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 used 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.
Adult: One tablet (typically containing Drotaverine 80mg + Mefenamic Acid 250mg) three times daily. For dysmenorrhea, start at the onset of pain or menses. Maximum: 3 tablets per day. Should be taken with or after food.
Note: Take with a full glass of water, preferably with or immediately after meals to minimize gastrointestinal upset. Do not crush or chew unless specified. Use for the shortest duration necessary to control symptoms.
The combination exerts a dual mechanism: Drotaverine causes direct relaxation of smooth muscle (visceral antispasmodic), while Mefenamic Acid inhibits prostaglandin synthesis (analgesic, anti-inflammatory). This provides synergistic relief in conditions like dysmenorrhea where uterine smooth muscle spasm and elevated prostaglandins are key pathophysiological factors.
Pregnancy: Category C (US FDA). Avoid in first and second trimesters unless potential benefit justifies risk. CONTRAINDICATED in third trimester due to risk of premature closure of ductus arteriosus, delayed labor, and potential renal dysfunction in the neonate.
Driving: Caution advised. May cause dizziness, vertigo, or drowsiness in some patients. Patients should not drive or operate machinery until they know how the medication affects them.
| Anticoagulants (Warfarin, Acenocoumarol) | Increased risk of bleeding due to platelet inhibition and protein binding displacement by Mefenamic Acid. | Major |
| Other NSAIDs (including Aspirin) | Increased risk of GI toxicity (ulcers, bleeding) with no additional therapeutic benefit. | Major |
| Lithium | Mefenamic Acid can decrease renal clearance of Lithium, leading to increased Lithium levels and toxicity. | Major |
| Methotrexate | Mefenamic Acid may decrease renal excretion of Methotrexate, increasing its toxicity. | Major |
| Diuretics (Furosemide, Thiazides) | Reduced diuretic and antihypertensive efficacy; increased risk of renal impairment. | Moderate |
| Antihypertensives (ACE inhibitors, ARBs, Beta-blockers) | Reduced antihypertensive effect; increased risk of renal impairment. | Moderate |
| Corticosteroids (e.g., Prednisolone) | Markedly increased risk of GI ulceration and bleeding. | Major |
| Selective Serotonin Reuptake Inhibitors (SSRIs) | Increased risk of upper gastrointestinal bleeding. | Moderate |
| Cyclosporine | Increased risk of nephrotoxicity. | Major |
| Quinolone Antibiotics | Theoretical increased risk of seizures with NSAIDs; Drotaverine may have CNS effects. | Moderate |
Same composition (Drotaverine (NA) + Mefenamic Acid (NA)), different brands: