Meftal%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520spas

# 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 abdominal pain and cramps associated with irritable bowel syndrome. * Management of spasmodic conditions of the gastrointestinal tract. ## Adult Dosing * **Mefenamic Acid:** 250 mg every 6 hours as needed, not to exceed 500 mg every 6 hours or 7 days of continuous use. * **Dicyclomine Hydrochloride:** 20 mg every 6 hours as needed. The typical adult dose for Meftal spas is one tablet taken orally every 6 hours as needed. The maximum duration of treatment should not exceed 7 days. ## Pediatric Dosing Dosing for Meftal spas in pediatric patients has not been established. Mefenamic acid is generally not recommended for children under 12 years of age due to the risk of Reye's syndrome. Dicyclomine is not recommended for infants and children with conditions such as glaucoma, prostatic hypertrophy, or paralytic ileus. ## Dose Adjustments * **Renal Impairment:** Use with caution. Mefenamic acid is renally excreted and can cause renal toxicity. Data on specific dose adjustments are limited. * **Hepatic Impairment:** Use with caution. Mefenamic acid can cause hepatic dysfunction. Data on specific dose adjustments are limited. * **Elderly:** Use with caution due to increased risk of adverse effects, particularly gastrointestinal bleeding and renal toxicity. ## Contraindications * Hypersensitivity to mefenamic acid, dicyclomine, or any component of the formulation. * Patients with inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis). * Obstructive uropathy or obstructive gastrointestinal lesions. * Myasthenia gravis. * Glaucoma. * Gastrointestinal bleeding or perforation. * Severe renal or hepatic impairment. * During the third trimester of pregnancy. * In patients who have experienced bronchospasm, asthma, or allergic-type reactions after taking aspirin or other NSAIDs. ## Adverse Effects **Common:** * **Gastrointestinal:** Nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, dry mouth, blurred vision, urinary retention. * **Central Nervous System:** Dizziness, drowsiness, headache. **Serious:** * **Gastrointestinal:** Gastrointestinal bleeding, ulceration, perforation. * **Cardiovascular:** Increased risk of myocardial infarction and stroke with NSAID use. * **Renal:** Renal impairment, acute renal failure. * **Hepatic:** Hepatotoxicity. * **Hematologic:** Anemia, leukopenia, thrombocytopenia. * **Ophthalmic:** Angle-closure glaucoma. ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding. * **Other NSAIDs, Aspirin:** Increased risk of adverse effects, particularly gastrointestinal bleeding. * **Diuretics, ACE inhibitors, ARBs:** Reduced antihypertensive effect and increased risk of renal impairment. * **Lithium, Methotrexate:** Increased serum levels and risk of toxicity. * **Anticholinergics:** Additive anticholinergic effects. * **CNS Depressants:** Additive sedative effects. ## Monitoring * Monitor for signs and symptoms of gastrointestinal bleeding (e.g., hematemesis, melena, abdominal pain). * Monitor for signs of renal toxicity (e.g., changes in urine output, elevated creatinine and BUN). * Monitor for signs of hepatic dysfunction (e.g., jaundice, elevated liver enzymes). * Monitor for changes in vision or signs of acute glaucoma. * Monitor for signs of urinary retention. ## Clinical Pearls * Meftal spas should be used for the shortest duration necessary to control symptoms. * Administer with food or milk to minimize gastrointestinal upset. * Patients should be advised to report any signs of bleeding, severe abdominal pain, or changes in vision. * Due to the anticholinergic effects of dicyclomine, caution is advised in patients with conditions such as benign prostatic hypertrophy, heart disease, or hyperthyroidism. *** *This information is intended for healthcare professionals. Always consult the most current prescribing information and relevant guidelines for complete and up-to-date details before making any clinical decisions.*