Norvis 50 mg Tablet

Norvis 50 mg tablet is a Tiemonium Methylsulphate preparation manufactured by Square Pharmaceuticals PLC, Pabna. It is an antispasmodic medicine used to relieve cramping pain arising from the digestive tract, biliary system, urinary tract and uterus. Doctors in Bangladesh commonly prescribe Norvis for colicky abdominal pain, painful spasms in irritable bowel syndrome, biliary and renal colic, and period-related cramps.

Tiemonium Methylsulphate is an antimuscarinic agent. It blocks muscarinic acetylcholine receptors on the smooth muscle of internal organs, reducing excessive, painful contractions and allowing the muscle to relax. Because it is a quaternary ammonium compound, very little crosses into the brain, so it relieves visceral spasm with minimal central side effects such as drowsiness.

• Spasmodic (colicky) abdominal pain of gastrointestinal origin
• Painful spasm in irritable bowel syndrome and spastic colon
• Biliary colic (gallbladder-related cramping pain), as part of doctor-directed care
• Renal and ureteric colic with urinary tract spasm
• Dysmenorrhoea (painful menstrual cramps) and other gynaecological spasm
• Spasm-related pain in gastroenteritis or dysentery, alongside treatment of the cause

The dose of Norvis should be decided by a registered doctor based on the cause and severity of the spasm. For adults, the commonly used oral range of tiemonium methylsulphate is 50 mg two to three times daily, continued only for the short period the doctor advises. An injectable form exists for severe colic and is given under medical supervision only.

Swallow the tablet with water, with or without food. For children, use is weight-based and only on a doctor's prescription. Do not exceed the prescribed dose, and return to your doctor if pain persists rather than increasing it yourself.

Side effects of tiemonium are mostly mild anticholinergic effects: dry mouth, blurred vision, constipation, nausea and reduced sweating. Some people notice a faster heartbeat, mild dizziness or difficulty passing urine, particularly older men with prostate enlargement.

These effects are dose-related and usually settle when the medicine is stopped. Rarely, allergic reactions with rash, itching or swelling occur. Because reduced sweating can cause overheating, take care in hot weather. Seek medical help promptly for inability to pass urine, severe constipation with abdominal distension, eye pain with halos around lights, palpitations or any sign of a severe allergic reaction.

Use tiemonium with caution and tell your doctor first if you have prostate enlargement or difficulty urinating, a history of glaucoma, heart disease or fast heart rhythms, thyroid overactivity, fever, severe constipation or reflux disease. The elderly are more sensitive to anticholinergic effects and need careful dosing.

An antispasmodic relieves pain but does not treat the cause. Sudden severe abdominal pain with fever, vomiting, a rigid abdomen, blood in stool or urine, or pain lasting more than a day must be properly evaluated before or alongside symptomatic relief. Avoid driving if your vision blurs, and limit exertion in hot environments while taking it.

Tiemonium's anticholinergic actions add up with other medicines having similar effects — atropine-like drugs, tricyclic antidepressants such as amitriptyline, older antihistamines, some antipsychotics and medicines for Parkinson's disease or urinary urgency. Combined use increases dry mouth, constipation, urinary difficulty and confusion risk, especially in the elderly.

By slowing gut movement it may alter the absorption of some other oral medicines. Combining it with amantadine or disopyramide also heightens anticholinergic load. Alcohol may worsen dizziness. Tell your doctor and pharmacist about all medicines, supplements and herbal remedies you take so combinations can be checked.

Tiemonium methylsulphate is contraindicated in people with known hypersensitivity to it, in narrow-angle (angle-closure) glaucoma or a predisposition to it, in urinary retention or significant prostate-related outflow obstruction, and in conditions where slowing the gut is dangerous, such as paralytic ileus, intestinal obstruction, toxic megacolon or severe ulcerative colitis.

It should also be avoided in myasthenia gravis and in significant obstructive uropathy. People with severe heart disease or tachyarrhythmias need specialist judgement before use. If you have ever reacted badly to an antispasmodic or atropine-like medicine, tell your doctor before taking it.

Pregnancy: There are no adequate controlled studies of tiemonium in pregnant women. It should be used in pregnancy only when a doctor considers it clearly necessary, at the lowest effective dose for the shortest time, after weighing benefit against possible risk.

Lactation: It is not well established how much tiemonium passes into breast milk. As a precaution, breastfeeding mothers should take it only on medical advice. Anticholinergic medicines can occasionally reduce milk supply, so watch for this and for any unusual irritability, constipation or feeding difficulty in the baby, and inform your doctor.

Store below 30°C in a cool, dry place away from direct sunlight and moisture. Keep the tablet in its original packaging until use. Keep out of the reach and sight of children. Do not use after the expiry date printed on the pack, and dispose of unused medicine safely, preferably through a pharmacy rather than household waste.