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Irritable bowel syndrome - Management
What should I consider when prescribing an antispasmodic?
- Antispasmodics may be used on an 'as required' basis [AGA, 2002]:
- Up to three times a day for acute attacks of pain, or
- Before meals if postprandial symptoms predominate.
- Direct-acting smooth muscle relaxants are generally well tolerated, occasional heartburn and perianal irritation may occur with therapeutic peppermint oil.
- There are no clinically significant drug interactions reported with mebeverine, alverine, or therapeutic doses of peppermint oil [BNF 55, 2008].
- Direct-acting smooth muscle relaxants are contraindicated in people with a paralytic ileus [BNF 55, 2008].
- Because there is a lack of published evidence in humans concerning the use of mebeverine hydrochloride, alverine citrate, or therapeutic doses of peppermint oil in pregnancy, the use of these drugs during pregnancy is not recommended [NTIS, 2008a].
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