What is the recommended dose and frequency of drotavarine for stomach pain in adults?

Drotaverine Dosage for Adult Stomach Pain

For adults with stomach pain, drotaverine should be administered at a dose of 80 mg three times daily.

Mechanism and Efficacy

Drotaverine is an antispasmodic medication that works by inhibiting phosphodiesterase, enhancing cAMP-dependent pathways that lead to smooth muscle relaxation in the gastrointestinal tract 1. This mechanism is particularly effective for relieving abdominal pain associated with spasms.

Research demonstrates that drotaverine at 80 mg three times daily significantly reduces:

• Pain frequency (77.7% of patients showed improvement after 4 weeks)
• Pain severity scores (77.7% improvement vs 30.6% with placebo)
• Global relief in abdominal pain (85.9% patient-perceived improvement) 2

Dosing Guidelines

The recommended dosing regimen for drotaverine in adults with stomach pain is:

• Dose: 80 mg tablet
• Frequency: Three times daily
• Duration: Up to 4 weeks for chronic conditions; 3 days for acute conditions 3, 2

For mild symptoms, a lower dose of 10-15 drops up to 3 times daily may be used according to the FDA label 4.

Clinical Applications

Drotaverine is particularly effective for:

1. Irritable Bowel Syndrome (IBS): Especially effective in diarrhea-predominant IBS 5, 2
2. Acute infectious gastroenteritis: When combined with paracetamol (500 mg), it provides superior pain relief compared to paracetamol alone 3
3. Abdominal cramps and spasms: 74% of patients use it for pain and 67% for cramps 6

Onset and Duration of Action

• Onset: Significant pain relief begins within 60 minutes of administration 3
• Peak effect: Maximum pain relief typically occurs within 2 hours 3
• Duration: Effects last approximately 4-6 hours, necessitating the three-times-daily dosing schedule

Special Considerations

1. Combination therapy:

   • When combined with paracetamol (500 mg), drotaverine (80 mg) shows enhanced efficacy for abdominal pain in acute infectious gastroenteritis 3
   • Drotaverine has complementary effects with hyoscine butylbromide, as they work through different pathways 1

2. Safety profile:

   • Well-tolerated with minimal side effects 2
   • 98% of patients report satisfaction with treatment 6

Monitoring

Monitor for:

• Pain relief response within 1-2 hours after administration
• Improvement in stool frequency if diarrhea is present
• Any adverse effects, though these are typically minimal

Practical Considerations

• For acute stomach pain, treatment for 3 days is often sufficient 3
• For chronic conditions like IBS, a 4-week treatment course shows significant improvement 2
• Self-medication is common (83% of patients), but physician consultation is recommended for persistent symptoms 6

Drotaverine can be taken with or without food, but for optimal absorption, it's best administered 30 minutes before or after meals 4.