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2. Summary
Nu-Spasm® is a peripherally acting antispasmodic containing hyoscine-N-butylbromide, a quaternary ammonium antimuscarinic agent. It is primarily used for symptomatic relief of smooth-muscle spasms involving the gastrointestinal, biliary, genitourinary, and uterine systems. Due to its limited systemic absorption and poor penetration of the blood–brain barrier, central nervous system effects are uncommon.
3. Brand Name
Nu-Spasm® نو-سبازم®
4. Category
- Antispasmodic
- Antimuscarinic (Peripheral)
- Gastrointestinal and Genitourinary Smooth Muscle Relaxant
5. Active Ingredient
Hyoscine-N-butylbromide (Scopolamine butylbromide)
6. Pharmaceutical Form & Strength
- Film-coated tablets: 10 mg
- Injection (ampoules): 20 mg / 1 mL
- Syrup: 1 mg / mL
7. Manufacturer & Marketing Authorization Holder
Egyptian International Pharmaceutical Industries Co. (EIPICO) 10th of Ramadan City, Egypt
8. Mechanism of Action
Hyoscine-N-butylbromide competitively blocks muscarinic acetylcholine receptors (M1–M3) in smooth muscle, inhibiting parasympathetic-mediated contractions. This results in relaxation of visceral smooth muscle and relief of spasmodic pain. Its quaternary ammonium structure limits central nervous system penetration, distinguishing it from tertiary anticholinergics.
9. Spectrum of Activity
Not applicable. Nu-Spasm® has no antimicrobial or antiparasitic activity. Its effect is confined to smooth-muscle relaxation.
10. Pharmacokinetics
- Absorption: Poor oral absorption (<1%)
- Distribution: Highly polar; does not readily cross the blood–brain barrier
- Metabolism: Partial hepatic metabolism
- Excretion: Primarily fecal; minor renal excretion
- Onset of action:
- Oral: ~30–60 minutes
- IM/IV: within minutes
- Duration: Approximately 6–8 hours
11. Indications
- Gastrointestinal spasms and hypermotility (including IBS)
- Biliary tract spasm and biliary colic
- Urinary tract spasm and renal colic
- Dysmenorrhea
- Adjunctive symptomatic relief in peptic ulcer disease
- Reduction of smooth-muscle motility during certain diagnostic procedures (parenteral form)
12. Administration
Adults
- Oral: 10–20 mg, 3–4 times daily
- IM or slow IV: 20 mg; may be repeated if necessary under medical supervision
Children
- Syrup formulation only
- Dose adjusted according to age and body weight; prescribed by a clinician
13. Method of Preparation
No preparation required. All dosage forms are supplied ready for use. Injectable solution should be visually inspected before administration.
14. Contraindications
- Hypersensitivity to hyoscine-N-butylbromide or belladonna alkaloids
- Myasthenia gravis
- Narrow-angle glaucoma
- Paralytic ileus or mechanical gastrointestinal obstruction
- Megacolon
- Severe prostatic hypertrophy with urinary retention
- Porphyria
15. Warnings & Precautions
- Use cautiously in elderly patients
- May precipitate urinary retention or tachycardia
- Avoid use in undiagnosed acute abdominal pain with systemic symptoms
- Reduced sweating may increase risk of heat intolerance
- Parenteral administration should be slow to avoid cardiovascular effects
16. Drug Interactions
Additive anticholinergic effects with:
- Tricyclic antidepressants
- First-generation antihistamines
- Antipsychotics
- Antagonizes prokinetic agents (e.g., metoclopramide)
- May reduce absorption of drugs affected by GI motility (e.g., digoxin)
17. Side Effects
Common
- Dry mouth
- Mild tachycardia
- Constipation
- Blurred vision
Uncommon/Rare
- Urinary retention
- Reduced sweating
- Hypersensitivity reactions
- Very rare: anaphylaxis (mainly with injections)
Central anticholinergic effects are uncommon.
18. Use in Special Populations
- Pregnancy: Not routinely recommended; use only if benefit outweighs risk
- Lactation: Caution advised; consult updated guidance
- Pediatrics: Use syrup formulation with medical supervision
- Geriatrics: Increased susceptibility to anticholinergic effects
- Hepatic/Renal impairment: Use with caution
19. Storage Conditions
- Store below 30°C
- Protect from light
- Keep out of reach of children
20. Additional Sections
Overdose Management:
Supportive and symptomatic treatment. Severe anticholinergic toxicity may require specialist management.
Driving & Machinery:
Generally safe, but caution advised if visual disturbances occur.
21. Frequently Asked Questions (FAQ)
Q: Does Nu-Spasm® cause drowsiness? A: Drowsiness is uncommon due to minimal CNS penetration.
Q: Is it an antibiotic? A: No. It has no antimicrobial activity.
Q: Can it be used long-term? A: Typically intended for short-term symptomatic relief; long-term use requires medical supervision.
22. References
- British National Formulary (BNF) – Hyoscine butylbromide
- Martindale: The Complete Drug Reference
- WHO Drug Information – Antimuscarinic agents
- Goodman & Gilman’s The Pharmacological Basis of Therapeutics
- EIPICO Product Literature (Revision: December 2007 – historical reference)
