Levodopa
Moderate
Database
Reduced anti-parkinsonian effect of levodopa, worsening of tremor and rigidity.
Avoid concomitant use. If unavoidable, monitor for reduced efficacy of levodopa and consider dose adjustment of levodopa.
Drug reference
drotaverine
PDE-4 inhibitor, Non-anticholinergic smooth muscle antispasmodic · Antispasmodic
PDE-4 inhibitor, Non-anticholinergic smooth muscle antispasmodicAntispasmodic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
—
none in our sources
PREGNANCY
—
not curated
Mechanism
Drotaverine is a novel non-anticholinergic smooth muscle antispasmodic which acts by inhibiting phosphodiesterase-4 (PDE-4) selectively for smooth muscle. This leads to elevation of intracellular cAMP/cGMP, attending smooth muscle relaxation. Changes in membrane ionic fluxes and membrane potential have also been shown.
Indications
Intestinal colicBiliary colicRenal colicIrritable bowel syndromeUterine spasms
Dosing
- Adult
- 40–80 mg TDS oral; 40 mg/2 ml inj.
Side effects
Common
HeadacheDizzinessConstipationFlushing
Serious
- Fall in BP (can occur on i.v. injection)
Drug interactions
Antihypertensives (e.g., Ace Inhibitors, Arbs, Diuretics)
Mild
Database
Increased risk of orthostatic hypotension, dizziness, and syncope.
Monitor blood pressure, especially during initiation or dose changes. Advise patients to stand up slowly.
Benzodiazepines
Mild
Database
Increased sedation, dizziness, and impaired psychomotor function.
Advise caution when driving or operating machinery. Monitor for excessive sedation.
Opioid Analgesics
Mild
Database
Increased sedation, dizziness, and impaired psychomotor function.
Advise caution when driving or operating machinery. Monitor for excessive sedation.
Tricyclic Antidepressants (tcas)
Mild
Database
Increased risk of anticholinergic side effects such as dry mouth, constipation, urinary retention, and blurred vision.
Monitor for increased anticholinergic side effects. Consider alternative antispasmodics if these effects are bothersome.
Related guidelines
Irritable bowel syndrome
ISG · Gastroenterology · 2023
Acute coronary syndrome in chronic kidney disease
CSI · Cardiology · 2020
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Coronary angiography with renal dysfunction
CSI · Cardiology · 2020
Abnormal uterine bleeding
FOGSI · Obstetrics & Gynaecology · 2016
Ask House about drotaverine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e·Verified: 2026-05-10 · House clinical team