From the Guidelines
Meteospasmyl and mebeverine are both effective antispasmodic medications for treating irritable bowel syndrome (IBS), but the choice between them should be based on individual patient symptoms and response, with Meteospasmyl potentially offering better relief for gas-related symptoms.
Key Considerations
- Both medications work by relaxing the smooth muscles in the gut to relieve abdominal pain and discomfort.
- Meteospasmyl contains alverine citrate combined with simethicone, which helps reduce gas and bloating, while mebeverine is a single-ingredient medication.
- The typical dosage for Meteospasmyl is one capsule (60mg alverine/300mg simethicone) taken 2-3 times daily before meals, while mebeverine is usually taken as 135mg three times daily before meals or 200mg twice daily in extended-release form.
- Both medications have similar safety profiles with minimal side effects and few drug interactions, making them suitable for long-term use.
Evidence-Based Recommendations
- According to the British Society of Gastroenterology guidelines on the management of IBS 1, antispasmodics, including mebeverine, may be an effective treatment for global symptoms and abdominal pain in IBS.
- A meta-analysis identified 26 RCTs, containing 2811 patients, which compared 13 different antispasmodics with placebo, and found that fewer patients treated with antispasmodics had persistent global symptoms or abdominal pain (RR 0.65; 95% CI 0.56 to 0.76) 1.
- The guidelines also recommend that the choice of treatment should be based on individual patient symptoms and response, and that patients should be advised to take regular exercise and consider dietary therapies, such as soluble fibre, as first-line treatments 1.
Clinical Implications
- Clinicians should consider the individual patient's symptom profile and response when choosing between Meteospasmyl and mebeverine.
- Patients with gas-related symptoms may benefit from Meteospasmyl's added benefit of simethicone.
- Both medications can be discontinued without tapering when symptoms improve, and have minimal side effects and few drug interactions, making them suitable for long-term use.
From the Research
Comparison of Meteospamyl and Mebeverine
- There are no direct studies comparing Meteospamyl and Mebeverine in the provided evidence.
- However, the efficacy and safety of Mebeverine in the treatment of Irritable Bowel Syndrome (IBS) have been studied extensively 2, 3, 4, 5, 6.
- Mebeverine has been shown to be effective in reducing abdominal pain and improving bowel habits in patients with IBS 2, 3, 4.
- The safety profile of Mebeverine is also well-established, with few adverse events reported in clinical trials 2, 4, 5.
- A systematic review of Mebeverine in IBS found that it is mostly well-tolerated, but its efficacy in global improvement of IBS is not statistically significant 4.
- Another study compared the efficacy of Mebeverine with a calcium channel blocker, pinaverlum bromide, in patients with diarrhoea-predominant IBS, and found that both drugs have similar therapeutic efficacies 3.
- A double-blind crossover comparison study found that Mebeverine sustained release and plain Mebeverine have equivalent efficacy and tolerance in the treatment of IBS 5.
- A feasibility randomised controlled trial is being conducted to assess the effectiveness of Mebeverine, methylcellulose, and a patient self-management cognitive behavioural therapy website in the management of IBS in primary care 6.