China
Africa
Explore chapters and articles related to this topic
A lady with abdominal cramps
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
As well as lifestyle modification, a sensible starting point for this patient would be to prescribe a course of an antispasmodic. Mebeverine (135 mg up to 3 times/day) or hyoscine butylbromide (10 mg up to 3 times/day) could be of potential benefit. Hyoscine (buscopan), an antimuscarinic (anticholinergic) drug, reduces intestinal motility, while mebeverine is thought to have a direct relaxant effect on intestinal smooth muscle.
Gynaecology: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
If symptoms suggest irritable bowel syndrome (IBS), this is treated with high-fibre diet and an antispasmodic, such as mebeverine. If pain is inadequately controlled, the patient may be referred to the pain management team or specialist pelvic pain clinic (1).
Rational Medical Therapy of Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Richard M. Sperling, Kenneth R. McQuaid
Limited placebo-controlled trials of antispasmodics in the treatment of IBS have been performed, most of which suffer from such severe methodological flaws that no valid conclusions can be drawn. Mebeverine was reported to be superior to placebo in controlling symptoms in one study of 40 IBS patients (168), while another study reported significant improvement in 10 patients in bowel function, abdominal pain, and overall assessment (169). However, both studies used inappropriate statistical analysis, rendering all conclusions unreliable (25,156). In a 16-week, double-blind crossover study of 12 patients, Kruis et al. (170) was unable to show any significant improvement with mebeverine.
A safety evaluation of dimethyl fumarate in moderate-to-severe psoriasis
Published in Expert Opinion on Drug Safety, 2020
Radomir Reszke, Jacek C. Szepietowski
GI symptoms are usually most bothersome during the first 3–6 weeks of treatment and their intensity decreases in the subsequent weeks. Unfortunately, their intensity is neither associated with the time of drug intake (morning vs. evening) nor with concurrent food intake. According to the European expert consensus, routine administration of additional drugs aimed at alleviating GI symptoms is not recommended. However, mebeverine might be considered due to its antispasmodic properties [10]. In general, the tendency for flushing usually appears within the first few weeks of DMF intake and decreases over time. Each episode begins quickly after drug intake and resolves within several hours [10]. Unfortunately, a randomized, double-blind, placebo-controlled study demonstrated that cetirizine in a dose of 10 mg daily failed to decrease the frequency of the most common AEs associated with the use of FAE combination therapy (GI symptoms and flushing) [48]. On the other hand, DMF intake during evening, as well as concurrent usage of aspirin, were associated with lower intensity of flushing [10,49]. Leukopenia, especially including lymphopenia, are also relatively frequent adverse effects of DMF treatment, occurring predominantly during drug initiation or dose increase [10]. These issues typically improve after dose reduction, although occasionally they warrant discontinuation of DMF. The alterations concerning white blood cell count require frequent monitoring in order to capture the abnormalities, should they reach dangerous levels.