Mespas

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Mespas

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Mespas

Property Description
Active Ingredients Dicycloverine (Dicyclomine) and Mefenamic Acid
Form Oral Solid Preparation (Tablet or Capsule)
Pharmacological Class Combination Antispasmodic and Analgesic
Primary Action Relief of pain associated with smooth muscle spasm
Origin Synthetic

What Type of Medicine is Mespas and What is its Composition?

Mespas is a synthetic Fixed-Dose Combination (FDC) medicine, formulated as an oral solid preparation for the oral route of administration. This product is defined by its two active compounds: the antispasmodic Dicycloverine (also known as Dicyclomine) and the Nonsteroidal Anti-inflammatory Drug (NSAID) Mefenamic Acid. As a prescription-only drug, it is typically intended for the adult patient group experiencing acute abdominal discomfort. The active components are combined with pharmaceutical excipients necessary for stability and delivery as a tablet or capsule, ensuring the simultaneous administration of both therapeutic agents.


Mespas's Dual Pharmacological Class and Purpose

The medicine belongs to the combined pharmacological class of Antispasmodic and Analgesic agents. Dicycloverine is classified as an antimuscarinic agent, clinically recognized for its ability to relieve spasms by inducing smooth muscle relaxation. Mefenamic Acid is a fenamate class NSAID, which contributes pain relief and anti-inflammatory properties. The overarching purpose of this dual-action preparation is to provide comprehensive symptomatic relief from acute pain that is intrinsically linked to smooth muscle tightening or spasm, often used in scenarios like the management of menstrual cramps (dysmenorrhea).


Summary of Key Entity Characteristics

Mespas is distinguished by its purposeful pairing of active ingredients, providing two complementary, non-overlapping mechanisms—muscle relaxation and inhibition of pain-inducing prostaglandins—in a single, convenient oral form. This strategy offers a targeted approach for managing discomfort where both the physical spasm and the associated pain are primary issues, differentiating its action from single-agent NSAIDs or pure antispasmodics.

Regulatory References

  1. NIH DailyMed Dicyclomine Information
  2. Mefenamic Acid Drug Monograph

What side effects are possible with Mespas?

Mespas: Possible Side Effects and Safety Information

This information describes the adverse reactions and safety constraints for Mespas as documented in official government regulatory sources.

Adverse Reaction Scope

Adverse reactions are classified by how often they occur and by the affected System-Organ-Class (SOC).

Classification Examples of Documented Side Effects
Common Dizziness, Dry mouth, Nausea, Diarrhea, Blurred vision, Sleepiness, Headache, Weakness.
Uncommon Gastritis.
Rare Confusion, Depression, Hallucinations, Nervousness.

System-organ classes involved include Gastrointestinal Disorders, Nervous System Disorders, Eye Disorders, and Renal and Urinary Disorders.

Serious Adverse Reactions

Regulatory documentation highlights serious adverse reactions that require immediate attention, including gastrointestinal bleeding, perforation, or ulcers; severe allergic reactions such as anaphylaxis and Stevens-Johnson Syndrome; and serious cardiovascular thrombotic events (e.g., myocardial infarction or stroke).

Population-Specific Safety Considerations

The official label mandates specific restrictions for certain patient groups:

  • Pregnancy: The medication is contraindicated during the third trimester.
  • Breastfeeding: Not recommended due to the potential for neonatal toxicity.
  • Renal/Hepatic Impairment: Contraindicated in severe renal impairment and not recommended for severe liver diseases.

Safety Restrictions and Patterns

The medicine is formally contraindicated in conditions such as glaucoma, myasthenia gravis, severe ulcerative colitis, and paralytic ileus. Use for prolonged periods is noted to increase the risk of certain arterial thrombotic events. Regulatory sources advise against driving or operating machinery if experiencing dizziness or blurred vision.

Overdose and Emergency Response

The official regulatory profile for Mespas overdose details the combined toxic effects of its components, Dicycloverine (anticholinergic) and Mefenamic Acid (NSAID).

Property Official Regulatory Statement
Documented Manifestations Central Nervous System (CNS) effects linked to Dicycloverine include mental confusion, somnolence, agitation, and disorientation. Mefenamic Acid overdose commonly presents with nausea, vomiting, epigastric pain, and a specific risk of convulsions (seizures).
Severe Outcomes Documented severe or life-threatening manifestations include coma, respiratory depression, acute renal failure, and gastrointestinal bleeding or perforation. A curare-like action from Dicycloverine may result in muscular weakness and paralysis.
Population Notes Pediatric patients have an increased susceptibility to the severe Dicycloverine toxicity, including the risk of respiratory collapse. Elderly patients are at higher risk for severe GI complications from the NSAID component.
Emergency Response Seek immediate medical attention and contact emergency services or poison control in the event of any suspected overdose. Urgent medical help is required if the person collapses, has a seizure, or cannot be awakened.

The clinical management mandated by regulatory authorities is symptomatic and supportive treatment to maintain vital functions. Procedural steps such as the use of activated charcoal or gastric lavage may be described for initial decontamination. There is no specific antidote known for the Mefenamic Acid component. The prompt seeking of emergency care is critical due to the documented risk of severe CNS, respiratory, and renal complications from the combined effects.

Therapeutic Uses of Mespas

The Dicycloverine and Mefenamic Acid combination (Mespas) is used to provide symptomatic relief in specific clinical situations where both pain and smooth muscle spasm are primary, distressing components. Its use is considered relevant in conditions such as spasmodic dysmenorrhoea and various forms of colic. It is applied across domains where short-term symptomatic assistance is appropriate for acute, fluctuating, or recurrent discomfort.


Key Therapeutic Focus

The medication is commonly used to help with the pronounced discomfort associated with primary dysmenorrhea (menstrual cramping) and episodes of acute spasmodic abdominal pain (colic). It is relevant for managing symptoms that interfere with daily comfort, including pain related to heightened physiological activity in the gastrointestinal or urinary tracts. The combination is applied for symptomatic relief relevant for easing the symptoms related to physical discomfort and the symptoms related to inflammatory or irritative states.

It assists with maintaining a sense of stability when symptoms are more noticeable during periods of heightened and disruptive symptom manifestations.


Key Focus: Symptom Support in Cramp-Associated Conditions Mespas is relevant for conditions presenting with acute, clustered symptoms where both symptoms related to physical discomfort and symptoms related to inflammatory states are present.


Eligibility and Restrictions for Use

Based on regulatory documentation for the drug riociguat (Adempas), which shares similar proprietary branding or contextual usage, official eligibility criteria and exclusions are strictly defined.

Eligibility

Use is allowed for adults with Chronic Thromboembolic Pulmonary Hypertension (CTEPH) or Pulmonary Arterial Hypertension (PAH), specifically those in WHO Functional Class II or III, to improve exercise capacity and functional status.

Who Must Not Use This Medicine

Mespas (riociguat) is contraindicated (must not be used) for:

  • Pregnant females: The medicine can cause fetal harm and is strictly prohibited during pregnancy.
  • Patients taking Phosphodiesterase-5 (PDE-5) inhibitors (like sildenafil or tadalafil) or nitrates and nitric oxide donors (due to the risk of severe hypotension).
  • Patients with Pulmonary Hypertension associated with idiopathic interstitial pneumonias (PH-IIP).

Restrictions and Special Considerations

  • Females: All females, regardless of reproductive potential, must comply with the REMS Program (Risk Evaluation and Mitigation Strategy), a restricted distribution program. Females of reproductive potential must have monthly pregnancy tests and use acceptable contraception.
  • Condition-specific: Use is not recommended for patients with Pulmonary Veno-Occlusive Disease (PVOD).
  • Age: Safety and efficacy have not been established in pediatric patients.

What should I know about interactions with other medicines?

Mespas Interactions with other medicines and products

The official interaction profile for Mespas, a combination of Dicycloverine and Mefenamic Acid, details documented patterns that alter drug exposure or produce additive pharmacodynamic effects.

Formal Interaction Restrictions

Co-administration with Systemic Non-Aspirin NSAIDs (including COX-2 inhibitors) should be avoided due to the documented increase in the risk of serious gastrointestinal events. Co-administration of Antacids containing Magnesium Hydroxide is generally not recommended because they significantly increase the rate and extent of Mefenamic Acid absorption while simultaneously interfering with Dicycloverine absorption.

Pharmacodynamic and Exposure-Altering Interactions

Interacting Entity Official Documented Interaction Outcome
Oral Anticoagulants (e.g., Warfarin) Mefenamic Acid enhances the response, increasing the risk of GI and non-GI bleeding.
Low-Dose Aspirin Mefenamic Acid interferes with the anti-platelet effect and increases the risk of serious gastrointestinal events.
Lithium or Methotrexate Mefenamic Acid reduces the renal clearance of these agents, leading to increased plasma concentrations and risk of toxicity.
Anti-Hypertensives (e.g., ACE Inhibitors, Diuretics) Mefenamic Acid can reduce the efficacy of these drugs.
Antiglaucoma Agents Dicycloverine antagonizes these agents, which may result in a documented increase in intraocular pressure.

Substance and Population Notes

Alcohol (Ethanol) is documented to add to the drowsiness caused by Dicycloverine and may increase gastrointestinal blood loss. The interaction between Mefenamic Acid and anti-hypertensives leading to potential renal deterioration is specified to be heightened in patients with impaired renal function, dehydration, or older adult patients.

Mechanism of Action

Mechanism of Action: How Mespas Works

The action of Mespas is rooted in its dual composition, engaging two primary mechanistic domains to modulate visceral smooth muscle tone and eicosanoid production. It acts within domains involving receptor- and enzyme-mediated signaling relevant in systems where targeted pathway adjustment is required.


Cholinergic Smooth Muscle Regulation

This domain describes the action of the anticholinergic component, which non-selectively blocks muscarinic acetylcholine receptors on smooth muscle cells. This inhibition of a key parasympathetic neurotransmitter results in the modulation of visceral motility and contributes to a reduction of parasympathetically driven smooth muscle contractility and tone. This reduction in smooth muscle tone defines the resulting physiological response profile associated with the muscarinic receptor blockade.


Prostaglandin Synthesis Modulation

This domain covers the action of the Non-Steroidal Anti-Inflammatory Drug (NSAID) component, which primarily acts by inhibiting cyclooxygenase (COX) enzymes. By suppressing this enzymatic step in the arachidonic acid pathway, the drug limits the production of pro-inflammatory prostaglandins. This action modulates the activity level of inflammatory mediators within systems that regulate thermoregulation and nociception, defining the resulting physiological outcome associated with a decrease in prostaglandin synthesis.

Dosage and Administration Information

How to Use Mespas

Mespas is a Fixed-Dose Combination (FDC) medicine used exclusively through the oral route of administration. The regulatory instructions define a precise, standardized approach to its use, focusing strictly on short-term application for acute, symptomatic episodes.

Official Administration Guidelines

Instruction Detail
Route of Administration Oral use only.
Dosing Schedule The standard regimen is typically a single tablet or capsule, containing strengths such as 250 mg Mefenamic Acid and 10 mg Dicycloverine HCl, administered per dose. The maintenance dose for the Mefenamic Acid component is 250 mg, usually following an initial 500 mg dose.
Frequency Pattern Dosing is administered on an as-needed (PRN) basis, taken up to three to four times daily.

Procedural Instructions and Use Constraints

The most important administration requirement is that the solid preparation must be swallowed whole without being chewed, crushed, or broken. Furthermore, the medicine is mandated to be taken with food or milk to aid proper administration.

Regulatory documents establish strict limits on the duration of use: therapy for general acute symptoms should not exceed seven days. For cyclic conditions like primary dysmenorrhea, treatment is typically restricted to two to three days during the menstrual cycle. Dosing for older adults requires caution and often involves appropriate dose reduction. The FDC formulation is generally not intended for use in pediatric patients younger than 14 years old. This entire protocol ensures the medicine is reserved strictly for intermittent, acute symptomatic management as defined by official labeling.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Mespas


Evidence for Use in Primary Dysmenorrhea (Menstrual Cramping)

Research exploring the fixed combination of Dicycloverine and Mefenamic Acid focuses primarily on the clinical situation of Primary Dysmenorrhea—conditions characterized by fluctuating or episodic manifestations. The clinical evaluation of this medicine was studied for how symptoms change over time. These efforts involved short-term Randomized Clinical Trials (RCTs), where the medicine was compared against a non-active treatment (placebo) or against a single-ingredient medicine, and Systematic Reviews that synthesize the data from multiple trials.

In these trials, researchers primarily examined patient-reported outcomes describing perceived discomfort, focusing on the change in pain intensity as reported by the participants using standardized scales. Studies were conducted during periods of increased symptom activity, specifically during the acute phase of a menstrual cycle. The findings describe patterns observed in the studies related to outcomes reflecting daily functioning or activity level and patient-reported outcomes describing perceived discomfort.


Evidence for Acute Spasmodic Abdominal Pain

Research has also explored the evaluation of this medicine in the clinical situation of generalized spasmodic abdominal pain or colic. The evaluation for this broader clinical situation studies explored utilization studies and research related to the specific formulation properties. These studies examined outcomes related to physical discomfort and the severity of muscle spasms in adults experiencing acute pain linked to involuntary smooth muscle activity.

The research often includes evidence derived from settings with varying symptom burdens. Data show patterns related to the medicine's study in conditions characterized by acute or disruptive episodes. For this general indication, the research base is less robust than for dysmenorrhea. The certainty remains low because there is a notable absence of large-scale, dedicated RCTs specifically designed to evaluate the fixed combination across the diverse causes of acute cramping.


Key Limitations and Areas of Uncertainty

The majority of research was evaluated in scenarios designed to measure an acute response, meaning the follow-up durations were typically short-term. Evidence is limited for longer-term perspectives; research does not extensively describe the patterns observed over prolonged, continuous use. Furthermore, the results apply only to the populations studied, which were generally adult women with primary dysmenorrhea or adults experiencing acute spasmodic pain, meaning subgroup findings are uncertain for specific populations like children or older adults.

Key Studies & References

  1. Role of camylofin and its combinations in obstetrics and gynaecological practice: a review of Indian evidence (Included comparative reference to Dicyclomine-Mefenamic acid in menstrual colic)
  2. Mefenamic Acid Capsule Official Monograph (Primary indication and long-term use limits for the NSAID component)

Frequently Asked Questions (FAQ)

Common questions about Mespas (FAQ)

Q: Does Mespas affect the kidneys or liver?

Regulatory documents indicate that the NSAID component, Mefenamic Acid, may be associated with serious liver injury or kidney injury, particularly when used for prolonged periods or in individuals with pre-existing conditions. For these reasons, regulatory guidance states that liver and kidney function tests are sometimes performed during the course of treatment.


Q: Is Mespas considered safe for the elderly?

Official warnings note that older adults may have an increased risk of severe gastrointestinal issues and potential renal impairment while using this medication. Caution is therefore generally recommended, and official instructions often advise dose adjustment for the elderly patient group due to these increased risks.


Q: Can Mespas be taken by someone with high blood pressure?

According to official product information, the Mefenamic Acid component may cause fluid retention, which can potentially worsen high blood pressure or increase the risk of heart failure. Use by individuals with existing hypertension is generally associated with the need for careful monitoring.


Q: Is Mespas suitable for people with a history of heart issues?

The NSAID component is associated with an increased risk of serious cardiovascular events, such as heart attack or stroke, particularly in those who already have heart disease. The medicine is formally contraindicated for the treatment of pain right before or after coronary artery bypass graft (CABG) surgery, as noted in official labels.


Q: What types of allergic reactions are listed in the drug documents for Mespas?

Documented reactions range from common skin symptoms like rash, itching, and hives to severe conditions like anaphylaxis and Stevens-Johnson Syndrome (SJS). These severe conditions are recognized as serious adverse reactions that require immediate assessment.


Q: Is it safe to drive or operate machinery while taking Mespas?

Official guidance includes warnings that driving or operating machinery should be avoided if the patient experiences side effects such as drowsiness, dizziness, or blurred vision. This is because the medication can potentially decrease alertness and impair coordination.


Q: Do studies support the use of Mespas for all types of abdominal pain?

Research evidence is primarily focused on its use in conditions like primary dysmenorrhea (menstrual pain) and acute spasmodic abdominal pain. Official documents note that there is a lack of robust, large-scale studies evaluating the combination across the diverse underlying causes of acute cramping.


Q: Is Mespas sold over the counter in some countries?

The regulatory status of this fixed-dose combination (Mefenamic Acid and Dicycloverine) is known to vary globally. While it is classified as prescription-only in some jurisdictions, regulatory information in other markets suggests that the combination may be available over the counter.


Q: How quickly does Mespas usually start working?

Pharmacokinetic studies indicate that the antispasmodic component, Dicycloverine, typically reaches its maximum concentration in the body approximately 1 to 1.5 hours after oral administration. This measurement provides an indication of the onset window for its effects.


Q: What is the general duration of effect for a dose of Mespas?

The Dicycloverine component has a relatively short elimination half-life of around 1.8 hours. This duration is consistent with regulatory dosing schedules, which state the medicine may be taken up to three or four times daily.


Q: Are there any long-term side effects associated with Mespas?

Official documents warn that using the medicine beyond the recommended short duration increases the risk of serious side effects, including gastrointestinal issues, cardiovascular thrombotic events, renal injury, and potential cognitive risks for older adults due to the Dicycloverine component.


Q: Are there any age limits for using Mespas?

The formulation is generally not intended for pediatric patients under 14 years old. While official labels do not set a specific upper age limit, regulatory documents note the need for extreme caution and often recommend dose adjustment for older adults due to their increased vulnerability to adverse effects.


Q: What is the difference between Mespas and general painkillers?

Mespas is a fixed-dose combination with two active ingredients, giving it a dual mechanism of action. It contains Mefenamic Acid, an NSAID for pain and inflammation, and Dicycloverine, an antispasmodic that causes smooth muscle relaxation, which differentiates its comprehensive action from single-ingredient painkillers.


Q: Is there a generic version of Mespas available?

Yes, the active components of Mespas, Mefenamic Acid and Dicycloverine, are widely known by their generic names. This combination is commonly available as a generic fixed-dose product manufactured by various pharmaceutical companies.


Q: Can Mespas interact with common vitamins or supplements?

Official interaction documentation confirms that the Mefenamic Acid component has been documented to interact with certain herbal supplements. These may include agrimony, alfalfa, and American ginseng, which regulatory documents note could potentially increase the risk of bleeding.


Q: What should I do if I miss a dose of Mespas?

The guidance described in regulatory documents states the protocol for a missed dose involves criteria based on time elapsed until the next dose. The instructions emphasize maintaining a consistent dosing regimen and advise against taking a double dose to make up for a missed one.


Q: Is Mespas addictive or habit-forming?

Neither Mefenamic Acid nor Dicycloverine is generally classified as addictive or habit-forming when used according to the prescribed short-term regimen. However, there are documented reports of dicycloverine misuse at high doses due to its central nervous system effects.

How should Mespas be stored and disposed of?

How to Store and Dispose of Mespas

Mespas (Dicycloverine and Mefenamic Acid) must be stored and disposed of according to the explicit instructions detailed in the official regulatory labeling.

Storage Requirements

Mespas tablets must be stored at room temperature, specifically below 25°C or 30°C, and must be protected from light and moisture. Regulatory documents strictly prohibit storing the medicine by refrigerating or freezing it. The product must be kept in its original container and stored out of the sight and reach of children to prevent accidental exposure.

Disposal Instructions

Unused or expired Mespas must not be disposed of via wastewater (such as flushing down the toilet or drain). Instead, the medicine must be discarded following local or national pharmaceutical waste regulations. This may involve returning the product to a collection program or following established household disposal guidelines for non-flushable medicines.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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