Dicyclomine (10mg) + Paracetamol (500mg) + Mefenamic Acid (250mg) (Medical Monograph)

Overview

A fixed-dose combination (FDC) analgesic-antispasmodic agent primarily used 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/antipyretic, and Mefenamic Acid is a peripherally-acting NSAID (Propionic acid derivative). 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 muscarinic acetylcholine receptor antagonist, reducing smooth muscle tone and motility in the gastrointestinal and genitourinary tracts, thereby relieving spasm. 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, providing analgesic and antipyretic effects. Mefenamic Acid is a non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing the peripheral synthesis of prostaglandins, which are key mediators of pain, inflammation, and fever.