Dicyclomine (10mg) + Paracetamol (325mg) + Mefenamic Acid (250mg) (Medical Monograph)

Overview

A fixed-dose combination (FDC) analgesic-antispasmodic agent used primarily for the symptomatic relief of pain and spasms associated with dysmenorrhea, abdominal colic, and other smooth muscle spasms. Dicyclomine is an anticholinergic antispasmodic, Paracetamol is a centrally-acting analgesic and antipyretic, and Mefenamic Acid is a peripherally-acting NSAID with analgesic, anti-inflammatory, and antipyretic properties. This combination provides a multi-modal approach to pain management, targeting both visceral spasm and pain pathways.

The combination exerts a synergistic effect on pain relief. Dicyclomine acts as a competitive antagonist at muscarinic (M1, M3) receptors in visceral smooth muscle, reducing acetylcholine-induced spasms and hypermotility. Paracetamol's exact mechanism is not fully elucidated but is believed to involve central inhibition of prostaglandin synthesis (COX-2 and COX-3 inhibition) and modulation of serotonergic and cannabinoid pathways. Mefenamic Acid is a competitive inhibitor of both cyclooxygenase (COX-1 and COX-2) enzymes, reducing the synthesis of prostaglandins, thromboxanes, and prostacyclins at the site of inflammation, thereby providing peripheral analgesic, anti-inflammatory, and antipyretic effects.