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 dicyclomine hydrochloride, an anticholinergic antispasmodic.
## Primary Indications
* Symptomatic relief of spasmodic pain associated with gastrointestinal conditions.
## Adult Dosing
* **Usual Dose:** 1 tablet orally every 8 hours.
* **Maximum Dose:** Not explicitly defined for the combination product, but individual component maximums should be considered. Mefenamic acid: typically 1500 mg/day. Dicyclomine: typically 40 mg/day.
## Pediatric Dosing
* Dosing for Meftal spas in pediatric patients is not established. Mefenamic acid pediatric dosing is available, but the combination is generally not recommended for children due to safety concerns and lack of specific pediatric data for the combination.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Mefenamic acid is renally cleared. Dose reduction may be necessary, particularly in severe impairment.
* **Hepatic Impairment:** Use with caution. Mefenamic acid is metabolized by the liver.
* **Elderly:** Increased risk of adverse effects with NSAIDs; use with caution.
## Contraindications
* Hypersensitivity to mefenamic acid, dicyclomine, or other NSAIDs.
* Active gastrointestinal bleeding or ulceration.
* Severe renal or hepatic impairment.
* Myasthenia gravis.
* Glaucoma (specifically narrow-angle glaucoma).
* Obstructive uropathy.
* Obstructive gastrointestinal disease.
* Uncontrolled heart failure.
* Asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
## Adverse Effects
* **Common:** Nausea, vomiting, diarrhea, abdominal pain, dizziness, dry mouth, blurred vision, constipation.
* **Serious:** Gastrointestinal bleeding/perforation, renal dysfunction, hepatic dysfunction, hypersensitivity reactions, cardiovascular events, anticholinergic toxicity (confusion, hallucinations, urinary retention, tachycardia).
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin):** Increased risk of bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal bleeding.
* **Other NSAIDs/Aspirin:** Increased risk of gastrointestinal toxicity and bleeding.
* **Diuretics/ACE inhibitors/ARBs:** Reduced antihypertensive effect and increased risk of renal dysfunction.
* **Lithium:** Increased lithium levels.
* **Methotrexate:** Increased methotrexate toxicity.
* **Anticholinergics:** Additive anticholinergic effects.
* **Antacids:** May affect absorption of mefenamic acid.
## Monitoring
* Monitor for signs and symptoms of gastrointestinal bleeding.
* Monitor renal and hepatic function, especially with prolonged use or in patients with pre-existing impairment.
* Monitor for signs of anticholinergic side effects.
* Monitor blood pressure.
## Clinical Pearls
* Meftal spas should be used for the shortest duration necessary to control symptoms.
* Administer with food or milk to minimize gastrointestinal upset.
* Advise patients to avoid activities requiring mental alertness until they know how the drug affects them, due to potential dizziness and blurred vision.
* Due to the anticholinergic component, caution is advised in the elderly and in patients with conditions that may be exacerbated by anticholinergics (e.g., constipation, urinary retention, cognitive impairment).
***
**Disclaimer:** This information is intended for healthcare professionals. Please consult the most current prescribing information and relevant clinical guidelines before making any treatment decisions. Drug information can change rapidly.
