Please check your internet connection and try again.
# Meftal-Spas
## Overview
Meftal-Spas is a combination analgesic and antispasmodic containing **Mefenamic Acid (250 mg)**, a non-steroidal anti-inflammatory drug (NSAID), and **Dicyclomine Hydrochloride (10 mg)**, an anticholinergic/antispasmodic agent.
## Primary Indications
* Symptomatic relief of abdominal pain and cramping (e.g., dysmenorrhea, gastrointestinal spasms).
* *Note:* It treats symptoms, not the underlying etiology of the pain.
## Adult Dosing
* **Standard Dose:** 1 tablet (250 mg Mefenamic Acid / 10 mg Dicyclomine) taken orally 3 to 4 times daily.
* **Maximum Dose:** Do not exceed 4 tablets in 24 hours. Limit therapy to the shortest duration possible, generally not exceeding 7 days.
## Pediatric Dosing
* **Children < 12 years:** Generally not recommended due to lack of established safety and efficacy data for this specific combination.
* **Children ≥ 12 years:** May follow adult dosing if clinically indicated by a physician, based on weight and severity. Consult local pediatric protocols.
## Dose Adjustments
* **Renal Impairment:** Contraindicated or requires extreme caution in severe renal impairment (CrCl < 30 mL/min).
* **Hepatic Impairment:** Use with caution; monitor for increased risk of toxicity.
* **Geriatric Patients:** Increased susceptibility to anticholinergic side effects (confusion, urinary retention, constipation). Dose reduction or avoidance is often preferred.
## Contraindications
* Hypersensitivity to Mefenamic Acid, Dicyclomine, or other NSAIDs.
* History of asthma, urticaria, or allergic-type reactions to aspirin/NSAIDs.
* Active peptic ulceration or gastrointestinal bleeding.
* Severe renal or hepatic failure.
* Cardiovascular disease (post-CABG surgery).
* Obstructive uropathy, glaucoma, myasthenia gravis, or paralytic ileus (due to Dicyclomine content).
## Adverse Effects
* **Common:** Dry mouth, blurred vision, dizziness, nausea, dyspepsia, and drowsiness.
* **Serious:** Gl bleeding, perforation, renal failure, cardiac events (MI/stroke), and severe skin reactions (SJS/TEN).
* **Anticholinergic Toxicity:** Tachycardia, confusion, urinary retention, and constipation.
## Key Drug Interactions
* **Anticoagulants (e.g., Warfarin):** Enhanced bleeding risk.
* **Other NSAIDs/Corticosteroids:** Increased risk of GI toxicity.
* **Antihypertensives/Diuretics:** Reduced efficacy of BP medications and potential for nephrotoxicity.
* **CNS Depressants:** Increased sedative effects when combined with Dicyclomine.
* **Digoxin:** Dicyclomine may increase serum levels by slowing GI motility.
## Monitoring
* Monitor for signs of GI bleeding (black stools, hematemesis).
* Monitor blood pressure periodically during long-term therapy.
* Assess for anticholinergic side effects in elderly populations.
## Clinical Pearls
* **Take with food/milk** to minimize gastrointestinal irritation caused by Mefenamic Acid.
* Advise patients to avoid driving or operating machinery if they experience drowsiness or blurred vision.
* Avoid alcohol, which may aggravate stomach irritation and drowsiness.
* Dicyclomine's anticholinergic effects can exacerbate symptoms in patients with BPH (Benign Prostatic Hyperplasia) or those predisposed to urinary retention.
***
**Educational Disclaimer:** This information is for educational purposes and does not substitute professional medical advice. Prescribing practices vary by region and clinical context. Always verify dosages, contraindications, and drug interactions against the most current local formulary or product monograph before prescribing or administering medication.
