Mebeverine hydrochloride

How it works

It is a direct-acting smooth muscle relaxant that reduces intestinal spasm by acting locally on gut musculature, without the antimuscarinic effects typical of other antispasmodics.

Prescribing in practice

• It is contraindicated in paralytic ileus, where reducing gut motility could be harmful, and should not be relied upon if symptoms suggest a more serious bowel disorder.
• It is generally well tolerated; rare hypersensitivity reactions including rash and angioedema have been reported.
• Modified-release preparations should be swallowed whole and are typically taken before meals.

Monitoring

No specific laboratory monitoring is required; review symptom control and reconsider the diagnosis if there is no improvement or if alarm features develop.

Counselling the patient

• Take the dose shortly before meals as directed, swallowing modified-release capsules whole.
• Seek review if your pain changes, worsens, or you notice bleeding or unexplained weight loss.

Evidence & guidelines

Antispasmodics such as mebeverine are recommended by NICE as an option for managing abdominal pain and spasm in irritable bowel syndrome.