Meftal%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520spas

# Meftal spas ## Overview Meftal spas is a combination product containing mefenamic acid and hyoscine butylbromide. Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis. Hyoscine butylbromide is an anticholinergic agent that exerts antispasmodic effects on the smooth muscle of the gastrointestinal tract. ## Primary Indications * Symptomatic relief of abdominal pain and cramping associated with gastrointestinal spasms. * Painful menstruation (dysmenorrhea). ## Adult Dosing * **Abdominal pain/cramping:** 1 tablet (mefenamic acid 250 mg / hyoscine butylbromide 10 mg) every 8 hours as needed, not to exceed 3 tablets in 24 hours. * **Dysmenorrhea:** 1 tablet every 8 hours as needed, starting with the onset of pain. ## Pediatric Dosing * Data on pediatric use is limited. Meftal spas is generally not recommended for children under 12 years of age due to the potential risks associated with NSAIDs and anticholinergics in this population. ## Dose Adjustments * **Renal Impairment:** Use with caution. Consider dose reduction or discontinuation if renal function deteriorates. Mefenamic acid is primarily renally excreted. * **Hepatic Impairment:** Use with caution. Mefenamic acid is metabolized in the liver. * **Elderly:** Use with caution. Elderly patients are at increased risk for NSAID-related adverse effects, including gastrointestinal bleeding, renal impairment, and cardiovascular events. ## Contraindications * Hypersensitivity to mefenamic acid, hyoscine butylbromide, or any excipients. * Active or history of recurrent peptic ulceration or gastrointestinal bleeding. * Severe heart failure, renal impairment, or hepatic impairment. * History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. * Obstructive uropathy or obstructive gastrointestinal lesions. * Tachyarrhythmias, uncontrolled glaucoma, myasthenia gravis, paralytic ileus, or megacolon. * Pregnancy (especially third trimester) and breastfeeding. ## Adverse Effects * **Common:** Nausea, vomiting, diarrhea, abdominal pain, dyspepsia, headache, dizziness. * **Less Common/Serious:** * **Gastrointestinal:** Gastritis, peptic ulceration, gastrointestinal bleeding, perforation. * **Renal:** Renal impairment, interstitial nephritis. * **Hepatic:** Hepatotoxicity, elevated liver enzymes. * **Cardiovascular:** Fluid retention, edema, hypertension, increased risk of myocardial infarction and stroke. * **CNS:** Drowsiness, confusion. * **Anticholinergic:** Dry mouth, blurred vision, urinary retention, constipation, tachycardia. * **Hematologic:** Anemia, leukopenia, thrombocytopenia. * **Hypersensitivity:** Rash, pruritus, bronchospasm, anaphylaxis. ## Key Drug Interactions * **NSAIDs (other):** Increased risk of gastrointestinal toxicity. * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding. * **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect; increased risk of renal impairment. * **Lithium:** Increased serum lithium levels. * **Methotrexate:** Increased risk of methotrexate toxicity. * **Anticholinergics (other):** Additive anticholinergic effects. * **Dopamine antagonists (e.g., metoclopramide):** May reduce the efficacy of hyoscine butylbromide. ## Monitoring * **Gastrointestinal:** Monitor for signs and symptoms of bleeding (e.g., melena, hematemesis). * **Renal Function:** Monitor BUN and creatinine, especially in patients with pre-existing renal disease or those on concurrent nephrotoxic agents. * **Hepatic Function:** Monitor liver enzymes. * **Blood Pressure:** Especially in patients with hypertension. * **Electrolytes:** Monitor for signs of fluid retention. ## Clinical Pearls * Meftal spas should be used at the lowest effective dose for the shortest duration necessary to control symptoms. * Administer with food or milk to minimize gastrointestinal upset. * Caution patients about potential drowsiness and impaired ability to drive or operate machinery. * Discontinue if any signs of gastrointestinal bleeding or severe adverse reaction occur. --- *This information is intended for healthcare professionals and does not substitute for professional medical advice. Always consult the most current prescribing information and local protocols.*