Tiropramide is an antispasmodic medication. It acts by increasing cAMP concentration in smooth muscle possibly because of inhibition of cAMP catabolism. The drug is marketed worldwide for the treatment of irritable bowel syndrome, biliary dyskinesia, acute spasmodic dysphoric syndromes, and other urological and gynecological disorders.

Fenpiverinium is a quaternary ammonium compound, it is an anticholinergic and antispasmodic agent. It is a constituent of Baralgin. The effects of the constituents of Baralgin (metamizole , fenpiverinium, and pitofenone ) on mechanical activity were studied in isolated human preparations of the upper urinary tract. Fenpiverinium blocked the increase in frequency of phasic-rhythmic contractions and the tonic tension development induced by acetylcholine. Fenpiverinium did influence neither spontaneous phasic activity nor activation by high potassium or norepinephrine. Fenpiverinium has exclusively anticholinergic properties. Fenpiverinium is a muscarinic acetylcholine receptor antagonist.

Benzilonium is an antispasmodic and antimuscarinic drug. Benzilonium bromide is a quarternary antimuscarinic agent with minimal passage of the blood-brain barrier.

Trimebutine [3,4,5-trimethoxybenzoic acid 2-(dimethylamino)-2-phenylbutylester] is a noncompetitive spasmolytic agent. The actions of trimebutine on the gastrointestinal tract are mediated via (i) an agonist effect on peripheral mu, kappa and delta opiate receptors and (ii) release of gastrointestinal peptides such as motilin and modulation of the release of other peptides, including vasoactive intestinal peptide, gastrin and glucagon. Trimebutine attenuated colonic motility mainly through the inhibition of L-type Ca(2+) channels at higher concentrations, whereas, at lower concentrations, it depolarized membrane potentials by reducing BK(ca) currents, resulting in the enhancement of the muscle contractions.Trimebutine accelerates gastric emptying, induces premature phase III of the migrating motor complex in the intestine and modulates the contractile activity of the colon. It is indicated for the treatment and relief of symptoms associated with the irritable bowel syndrome (spastic colon); and in postoperative paralytic ileus in order to accelerate the resumption of the intestinal transit following abdominal surgery.

Camylofin is an antimuscarinic. This medication is used as antispasmodic in biliary colic, renal and ureteric colic, dysmenorrhoea, peptic ulcer and chronic enterocolitis. It is used to treat stomach ache in infants and children. Camylofin should be the first choice and may be preferred over other drugs for cervical dilatation and acceleration of active phase of labor.

Phloroglucinol is an organic compound that is used in the synthesis of pharmaceuticals and explosives. Phloroglucinol is a phenol derivative with antispasmodic properties that is used primarily as a laboratory reagent. The mechanism of action is most likely based on the direct inhibition of the voltage-dependent calcium channels of smooth muscle; however, the modulation of prostaglandin or nitric oxide release has also been suggested. Although it has long been used in clinical practice as an antispasmodic for painful urogenital and gastrointestinal conditions, in an early study on anesthetized rats, phloroglucinol was found to be inactive toward the contraction of the duodenum, ileum and colon. Similarly, in anesthetized dogs, phloroglucinol plus trimethyl-phloroglucinol failed to antagonize acetylcholine-induced contraction of the colon. In parallel with animal studies, phloroglucinol plus trimethyl-phloroglucinol had no clear effects in humans on ascending and sigmoid colon hypermotility evoked by neostigmine. However in Irritable bowel syndrome (IBS) patients iv phloroglucinol effectively reduced postprandial rectosigmoid motility increases after a test meal, compared to placebo. In another study of IBS patients, phloroglucinol inhibited phasic contractions provoked by intrarectally injected glycerol, but it did not modify colonic tone. In an open-label study of 100 IBS patients selected according to the Rome II criteria, po 50 mg phloroglucinol was administered three times daily for two months. The 68 patients who completed the study reported significant improvement in abdominal pain, frequency of stools per day, urgency, passage of mucus per the rectum, sense of incomplete defecation and bloating. Nevertheless, straining was unchanged. Further, a multicenter, randomized, double-blind, placebo-controlled trial examined the effects of phloroglucinol/trimethylphloroglucinol (62.2 mg P plus 80 mg TMP three times daily) or placebo for 7 d in 307 IBS patients diagnosed using the Rome II criteria. The relative decrease in pain intensity and the responder rate were significantly higher in the P/TMP-treated group, compared to the placebo-treated group. Further, the treatment effect persisted up to the 7th day in a higher percentage of patients treated with P/TMP than in those treated with placebo.

This medicine promotes secretion of the bile and pancreatic juice, and accelerates flaccidity of the smooth muscle in the gastrointestinal tract (sphincter of hepatopancreatic ampulla etc.) to lower internal pressure of the gallbladder and bile duct. It improves the symptoms of the bile duct and pancreatic disease. It is usually used for improvement of cramp and bile secretion associated with cholelithiasis, cholecystitis, cholangitis, dyskinesia of the biliary tract or postcholecystectomy syndrome, or pain and gastrointestinal symptoms associated with chronic pancreatitis. Side effects are nausea, constipation, abdominal bloating, diarrhea, rash, itch, etc.

Moxaverine, a derivative of papaverine, is a phosphodiesterase inhibitor. Moxaverine has been studied in phase III of a clinical trial for the treatment of ocular blood flow in patients with age- related macular degeneration and primary open angle glaucoma. In addition, it has been studied in phase II of the clinical trial for the treatment of ischemia. This compound is prohibited by FEI (International Federation of equine).

Diisopromine, a spasmolytic and a choleretic, in combination with sorbitol was marketed under the brand name Agofell. Agofell is prescribed for the biliary stasis and biliary insufficiency, hypotonia of the gall bladder, spasm of the biliary duct and of the sphincter of Oddi, cholecystitis, cholelithiasis, post cholecystotomy syndrome.

Proxazole or 3-alpha-Phenyl-propyl-5-beta-diethylaminoethyl-1,2,3-oxadiazole is a drug used for functional gastrointestinal disorders. It’s an unusual drug because it possesses both anti-inflammatory and antispasmodic properties and because each of these two properties has some uncommon features. The antiinflammatory action takes place mostly against edematous responses and is devoid of ulcerogenic effects which are instead produced by most anti-inflammatory drugs; moreover proxazole prevents indomethacin-induced ulcers without exerting any anti-secretory effect. The antispasmodic activity results in a specific inhibition of smooth muscle spasm, both at the vascular and at the intestinal level, without significant interferences with the physiologic activity of that tissue.