Usage
- Mebeverine is prescribed for the symptomatic relief of irritable bowel syndrome (IBS) and other gastrointestinal conditions characterized by smooth muscle spasms, such as abdominal pain, cramps, persistent non-specific diarrhea (with or without alternating constipation), and flatulence.
- Pharmacological classification: Antispasmodic, Musculotropic antispasmodic agent.
- Mebeverine acts directly on the smooth muscle of the gastrointestinal tract, relaxing the muscle spasms without affecting normal gut motility. The exact mechanism is unknown, but multiple pathways may contribute to this effect.
Alternate Names
- Mebeverine hydrochloride.
- Brand Names: Colofac®, Aurobeverine®, Duspatal® (international variations may exist).
How It Works
- Pharmacodynamics: Mebeverine exerts a direct relaxant effect on the smooth muscle of the gastrointestinal tract. It does not interfere with normal peristalsis.
- Pharmacokinetics: Mebeverine is well-absorbed after oral administration. It is metabolized in the liver, primarily by ester hydrolysis. The main metabolite is veratric acid. Excretion occurs through the kidneys.
- Mode of Action: Mebeverine acts directly on the smooth muscle cells, potentially through calcium channel blockade, though the precise mechanism is still not fully elucidated.
- Receptor binding, enzyme inhibition, or neurotransmitter modulation: Although classified as an anticholinergic, it exhibits minimal antimuscarinic effects.
- Elimination pathways: Renal excretion.
Dosage
Standard Dosage
Adults:
- Standard-release tablets (135 mg): One tablet three times daily, taken 20 minutes before meals.
- Modified-release capsules (200 mg): One capsule twice daily.
Children:
- Children over 10 years: 135mg (one standard tablet) or 150mg of oral suspension, three times daily, 20 minutes before meals.
- Children under 10 years: Not generally recommended.
Special Cases:
- Elderly Patients: No specific dose adjustments are typically necessary.
- Patients with Renal Impairment: Use with caution in marked renal insufficiency.
- Patients with Hepatic Dysfunction: Use with caution in marked hepatic impairment.
- Patients with Comorbid Conditions: Use with caution in patients with cardiac dysrhythmias, specifically partial or complete heart block, angina, or severe ischemic heart disease.
Clinical Use Cases
Mebeverine is not typically indicated for use in settings like intubation, surgical procedures, mechanical ventilation, intensive care, or emergency situations. Its primary role is in managing chronic gastrointestinal conditions like IBS.
Dosage Adjustments
Dose modifications may be necessary based on patient-specific factors, including renal/hepatic impairment. Always follow the latest medical guidelines specific to India for appropriate dosage adjustments.
Side Effects
Common Side Effects
- Constipation
- Indigestion
- Heartburn
- Dizziness
- Headache
Rare but Serious Side Effects
- Hypersensitivity reactions (anaphylaxis, angioedema)
Long-Term Effects
Limited data are available on long-term effects of Mebeverine.
Adverse Drug Reactions (ADR)
Contraindications
- Paralytic ileus
- Hypersensitivity to mebeverine.
Drug Interactions
- Limited information is available on specific drug interactions.
Pregnancy and Breastfeeding
- Pregnancy: Limited data available. Use with caution.
- Breastfeeding: Limited data available. Use with caution.
Drug Profile Summary
- Mechanism of Action: Directly relaxes gastrointestinal smooth muscle.
- Side Effects: Constipation, indigestion, heartburn, dizziness, headache. Rarely, hypersensitivity reactions.
- Contraindications: Paralytic ileus, hypersensitivity.
- Drug Interactions: Limited data available.
- Pregnancy & Breastfeeding: Use with caution.
- Dosage: Adults: 135 mg TID or 200 mg BID (modified-release). Children (over 10 years): 135mg TID.
- Monitoring Parameters: Monitor for symptom relief and adverse effects.
Popular Combinations
- Mebeverine is sometimes combined with Ispaghula husk (a bulk-forming laxative) for added benefit in IBS management.
Precautions
- General Precautions: Evaluate for hypersensitivity and underlying medical conditions.
- Specific Populations: Use with caution in pregnancy and breastfeeding. Use with caution in children under 10 and individuals with renal or hepatic impairment.
- Lifestyle Considerations: No specific lifestyle restrictions are generally associated with Mebeverine use.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Mebeverine?
A: Adults: 135 mg three times a day (standard release) or 200 mg twice a day (modified release). Children (over 10): 135mg TID.
Q2: How does Mebeverine work?
A: It directly relaxes the smooth muscle of the gastrointestinal tract, relieving spasms without affecting normal bowel movements.
Q3: What are the common side effects of Mebeverine?
A: Common side effects include constipation, indigestion, heartburn, dizziness, and headache.
Q4: Can Mebeverine be used during pregnancy?
A: Limited data on pregnancy safety are available. Use with caution under medical supervision if benefits outweigh risks.
Q5: Is Mebeverine safe for long-term use?
A: Long-term safety data is limited.
Q6: Are there any drug interactions with Mebeverine?
A: Currently, limited information on specific drug interactions is available. Consult resources like the latest Indian pharmacopoeia for updated information.
Q7: What should patients do if they miss a dose?
A: Skip the missed dose and continue with the next scheduled dose. Do not double the dose.
Q8: Can Mebeverine be used in children?
A: It is generally not recommended for children under 10 years of age. For children over 10, consult with a pediatrician.
Q9: Can Mebeverine be used to treat other gastrointestinal conditions besides IBS?
A: Yes, Mebeverine can be used to treat other GI conditions where smooth muscle spasms are a symptom.
A: Standard-release tablets are taken three times a day, while modified-release capsules are taken twice a day, offering more prolonged symptom relief.
