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Antispasmodic (Direct-Acting) Pregnancy: No known harmful effects — limited data. Use only if clearly needed.

Mebeverine Hydrochloride

Brand names: Colofac, Colofac MR

Adult dose

Dose: 135mg TDS (30 min before meals). Modified-release: 200mg BD (Colofac MR — 30 min before meals).
Route: Oral
Frequency: Three times daily before meals (standard) or twice daily (MR)
Max: 405mg/day (standard tablets)
Direct smooth muscle relaxant — does not have anticholinergic side effects. First-line antispasmodic for IBS (NICE CG61). Onset within 1 hour. Modified-release preferred for once-daily compliance.

Paediatric dose

Route: Oral
Frequency: Three times daily
Max: 135mg per dose
Not recommended in children <10 years (limited evidence). Children 10–17 years: 135mg TDS (30 min before meals). Source: BNF for Children 2024.

Dose adjustments

Renal

No dose adjustment required.

Hepatic

No dose adjustment required.

Clinical pearls

  • NICE CG61 (IBS): mebeverine is recommended as first-line antispasmodic for abdominal pain/cramping in IBS.
  • No anticholinergic effects — safe in elderly, glaucoma, BPH (unlike hyoscine or dicycloverine).
  • Modified-release (200mg BD) improves adherence — no difference in efficacy vs TDS standard.
  • If inadequate response after 4 weeks, reassess diagnosis and consider psychological therapies, low-FODMAP diet, or tricyclic antidepressants.

Contraindications

  • Paralytic ileus
  • Known hypersensitivity

Side effects

  • Very well tolerated — no significant anticholinergic side effects
  • Headache (uncommon)
  • Allergic skin reactions (rare)

Interactions

  • No clinically significant interactions documented

Monitoring

  • Symptom response (reassess at 4 weeks)

Reference: BNFc; BNF 90; NICE CG61 Irritable Bowel Syndrome. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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