Meftal%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520spas

# Meftal spas ## Overview Meftal spas is a combination medication containing mefenamic acid, a nonsteroidal anti-inflammatory drug (NSAID), and dicyclomine hydrochloride, an anticholinergic antispasmodic. ## Primary Indications * Relief of abdominal pain associated with smooth muscle spasms, particularly in conditions like irritable bowel syndrome and menstrual pain. ## Adult Dosing * **Meftal spas tablet:** Typically 1 tablet (containing mefenamic acid 250 mg and dicyclomine hydrochloride 20 mg) every 8 hours as needed for pain. Maximum dose should not exceed 4 tablets in 24 hours. * **Meftal spas suspension:** Refer to specific product labeling for suspension dosing, as concentrations can vary. ## Pediatric Dosing * Dosing in pediatric patients is not well-established and should be determined by a healthcare provider based on age, weight, and clinical response. Mefenamic acid is generally not recommended for children under 14 years of age due to potential risks. ## Dose Adjustments * **Renal Impairment:** Use with caution. Mefenamic acid is renally excreted, and dose reduction may be necessary in severe renal impairment. * **Hepatic Impairment:** Use with caution. Mefenamic acid can affect liver function. * **Elderly:** Increased risk of adverse effects, especially gastrointestinal bleeding and renal toxicity. Use with caution and at the lowest effective dose. ## Contraindications * Hypersensitivity to mefenamic acid, dicyclomine, or other NSAIDs. * Active gastrointestinal ulceration or bleeding. * Severe renal or hepatic impairment. * Glaucoma. * Myasthenia gravis. * Obstructive uropathy or gastrointestinal obstruction. * Unstable heart failure. * Children under 14 years (for mefenamic acid component). ## Adverse Effects * **Common:** Nausea, vomiting, diarrhea, constipation, abdominal pain, dizziness, drowsiness, dry mouth. * **Serious:** Gastrointestinal bleeding, perforation, ulceration; renal failure; hepatotoxicity; cardiovascular events (MI, stroke); Stevens-Johnson syndrome, toxic epidermal necrolysis; blurred vision, urinary retention (anticholinergic effects). ## Key Drug Interactions * **Anticoagulants (e.g., warfarin):** Increased risk of bleeding. * **Other NSAIDs/Aspirin:** Increased risk of GI toxicity. * **Corticosteroids:** Increased risk of GI ulceration. * **Diuretics, ACE Inhibitors, ARBs:** Reduced antihypertensive effect, increased risk of renal impairment. * **Lithium:** Increased lithium levels. * **Anticholinergics:** Additive anticholinergic effects. ## Monitoring * Renal and hepatic function. * Signs and symptoms of GI bleeding. * Blood pressure. * Signs of anticholinergic toxicity (e.g., blurred vision, urinary retention). ## Clinical Pearls * Mefenamic acid is generally used for short-term relief of pain. * Dicyclomine can cause significant anticholinergic side effects, particularly in the elderly. * Advise patients to take with food or milk to minimize GI upset. * Discontinue if significant adverse effects occur. *** *Disclaimer: This information is intended for clinical use and does not replace professional medical advice. Always consult the most current prescribing information and guidelines before making any treatment decisions. Verify the information with the official product monograph or other reliable sources.*