What is Meftal-Spas® Tablets / Drops / Suspension / Injection?
Meftal-Spas® Tablets is a combination of two medicines: Dicyclomine and Mefenamic Acid. Dicyclomine is an anticholinergic that works by relaxing the muscles in the stomach and gut (intestine). It stops sudden muscle contractions (spasms), thereby relieving cramps, pain, bloating, and discomfort. Mefenamic Acid is a non-steroidal anti-inflammatory drug (NSAID) that works by blocking the release of certain chemical messengers that cause abdominal pain and inflammation (swelling). Together, they relieve menstrual cramps and stomach cramps.
Meftal-Spas® Suspension is commonly given to treat stomach pain, bloating, and abdominal cramps, and pain associated with excessive acidity, gas, infections, and gastrointestinal tract diseases. It also controls symptoms of irritable bowel syndrome. It relaxes the muscles of the gut and absorbs the extra gas. Meftal-Spas® Suspension is a mixture of two active medicines Dicyclomine, an antispasmodic agent, and Simethicone, an antifoaming medicine. Dicyclomine works by relaxing the muscles in your stomach and gut (intestine). It stops sudden muscle contractions (spasms), thereby relieving abdominal cramps and pain. Whereas, Simethicone disintegrates gas bubbles and allows easy passage of gas.
Meftal-Spas® Drops is commonly given to treat stomach pain, bloating, and abdominal cramps, and pain associated with excessive acidity, gas, infections, and gastrointestinal tract diseases. It also controls symptoms of irritable bowel syndrome. It relaxes the muscles of the gut and absorbs the extra gas. Meftal-Spas® Drops is a mixture of two active medicines Dicyclomine, an antispasmodic agent, and Simethicone, an antifoaming medicine. Dicyclomine works by relaxing the muscles in your stomach and gut (intestine). It stops sudden muscle contractions (spasms), thereby relieving abdominal cramps and pain. Whereas, Simethicone disintegrates gas bubbles and allows easy passage of gas.
- In Treatment of Abdominal pain: Meftal-Spas® Drops/Suspension effectively relieve sudden muscle spasms or contractions in the stomach and intestine (gut), thereby relaxing the muscles and improving the movement of food. This helps to treat abdominal pain (or stomach pain) as well as cramps, bloating, and discomfort. Give Meftal-Spas® Drops to your child in the dose and duration as prescribed for maximum benefit.
- In Treatment of Irritable bowel syndrome: Irritable bowel syndrome is a chronic (long-term) inflammatory disease of the large intestine (colon) that usually needs long-term management. This can lead to bleeding, frequent diarrhea, bloating, flatulence, cramps, and stomach pain. Meftal-Spas® Drops/Suspension relax the muscles in your stomach and gut (intestine) and relieve these symptoms effectively. Usually, it is used as an add-on medicine along with other medicines which are given for the management of your child’s condition. Continue giving it to your child for as long as the doctor may advise you to.
What is Meftal Spas® Tablet?
Pain relief is often sought for a variety of conditions ranging from the common musculoskeletal pains to migraine throb and menstrual cramps. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) have long since offered an alternative to the more potent and addictive opiate-based pain ameliorating agents.
The evolution of NSAIDs has come a long way since Aspirin was first used in 1899 for treating pain and fever. Subclass after subclass has progressively been discovered in this group and ultimately today, we have the preferential and selective COX-2 (Cyclooxygenase enzyme) inhibitors. Moreover, such NSAIDs have been fine-tuned with the addition of other drugs that control spasms for pains pertaining to involuntary organs of the body such as the uterus and female genital tract.
Enter Meftal-Spas®, a time-tested and reliable pain-killing combination. Meftal-Spas® tablet not only controls pain very effectively but also relaxes bodily spasm which commonly arises from menstruation or intestinal colic.
Meftal Spas is marketed by Blue Cross Laboratories in a blister pack of ten tablets. Each tablet is a combination of the NSAID Mefenamic Acid 250mg and the anti-spasmodic Dicyclomine 10mg (also known as Dicycloverine). This tablet is more well known as Meftal 250 mg. The Meftal Spas “DS” version that is also marketed has double strengths of the same constituent agents with Mefenamic Acid 500mg and Dicyclomine 20 mg. This tablet is more well known as Meftal 500 mg.
Indications, Applications, and Uses
What is Meftal Spas used for? Mefenamic Acid belongs to the sub-class of ‘Anthranilic Acid Derivative’ and is a nonselective NSAID. Meftal Spas has efficacious analgesic properties which are put to good use in the following situations – Muscle pains, joint pains, toothaches, menstrual pain, and headaches/mild migraine. Below is a list of indications for which the medicine Meftal Spas has been found to be beneficial:
- Chronic pain disorders: Osteoarthritis, Rheumatoid Arthritis, Lumbago, Premenstrual Dysphoric Disorder, and Chronic pelvic pain, Perioperative, and postpartum pain control.
- Fever Control: Mefenamic Acid proves to be quite an effective antipyretic and is useful to control temperature rise from any cause except heat strokes.
- Anti-Inflammatory Properties: Anti-inflammatory properties of Mefenamic acid are rather weak when compared to other non-selective NSAIDs like Ibuprofen or Diclofenac/Aceclofenac. Nevertheless, it does bring about mild degrees of reduction in soft tissue swellings and injuries associated with tooth caries, fractures, or minor surgery.
Dicyclomine boosts the analgesic properties of Mefenamic acid by providing spasm relief in cramps and colic from various etiologies especially menstrual pain or dysmenorrhoea, ureteric colic from urinary tract infections, urinary stone problems, and intestinal colic in enteritis, colitis, or gastroenteritis.
How does Meftal Spas work?
Pharmacodynamics and mechanism of actions. Pain, inflammation, and fever in the human body are served through a group of chemicals referred to as inflammatory mediators. Prominent among these are the Prostaglandins – Prostacyclin and Thromboxane A2; other mediators include the various leukotrienes.
Inflammatory prostaglandins are produced from Arachidonic acid through the actions of various enzymes. Cyclooxygenase type 2 or COX – 2 is responsible for the ultimate step in the formation of inflammatory prostaglandins.
Mefenamic Acid blocks all varieties of COX including COX-2 and the consequent production of these prostaglandins. Dicyclomine on the other hand is an anticholinergic agent. Anti Cholinergic affects various bodily functions in different ways. Some of their actions include raising the heart rate (tachycardia), dilatation of the pupil and blurring of vision, intestinal smooth muscle relaxation- constipation, relaxation of the smooth muscles of the urinary bladder/ureter – retention, relaxation of the respiratory passages, and marked decrease in bodily secretions namely sweat, saliva, tears, and respiratory/bronchial secretions.
Meftal Spas medicine, therefore, removes pain and relieves spasms. It is particularly tailored to women with pelvic cramps, dysmenorrhea, breast congestion, and chronic pelvic pain. Urinary tract spasms and intestinal colic too benefit from it.
Meftal Spas Dosage and Mode of Administration
Often the dose of Meftal Spas is dictated by the severity of the pain. Usually twice daily to thrice a day dosing is effective and in severe cases or where recommended, the DS formulation also referred to as Meftal 500 mg(mentioned above) may be used. It is of noteworthy mention that Meftal Spas may not be taken on an empty stomach. After meal doses are preferred as it contains NSAID which causes stomach acidity.
Meftal Spas Side Effects and Adverse Drug Reactions
The side effects of Mefenamic acid are dose-dependent. With therapeutic doses for short intervals, hardly any reactions are known to occur, but a longer duration of usage and higher doses can cause severe effects. The list of possible side effects of Meftal Spas medicine is given below:
- Skin Rash, Urticaria, and edema.
- Dizziness and other Central Nervous System manifestations such as drowsiness, visual disturbances, and convulsions with very high doses are known.
- Acidity, Gastritis, Epigastric discomfort, or distress is noted but gut bleeding is not significant.
- Diarrhea is the most important dose-related side effect. Other gastrointestinal side effects include nausea and constipation. Hypertension, tachycardia, syncope.
- Bronchospasm, Pulmonary edema.
- Aplastic anemia, Agranulocytosis, and Thrombocytopenia.
- Auto-immune Hemolytic anemia is a rare but serious complication.
- Deranged Liver Enzymes and abnormal renal function.
Reactions to Dicyclomine
The following are reactions to Dicyclomine: restlessness, confusion, excitement, hallucination, and delirium. Vision disturbances such as difficulty in accommodation or focusing and exacerbation of glaucoma, Palpitations, tachycardia, arrhythmias, and Urinary retention.
Contraindications and Precautions with Use of Meftal Spas Tablets
Meftal Spas is not to be used in the following situations and care must be taken to avoid its use these conditions such that your doctors’ advice is necessary when suffering from the following:
- Hepatic or renal disease/impairment
- Asthma, drowsiness may affect the ability to perform coordinated/ skilled tasks or to drive.
- Urinary retention, Paralytic ileus.
- Hyperthyroidism, Hypertension, Congestive heart failure, Cardiac arrhythmias, Coronary bypass graft surgery. Inflammatory Bowel Disease.
- Special precautions and consideration is warranted for the following individuals or physiological states
- Avoid use Neonates and children due to risks of respiratory depression and/or failure.
Meftal Spas during Pregnancy and Lactation: Meftal Spas (Mefenamic Acid) is classified as US FDA CLASS “C” in the first two trimesters of pregnancy (Animal reproduction studies have shown an adverse effect on the fetus) and as CLASS “D” in the third trimester. While for Dicyclomine it is CLASS “C” through all trimesters of pregnancy.
Drug Interactions with Meftal Spas Tablets
Listed below are some of the important drug interactions of Meftal Spas tablets:
- Concomitant administration with Aspirin has synergistic effects with the potential to worsen the side effect profile of the either drug.
- Mefenamic acid diminishes the anti-hypertensive effects of ACE inhibitors.
- Mefenamic Acid elevates Lithium levels in the blood and increases Methotrexate toxicity.
- The lowering of sodium excretory effect of diuretics such as furosemide and thiazides is notable in some patients.
- The risk of Gut bleeding is higher when Mefenamic acid is combined with warfarin, than with the use of these drugs alone or singly.
- Dicyclomine’s absorption is reduced in the presence of antacids, while it can itself interfere in the absorption of slowly dissolving forms of drugs like Digoxin, wherein abnormally high levels of the drug can result.
- It can antagonize the effects of gut motility agents like metoclopramide and anti-glaucoma drugs.
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