Mebeverine is a
drug used to alleviate some of the symptoms of
irritable bowel syndrome. It works by relaxing the muscles in and around the gut.[1]
Medical use
Mebeverine is used to alleviate some of the symptoms of
irritable bowel syndrome (IBS) and related conditions; specifically stomach pain and cramps, persistent diarrhoea, and flatulence.[2]
Data from controlled clinical trials have not found a difference from placebo or statistically significant results in the global improvement of IBS.[3][4]
It has not been tested in pregnant women nor in pregnant animals so pregnant women should not take it; it is expressed at low levels in breast milk, while no adverse effects have been reported in infants, breastfeeding women should not take this drug.[1]
Adverse effects
Adverse effects include hypersensitivity reactions and allergic reactions, immune system disorders, skin disorders including hives, oedema and widespread rashes.[2]
Additionally, the following adverse effects have been reported: heartburn, indigestion, tiredness, diarrhoea, constipation, loss of appetite, general malaise, dizziness, insomnia, headache, and decreased pulse rate.[1]
Mebeverine can, on highly rare occasions, cause drug-induced acute angle closure glaucoma.[5]
In a urine drug-screening test, mebeverine can affect a false positive result for amphetamines.[6]
Mechanism of action
Mebeverine is an
anticholinergic but its
mechanism of action is not known; it appears to work directly on smooth muscle within the gastrointestinal tract and may have an anaesthetic effect, may affect
calcium channels, and may affect muscarinic receptors.[2]
It is metabolized mostly by
esterases, and almost completely. The metabolites are excreted in urine.[2]
Mebeverine exists in two
enantiomeric forms. The commercially available product is a
racemic mixture of them. A study in rats indicates that the two have different
pharmacokinetic profiles.[7]
History
It is a second generation
papaverine analog, and was first synthesized around the same time as
verapamil.[8]
^Hatami M, Farhadi K, Tukmechi A (August 2012). "Fiber-based liquid-phase micro-extraction of mebeverine enantiomers followed by chiral high-performance liquid chromatography analysis and its application to pharmacokinetics study in rat plasma". Chirality. 24 (8): 634–9.
doi:
10.1002/chir.22057.
PMID22700279.