Please check your internet connection and try again.
# Meftal spas
## Overview
Meftal spas is a combination product containing mefenamic acid (a nonsteroidal anti-inflammatory drug, NSAID) and hyoscine-N-butylbromide (an anticholinergic antispasmodic). Mefenamic acid inhibits prostaglandin synthesis, reducing inflammation and pain. Hyoscine-N-butylbromide relaxes smooth muscle in the gastrointestinal tract.
## Primary Indications
* Symptomatic relief of abdominal pain associated with spasms, cramps, and associated inflammatory conditions, particularly in gynecological disorders and irritable bowel syndrome.
## Adult Dosing
* **Mefenamic Acid:** Typically 250 mg to 500 mg every 8 hours as needed. Maximum daily dose: 1500 mg.
* **Hyoscine-N-butylbromide:** Typically 10 mg to 20 mg every 8 hours as needed. Maximum daily dose: 80 mg.
* **Combination Product:** Specific dosing for the combination product will depend on the available formulation. Follow manufacturer's recommendations. Often, one tablet is taken every 8 hours.
## Pediatric Dosing
* Information on pediatric use of Meftal spas is limited. Mefenamic acid dosing in children over 6 months is generally 5-7 mg/kg/dose every 6-8 hours. Hyoscine-N-butylbromide has limited pediatric data; use with caution if at all. **Consult specific pediatric guidelines or a pediatrician.**
## Dose Adjustments
* **Renal Impairment:** Use with caution. Mefenamic acid can worsen renal function.
* **Hepatic Impairment:** Use with caution.
## Contraindications
* Hypersensitivity to mefenamic acid, hyoscine-N-butylbromide, or other NSAIDs.
* History of asthma, urticaria, or allergic rhinitis precipitated by aspirin or other NSAIDs.
* Severe renal or hepatic impairment.
* Gastrointestinal bleeding or perforation.
* Obstructive uropathy or ileus.
* Myasthenia gravis.
* Tachyarrhythmias.
* Narrow-angle glaucoma.
* Prostatic hypertrophy with urinary retention.
* Third trimester of pregnancy.
## Adverse Effects
* **Common (Mefenamic Acid):** Gastrointestinal upset (nausea, vomiting, diarrhea, constipation, abdominal pain), headache, dizziness.
* **Common (Hyoscine-N-butylbromide):** Dry mouth, blurred vision, constipation, urinary retention, drowsiness, increased heart rate.
* **Serious:** Gastrointestinal bleeding, ulceration, perforation, renal impairment, hypersensitivity reactions, cardiovascular events (with NSAIDs).
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Other NSAIDs and Aspirin:** Increased risk of gastrointestinal adverse effects and bleeding.
* **ACE inhibitors, ARBs, Diuretics:** Reduced antihypertensive effect and increased risk of renal impairment.
* **Lithium:** Increased serum lithium levels.
* **Metoclopramide:** May antagonize the intestinal effects of hyoscine-N-butylbromide.
* **Anticholinergics:** Additive anticholinergic effects.
## Monitoring
* **Renal function:** Especially in elderly patients or those with pre-existing renal disease.
* **Liver function:** Periodically, especially with long-term use.
* **Signs of GI bleeding:** Melena, hematemesis.
* **Blood pressure:** Particularly with NSAID use.
## Clinical Pearls
* Use the lowest effective dose for the shortest duration necessary.
* Administer with food or milk to minimize gastrointestinal upset.
* Caution patients about operating machinery or driving due to potential dizziness or blurred vision.
* Due to anticholinergic effects, caution in the elderly and in patients with conditions exacerbated by anticholinergics.
* Not a first-line agent for chronic inflammatory conditions; reserved for symptomatic relief of acute episodes.
***
**Disclaimer:** This information is intended for educational purposes and is not a substitute for professional medical advice. Always consult the most current prescribing information and a qualified healthcare provider for any questions regarding medication.
