointing the other way: “Drotaverin kann die zervikale Dilatation fördern” (it may promote dilation of the cervix), and given by injection during birth it had no negative effect on mother or newborn. But: “Spaverin soll während der Schwangerschaft nicht angewendet werden” (Spaverin should not be used during pregnancy). |
| Hungary and Estonia, No-Spa tablets | In pregnancy, use with increased caution (Hungary) or with caution (Estonia). |
| Breastfeeding: Switzerland, Hungary, Estonia, Poland | Not recommended, for lack of adequate data. |
A Cochrane review of antispasmodics as a group in labour found low-quality evidence of a shorter first stage and “insufficient evidence” on safety for mother and baby (Cochrane, 2013).
Our own advice: whether to give anything during labour is a decision for the doctor or midwife managing the birth, not for the patient or the pharmacy. In pregnancy, ask your doctor first.
Who must not take it
Every label we checked says it must not be taken by people with:
- Warning: An allergy to drotaverine or any ingredient.
- Warning: Severe liver or kidney failure.
- Warning: Severe heart failure.
Also contraindicated in the Swiss product information (Spaverin): blocked bowel (ileus) and narrowings of the gut. In Poland’s label only: second- or third-degree heart block. The tablets contain lactose; Switzerland, Hungary, Estonia and Poland say people with rare inherited sugar intolerances should not take them. Low blood pressure: caution (Hungary, Estonia, Poland); not recommended (Switzerland).
Parkinson’s medicine (levodopa)
The Swiss, Hungarian and Polish labels say drotaverine weakens levodopa’s effect on Parkinson’s disease; Estonia’s says phosphodiesterase inhibitors such as papaverine do.
Hungary and Estonia: stiffness and tremor may get worse. Switzerland: Parkinson’s symptoms may get worse. Poland: caution when they are given together. If you take levodopa, tell your doctor before taking No-Spa.
No other interaction is listed on any of these labels.
Children
The labels disagree on the youngest age. We sell it for adults only.
| Label | Children |
|---|---|
| Switzerland | Not authorised under 18; contraindicated under 6. |
| Estonia | Contraindicated under 1 year; use in children not studied. |
| Poland | 40 mg: not under 6. 80 mg: not under 12. |
| Hungary | No-Spa 40 mg: no data under 6. Spaverin 80 mg: contraindicated under 12. |
Our own policy: adults only, matching the only use we list, which is the use Switzerland approved for adults.
Side effects
Hungary’s label (No-Spa 40 mg, June 2025) lists all its side effects as rare (up to 1 in 1,000 people).
| How often | Side effects |
|---|---|
| Rare | Allergic reactions (swelling, hives, rash, itching); headache, dizziness, sleeplessness; palpitations; a fall in blood pressure; nausea, constipation. |
Driving: if it makes you dizzy, don’t drive or use machines (Hungary’s label).
Checking your pack is genuine
As of 16 October 2026, no DRAP alert, recall or safety notice names No-Spa or drotaverine.
- No-Spa 40 mg comes in packs of 24 and No-Spa Forte in packs of 30 (3 strips of 10), as DRAP registers them for the packs we sell.
- Check that the batch number and expiry date are printed on both the carton and the blister.
- The maker on the carton may read Hoechst Pakistan Limited or sanofi-aventis Pakistan: the same company, which describes itself as “formerly Sanofi aventis Pakistan Limited”.
We buy only from authorised distributors, and check the batch and expiry on every item before it is packed.
Information as of 16 October 2026. DRAP publishes new alerts on dra.gov.pk.
Returns and replacements
Medicines and supplements can’t be returned once they have left our pharmacy.
- Returned medicine can never go back into saleable stock. That is a safety rule, not a commercial one.
- If an item arrives damaged or wrong, tell us on WhatsApp within 24 hours and we replace it. That is us fixing our mistake, not a return.
- Anything that arrives expired or within a month of expiry we replace or refund, your choice, with no time limit.
Frequently asked questions
What is Nospa used for?
Gut pain and cramps, in adults, is the one use every country we checked shares, and the only use Switzerland approved. Hungary, Estonia and Poland also list spasms of the bile ducts and urinary tract, and Hungary and Poland list period pain as an add-on use; Hungary also lists tension headache, as does Poland’s label for No-Spa Forte 80 mg. Switzerland was asked to approve those, headache and period pain as add-on uses, and did not. In Pakistan, Hoechst’s product page claims irritable bowel syndrome, renal colic, biliary colic and severe period pain: that is the maker’s claim, not a regulator’s approval.
Is no-spa good for period pain?
Hoechst, which makes No-Spa in Pakistan, claims it on its product page: “the management of severe pain during menstruation”. It is not an approved use in Switzerland: the company asked for it there as an add-on treatment, and Swissmedic did not approve it. Hungary and Poland list period pain only as an add-on treatment, and we found no placebo-controlled trial of drotaverine for period pain. Ask your doctor what suits you.
What is Nospa used for in pregnancy?
No country we checked approves it for any use in pregnancy or labour. Switzerland says it should not be used during pregnancy; Hungary and Estonia say use with caution. Poland’s label reports more bleeding after birth when it was given during labour, and says not to use it then. Ask your doctor before taking it if you are pregnant.
Can Nospa help with stomach pain?
Gut pain and cramps from functional gut disorders, in adults, is the use Switzerland approved, and two placebo-controlled trials found benefit in irritable bowel syndrome. See a doctor if stomach pain is severe; the Swiss label says to see one if symptoms persist or get worse.
Does Nospa make you sleepy?
Sleepiness is not listed as a side effect on the labels we checked. Hungary’s label lists dizziness and sleeplessness as rare side effects, and says not to drive or use machines if it makes you dizzy.
What is No-Spa Forte used for?
The same as No-Spa: it is the 80 mg strength of the same medicine, drotaverine. Gut pain and cramps in adults is the one use Switzerland approved and the use we list it for. We dispense No-Spa Forte on prescription.
Is Nospa a painkiller?
Its labels class it as an antispasmodic, not a painkiller. Drotaverine is an antispasmodic: Hungary’s label describes it as acting directly on smooth muscle, such as the wall of the gut, to relax spasm. It eases pain caused by cramping.
Is no spa an antibiotic?
No. Drotaverine, the medicine in No-Spa, is an antispasmodic: it relaxes the smooth muscle of organs such as the gut. It does not treat infections.
How fast does NOSPA work?
None of the tablet labels we checked gives a figure for how soon it relieves pain or cramps.
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Questions about No-Spa and No-Spa Forte Tablets (Drotaverine)?
Send your question on WhatsApp and a pharmacist will come back to you.
Written by the ePharmacyy pharmacy team.
Last checked against the sources below on
DRAP registration
- No-Spa Tablet (006168), Hoechst Pakistan Limited. DRAP’s registry shows: Reviewed, “Not Verified”.
- No-Spa Forte Tablet (029431), Hoechst Pakistan Limited. DRAP’s registry shows: Reviewed, “Not Verified”.
DRAP publishes no definition of this verification flag, so we can’t tell you what it means. We searched DRAP’s website for “No-Spa” and “drotaverine” on 16 October 2026 and found no alert naming No-Spa or drotaverine. When we tested it, the search did not find a word that appears only inside an alert’s attached PDF, so an alert that names a product only in its PDF may not show up. DRAP describes its registered products index as a provisional list that “cannot be used as a reference for any purpose”. Checked against the registry on .
Sources
- DRAP registered products: No-Spa Tablet, registration 006168
- DRAP registered products: No-Spa Forte Tablet, registration 029431
- Hoechst Pakistan: Our Products page, No-Spa entry (Wayback Machine snapshot, 7 December 2025)
- Swissmedic: SwissPAR Spaverin, approval 30 January 2023 (report dated 1 March 2023, PDF)
- Swissmedic: Public Summary SwissPAR Spaverin (28 April 2023, PDF)
- Swiss product information: Spaverin (Swissmedicinfo, German)
- Hungary: No-Spa 40 mg tablet, SmPC (OGYÉI, June 2025, Hungarian)
- Hungary: No-Spa forte 80 mg tablet, SmPC (OGYÉI, June 2022, Hungarian)
- Hungary: No-Spa injection, SmPC (OGYÉI, October 2024, Hungarian)
- Hungary: Spaverin 80 mg tablet, SmPC (OGYÉI, February 2019, Hungarian)
- Estonia: No-Spa 40 mg tablets, SmPC (Ravimiamet, July 2023, Estonian)
- Estonia: No-Spa injection, SmPC (Ravimiamet, July 2023, Estonian)
- Poland: No-Spa 40 mg tablets, SmPC (URPL, April 2024, Polish)
- Poland: No-Spa Forte 80 mg tablets, SmPC (URPL, September 2023, Polish)
- Cochrane: Antispasmodics for labour (2013, PubMed)
- Placebo-controlled trial of drotaverine in irritable bowel syndrome (2014, PubMed)
- Placebo-controlled trial of drotaverine by injection in renal colic (2003, PubMed)
- Poland: No-Spa Max 80 mg tablets, SmPC (URPL, August 2023, Polish)
- Poland: No-Spa 40 mg tablets, patient leaflet (URPL, Polish, PDF)