A fixed-dose combination (FDC) of an antispasmodic (Hyoscine butylbromide) 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 gastrointestinal/renal colic. The combination provides dual action: Hyoscine butylbromide relieves the spasm, while Mefenamic Acid reduces the inflammatory pain and prostaglandin-mediated uterine contractions.
Adult: One tablet (Hyoscine butylbromide 10mg + Mefenamic Acid 250mg) three times daily, or as directed by the physician. For dysmenorrhea, start at the onset of pain or menses.
Note: Take with or after food to minimize gastrointestinal irritation. Swallow whole with a full glass of water. Do not crush or chew. Should be used on an 'as-needed' basis for acute painful spasms, not for continuous long-term therapy.
Hyoscine butylbromide is a competitive antagonist at muscarinic (M1, M2, M3) receptors in the smooth muscle of the gastrointestinal, biliary, and genitourinary tracts. It does not cross the blood-brain barrier, minimizing central side effects. Mefenamic Acid is a potent inhibitor of cyclooxygenase (COX-1 and COX-2) enzymes, thereby inhibiting the synthesis of prostaglandins, thromboxanes, and prostacyclins, which are mediators of pain, inflammation, and fever.
Pregnancy: Category C (first and second trimester): Use only if potential benefit justifies potential risk to the fetus. Avoid in third trimester (Category D) due to risk of premature closure of ductus arteriosus, delayed labor, and potential for maternal and neonatal bleeding.
Driving: May cause dizziness, drowsiness, or blurred vision. Patients should not drive or operate machinery if affected.
| Other NSAIDs (e.g., Ibuprofen, Diclofenac, Aspirin) | Increased risk of GI ulceration and bleeding, reduced antiplatelet effect of aspirin | Major |
| Anticoagulants (Warfarin, NOACs) | Increased risk of bleeding due to antiplatelet effect and protein binding displacement | Major |
| Oral Corticosteroids (e.g., Prednisolone) | Markedly increased risk of GI ulceration | Major |
| ACE Inhibitors (e.g., Ramipril), ARBs, Diuretics | Reduced antihypertensive efficacy, increased risk of renal impairment | Moderate |
| Lithium | Increased serum lithium levels and toxicity | Moderate |
| Methotrexate | Increased methotrexate toxicity (especially at high doses) | Moderate |
| Anticholinergics (e.g., Tricyclic antidepressants, Antipsychotics) | Additive anticholinergic side effects (dry mouth, urinary retention, constipation) | Moderate |
| Probenecid | Increased and prolonged plasma levels of Mefenamic Acid | Moderate |
| SSRIs (e.g., Sertraline, Fluoxetine) | Increased risk of upper GI bleeding | Moderate |
| Antacids | May reduce absorption of Mefenamic Acid | Minor |
Same composition (Hyoscine butylbromide (10mg) + Mefenamic Acid (250mg)), different brands: