Chemistry:Mebeverine

From HandWiki
Short description: Chemical compound
Mebeverine
Mebeverine.svg
Mebeverine2.png
Clinical data
AHFS/Drugs.comInternational Drug Names
Routes of
administration
By mouth
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC25H35NO5
Molar mass429.557 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
  (verify)

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]

It does not have systemic anticholinergic side effects.[2]

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]

It was first registered in 1965.[9]

Availability

Mebeverine is a generic drug and is available internationally under many brand names.[10]

References

  1. 1.0 1.1 1.2 "Colofac data sheet". New Zealand Medicines and Medical Devices Safety Authority. 14 June 2017. http://www.medsafe.govt.nz/profs/datasheet/c/colofactab.pdf. 
  2. 2.0 2.1 2.2 2.3 2.4 "Colofac Tablets 135mg - Summary of Product Characteristics (SPC)" (in en). UK Electronic Medicines Compendium. 26 August 2016. https://www.medicines.org.uk/emc/medicine/2067. 
  3. "Role of antispasmodics in the treatment of irritable bowel syndrome". World Journal of Gastroenterology 20 (20): 6031–43. May 2014. doi:10.3748/wjg.v20.i20.6031. PMID 24876726. 
  4. "A systematic review of efficacy and tolerability of mebeverine in irritable bowel syndrome". World Journal of Gastroenterology 16 (5): 547–53. February 2010. doi:10.3748/wjg.v16.i5.547. PMID 20128021. 
  5. "Drug-induced acute angle closure glaucoma". Current Opinion in Ophthalmology 18 (2): 129–33. March 2007. doi:10.1097/ICU.0b013e32808738d5. PMID 17301614. 
  6. Optimisation, NECS Medicines (2015-07-21). "Misuse of hyoscine butylbromide (Buscopan) |" (in en-GB). http://medicines.necsu.nhs.uk/misuse-of-hyoscine-butylbromide-buscopan/. 
  7. "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. August 2012. doi:10.1002/chir.22057. PMID 22700279. 
  8. Sneader, Walter (2005). Drug Discovery: A History. John Wiley & Sons. p. 132. ISBN 9780471899792. https://books.google.com/books?id=Cb6BOkj9fK4C&pg=PA132. 
  9. "Mebeverine". druginfosys. http://druginfosys.com/Drug.aspx?DrugCode=438&DrugName=Mebeverine&type=1. 
  10. "Mebeverine". International. drugs.com. https://www.drugs.com/international/mebeverine.html.