Usage
Fenoverine is an antispasmodic medication primarily prescribed for the relief of gastrointestinal spasms and cramps. It’s commonly used to treat irritable bowel syndrome (IBS), a condition characterized by abdominal pain, bloating, and altered bowel habits (diarrhea or constipation). It may also be used to treat other conditions involving smooth muscle spasms in the gastrointestinal tract.
Alternate Names
While “Fenoverine” is the generic name, it’s marketed under various brand names, including Spasmopriv and Syncrospas.
How It Works
Pharmacodynamics: Fenoverine works by relaxing the smooth muscles in the gastrointestinal tract. It achieves this by modulating calcium channels in the muscle cell membranes, reducing calcium influx and inhibiting the contractions that cause spasms and pain. This mechanism allows for the relief of abdominal pain and discomfort associated with IBS and other gastrointestinal conditions. It also influences pain signaling pathways by blocking certain chemical messengers in the brain.
Pharmacokinetics: Fenoverine is well-absorbed when taken orally. It has a relatively rapid onset of action, typically within 30-60 minutes. The duration of its effects lasts for several hours. Fenoverine is metabolized in the liver and primarily excreted through the kidneys. The specific CYP enzymes involved in its metabolism haven’t been clearly identified in the sources.
Dosage
Standard Dosage
Adults:
The standard dose is 100 mg taken orally three times a day, preferably with food. For more severe cases, the dose can be increased up to 200 mg twice daily. Treatment duration shouldn’t exceed six weeks.
Children:
Fenoverine is not recommended for children under 18 years of age, as its safety and efficacy haven’t been established in this population.
Special Cases:
- Elderly Patients: Due to increased sensitivity, the maximum dose in the elderly is 100 mg three times a day.
- Patients with Renal Impairment: Caution should be used; dose adjustment may be necessary.
- Patients with Hepatic Dysfunction: Contraindicated in chronic liver disease. Caution advised in patients with a history of liver impairment.
- Patients with Comorbid Conditions: Use with caution in patients with cardiovascular conditions due to potential anticholinergic effects.
Clinical Use Cases
Fenoverine’s dosage recommendations do not change for specific clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations. Its primary usage is for gastrointestinal spasms and IBS.
Dosage Adjustments
Dosage adjustment might be necessary in patients with renal or hepatic impairment. Individual responses may vary, requiring personalized adjustments.
Side Effects
Common Side Effects:
Dry mouth, flushing, constipation, dry skin, difficulty urinating, muscle pain.
Rare but Serious Side Effects:
Rhabdomyolysis (muscle damage), allergic reactions (rash, itching, swelling), severe dizziness or hypotension. Seek immediate medical attention if these occur.
Long-Term Effects:
The available sources do not provide details on potential long-term complications from prolonged use of Fenoverine.
Adverse Drug Reactions (ADR):
Reversible rhabdomyolysis is a serious ADR that requires attention.
Contraindications
Hypersensitivity to Fenoverine, chronic liver disease, history of hyperthermia during or after anesthesia, renal insufficiency, mitochondrial myopathy, pregnancy, and breastfeeding are contraindications.
Drug Interactions
Fenoverine may interact with antihypertensive medications affecting calcium channels and anticholinergic drugs. It may also interact with drugs metabolized by liver enzymes, especially those involving the cytochrome P450 system. Interactions with paroxetine and sertraline are mentioned. Information on interactions with OTC medications, supplements, food, and alcohol is limited.
Pregnancy and Breastfeeding
Fenoverine is not recommended during pregnancy and breastfeeding due to limited safety information.
Drug Profile Summary
- Mechanism of Action: Relaxes smooth muscles by modulating calcium channels, relieving gastrointestinal spasms.
- Side Effects: Dry mouth, flushing, constipation, dry skin, difficulty urinating, muscle pain. Rarely, rhabdomyolysis, allergic reactions, or hypotension.
- Contraindications: Hypersensitivity, liver disease, history of hyperthermia during or after anesthesia, renal insufficiency, mitochondrial myopathy.
- Drug Interactions: Antihypertensives, anticholinergic drugs, certain antidepressants, and drugs metabolized by liver enzymes.
- Pregnancy & Breastfeeding: Not recommended.
- Dosage: Adults: 100 mg TID or 200 mg BID (max 6 weeks). Elderly: Max 100 mg TID.
- Monitoring Parameters: Monitor for muscle pain or weakness (rhabdomyolysis), allergic reactions, changes in blood pressure, and liver/kidney function if necessary.
Popular Combinations
The provided sources do not mention any popular drug combinations specifically with Fenoverine.
Precautions
Screen for allergies, metabolic disorders, and organ dysfunction before use. Exercise caution in pregnant/breastfeeding women, children, the elderly, and individuals with liver/kidney impairment. Driving restrictions are not typically needed. Limited information on interactions with alcohol, smoking, and diet.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Fenoverine?
A: Adults: 100 mg three times daily or 200 mg twice daily (max 6 weeks). Elderly: Max 100 mg three times daily. Children: Not recommended.
Q2: What are the common side effects?
A: Dry mouth, flushing, constipation, dry skin, and difficulty urinating are common.
Q3: What are the serious side effects?
A: Rhabdomyolysis, allergic reactions (rash, itching, swelling), severe dizziness or hypotension.
Q4: Can Fenoverine be used during pregnancy?
A: Fenoverine is generally not recommended during pregnancy due to limited safety data.
Q5: Is Fenoverine safe for breastfeeding mothers?
A: Fenoverine is not recommended during breastfeeding.
Q6: How does Fenoverine work?
A: It relaxes smooth muscles in the GI tract by modulating calcium channels, reducing spasms.
Q7: What conditions is Fenoverine used to treat?
A: Primarily IBS and other conditions involving gastrointestinal spasms.
Q8: Are there any drug interactions I should be aware of?
A: Yes, it may interact with some antihypertensives, anticholinergics, antidepressants, and drugs metabolized by the liver.
Q9: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember, unless it’s almost time for your next dose. Do not double the dose.
Q10: Can Fenoverine be used in elderly patients?
A: Yes, but with caution and at a lower dose. The maximum dose in the elderly is 100mg three times a day.
