What are the medications for abdominal cramps (abdominal pain)?

From the Guidelines

For abdominal cramps, the most effective treatment option is antispasmodic medications, such as dicyclomine (Bentyl) 20mg taken up to four times daily or hyoscyamine (Levsin) 0.125mg every 4 hours as needed, as they have been shown to provide significant relief from abdominal pain and global symptoms of irritable bowel syndrome (IBS) 1.

Treatment Options

• Antispasmodic medications: dicyclomine (Bentyl) 20mg taken up to four times daily or hyoscyamine (Levsin) 0.125mg every 4 hours as needed
• Non-prescription alternatives: peppermint oil capsules (0.2-0.4ml) taken three times daily with meals
• Pain relief medications: ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours or acetaminophen (Tylenol) 500-1000mg every 6 hours
• Menstrual cramp relief: naproxen sodium (Aleve) 220mg every 8-12 hours

Additional Relief Measures

• Heating pad applied to the abdomen for 15-20 minutes to improve blood flow and relax muscles

Important Considerations

• If cramps are severe, persistent (lasting more than 24 hours), or accompanied by fever, vomiting, or bloody stool, medical attention should be sought as these could indicate a more serious condition requiring different treatment 1.

From the FDA Drug Label

Hyoscyamine sulfate is effective as adjunctive therapy in the treatment of peptic ulcer. It can also be used to control gastric secretion, visceral spasm and hypermotility in spastic colitis, spastic bladder, cystitis, pylorospasm, and associated abdominal cramps May be used in functional intestinal disorders to reduce symptoms such as those seen in mild dysenteries, diverticulitis, and acute enterocolitis. For use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon,mucous colitis) and functional gastrointestinal disorders Also used as adjunctive therapy in the treatment of neurogenic bladder and neurogenic bowel disturbances (including the splenic flexure syndrome and neurogenic colon). Also used in the treatment of infant colic (elixir and drops) Hyoscyamine sulfate is indicated along with morphine or other narcotics in symptomatic relief of biliary and renal colic;

Medications for abdominal cramps include hyoscyamine sulfate, which can be used to control visceral spasm and hypermotility in conditions such as spastic colitis and irritable bowel syndrome, and to reduce symptoms of abdominal cramps associated with these conditions 2.

• Key uses of hyoscyamine sulfate for abdominal cramps include:
  • Adjunctive therapy in the treatment of peptic ulcer and irritable bowel syndrome
  • Control of gastric secretion, visceral spasm, and hypermotility in spastic colitis and other functional intestinal disorders
  • Symptomatic relief of biliary and renal colic when used with morphine or other narcotics

From the Research

Medications for Abdominal Cramps

• Antispasmodics are a common treatment option for abdominal cramps, including agents such as hyoscine-N-butyl bromide and mebeverine 3
• These medications work by relaxing the smooth muscle in the gastrointestinal tract, reducing cramping and pain
• Other antispasmodics, such as drotaverine, alverine, pinaverium, otilonium bromide, fenoverine, tiropramide, and trimebutine, are also being studied for their efficacy in treating abdominal cramps 3
• Peppermint oil has also been shown to be effective in reducing abdominal pain and improving symptoms of irritable bowel syndrome (IBS) 4
• In some cases, acetaminophen or NSAIDs may be added to antispasmodics for more severe cases of abdominal cramps 3
• Fixed-dose combinations of antispasmodics and NSAIDs or two different antispasmodics may also be effective in reducing abdominal cramps and improving patient compliance 3

Treatment Options for Specific Conditions

• For irritable bowel syndrome (IBS), peppermint oil has been shown to be a safe and effective short-term treatment option 4
• For inflammatory bowel diseases (IBD), conventional therapies such as 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α agents are still the mainstay of treatment 5
• For chronic abdominal pain, antispasmodics such as alverine, dicyclomine, hyoscine, hyoscyamine, mebeverine, otilonium, pinaverium, and trimebutine may be effective, but each agent should be considered on an individual basis 6