Drotimed-M

Drotaverine (80mg) + Mefenamic Acid (250mg)
Price: ₹22 - ₹38 for a strip of 10 tablets
Mfr: Medley Pharmaceuticals Ltd. | Form: Tablet

📋 Clinical Overview

A fixed-dose combination (FDC) of an antispasmodic (Drotaverine) and a non-steroidal anti-inflammatory drug (NSAID) of the fenamate class (Mefenamic Acid). It is primarily indicated for the symptomatic relief of pain associated with smooth muscle spasms, particularly in dysmenorrhea and abdominal colics. Drotaverine relieves spasm, while Mefenamic Acid reduces pain and inflammation. This combination is widely used in India for gynecological and gastrointestinal conditions.

💊 Dosage & Administration

Adult: One tablet (Drotaverine 80mg + Mefenamic Acid 250mg) every 6-8 hours as needed for pain. Should be taken with or after food. Maximum: 3 tablets in 24 hours.

Note: Take with a full glass of water, preferably with food or milk to minimize gastrointestinal upset. Do not crush or chew. Swallow whole. Do not lie down for at least 10 minutes after taking the tablet.

⚠️ Contraindications

  • Known hypersensitivity to Drotaverine, Mefenamic Acid, or other NSAIDs.
  • History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
  • Active peptic ulcer disease or history of recurrent ulcer/bleeding.
  • Severe hepatic impairment (Child-Pugh Class C).
  • Severe renal impairment (eGFR <30 mL/min).
  • Third trimester of pregnancy.
  • Inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis).

🔬 Mechanism of Action

The combination exerts a dual action: Drotaverine causes direct relaxation of smooth muscle, while Mefenamic Acid inhibits prostaglandin synthesis, providing analgesic, anti-inflammatory, and antipyretic effects. This synergistically relieves colicky pain arising from smooth muscle spasm in the uterus, gastrointestinal tract, and biliary system.

🤕 Side Effects

  • Nausea
  • Epigastric discomfort/heartburn
  • Dizziness
  • Headache
  • Dry mouth

🤰 Special Populations

Pregnancy: Pregnancy Category C (first and second trimester) and Category D (third trimester). Avoid in third trimester due to risk of premature closure of ductus arteriosus, delayed labor, and potential renal dysfunction in the newborn. Use in first and second trimesters only if clearly needed and for the shortest duration.

Driving: May cause dizziness, drowsiness, or blurred vision. Patients should not drive or operate machinery until they know how the medication affects them.

🔄 Drug Interactions

Anticoagulants (Warfarin, Acenocoumarol)Increased risk of bleeding due to platelet inhibition and protein binding displacement.Major
Other NSAIDs (Aspirin, Ibuprofen, Diclofenac)Increased risk of GI toxicity (ulcers, bleeding) with no added therapeutic benefit.Major
ACE Inhibitors (Ramipril, Enalapril) / ARBs (Losartan)Reduced antihypertensive effect; risk of worsened renal function.Moderate
Diuretics (Furosemide, Hydrochlorothiazide)Reduced diuretic and antihypertensive efficacy; risk of nephrotoxicity.Moderate
LithiumIncreased lithium levels and risk of toxicity due to reduced renal clearance.Major
MethotrexateIncreased methotrexate levels and risk of hematologic toxicity.Major
Corticosteroids (Prednisolone)Markedly increased risk of GI ulceration and bleeding.Major
Selective Serotonin Reuptake Inhibitors (SSRIs) e.g., FluoxetineIncreased risk of upper GI bleeding.Moderate
Antiplatelets (Clopidogrel)Increased risk of GI bleeding.Moderate
CyclosporineIncreased risk of nephrotoxicity.Major

🔁 Alternatives to Drotimed-M

Same composition (Drotaverine (80mg) + Mefenamic Acid (250mg)), different brands:

Drotin-M Meftal-Spas Dvay-M Spasmonil-Plus