Please check your internet connection and try again.
# Meftal-Spas
## Overview
Meftal-Spas is a combination drug containing **Mefenamic Acid** (an NSAID, 250 mg) and **Dicyclomine Hydrochloride** (an antispasmodic/anticholinergic, 10 mg). It acts as both an analgesic/anti-inflammatory and a smooth muscle relaxant.
## Primary Indications
* Management of spasmodic dysmenorrhea (menstrual cramps).
* Symptomatic relief of abdominal spasms/colic and gastrointestinal hypermotility.
## Adult Dosing
* **Standard Dose:** 1 tablet (250 mg Mefenamic Acid/10 mg Dicyclomine) orally every 6 to 8 hours as needed.
* **Maximum Dose:** Do not exceed 4 tablets in 24 hours. Limit therapy to 2–3 days for dysmenorrhea.
## Pediatric Dosing
* **Not recommended for children under 12 years of age.** Safety and efficacy have not been established in this population due to the potent anticholinergic effects of Dicyclomine and the general contraindications of NSAIDs in children.
## Dose Adjustments
* **Renal Impairment:** Contraindicated in patients with moderate to severe renal impairment. Use with caution in mild impairment.
* **Hepatic Impairment:** Use with caution; monitor for hepatotoxicity (Mefenamic Acid).
* **Geriatrics:** Use caution due to increased risk of anticholinergic side effects (confusion, urinary retention, constipation) and NSAID-related gastrointestinal and cardiovascular risks.
## Contraindications
* Known hypersensitivity to Mefenamic Acid, Dicyclomine, or aspirin/NSAIDs.
* Active peptic ulceration, inflammatory bowel disease (ulcerative colitis, Crohn’s).
* Obstructive uropathy or gastrointestinal obstruction.
* Severe renal or hepatic impairment.
* History of asthma or bronchospasm triggered by NSAIDs.
* Perioperative use in the setting of coronary artery bypass graft (CABG) surgery.
* Myasthenia gravis, glaucoma, and prostatic hypertrophy (due to anticholinergic effect).
## Adverse Effects
* **Common:** Dry mouth, dizziness, blurred vision, nausea, constipation, and drowsiness.
* **Serious:** Gastrointestinal bleeding/ulceration, fluid retention, cardiovascular events (MI/Stroke), transient hepatotoxicity, skin rash (Stevens-Johnson syndrome), and urinary retention.
## Key Drug Interactions
* **NSAIDs/Anticoagulants:** Increased risk of gastrointestinal bleeding.
* **Antihypertensives/Diuretics:** Decreased efficacy and increased risk of renal toxicity when used with NSAIDs.
* **Anticholinergics:** Synergistic effects (e.g., antihistamines, tricyclic antidepressants) increasing risk of dry mouth, tachycardia, and delirium.
* **Lithium/Methotrexate:** NSAIDs may increase serum levels and toxicity risk.
## Monitoring
* Monitor for signs of GI bleeding (black/tarry stools).
* Monitor blood pressure during long-term or repeat use.
* Monitor renal function (creatinine) and hepatic enzymes (ALT/AST) if repeated cycles are used.
* Assess for anticholinergic toxicity (urinary retention, confusion, extreme tachycardia).
## Clinical Pearls
* **Short-term use only:** This medication is not intended for chronic pain management. Long-term use of Mefenamic Acid increases risk of serious GI and cardiovascular events.
* **Administration:** Take with food or milk to minimize gastric irritation.
* **Driving:** Warn patients about potential drowsiness or blurred vision from the Dicyclomine component.
* **Self-Correction Note:** Always verify if local guidelines or brand formulations differ, as fixed-dose combination regulations vary by region.
***
**Educational Disclaimer:** This information is for educational purposes only. Clinical practice varies by region and jurisdiction. Always verify specific dosing, safety profiles, and current prescribing information against the manufacturer's official package insert and local hospital/clinical formulary guidelines before prescribing or administering medication.
