Mebeverine 135mg tablets

Background and aimsAntispasmodics and antidepressants are standard therapies for managing both the gastrointestinal symptoms and psychological comorbidities associated with irritable bowel syndrome (IBS). However, direct comparative evidence regarding their efficacy across different symptom domains is scarce. This systematic review and network meta-analysis aimed to assess the relative effectiveness of these agents on abdominal pain, psychological outcomes, overall IBS symptom severity, and quality of life (QoL).MethodsWe conducted a comprehensive search of PubMed, EMBASE, and Scopus to identify relevant randomized controlled trials evaluating antispasmodics and antidepressants for IBS. Eligible studies underwent quality assessment and were synthesized using network meta-analysis. We calculated standardized mean differences (SMDs) with 95% confidence intervals (CIs) for pain outcomes (VAS), anxiety, depression, the IBS Severity Scoring System (IBS-SSS), and QoL.ResultsTwenty-nine studies were included in the analysis. Significant reductions in pain (VAS) were observed with imipramine (SMD -34.06; 95%CI -51.89 to -16.22) and the alverine/simethicone combination (SMD -6.23; 95%CI -9.93 to -2.53), while mebeverine and anise oil showed benefits in specific IBS subgroups. The most substantial improvements in anxiety occurred with flupentixol-melitracen (SMD -6.63; 95%CI -10.13 to -3.13), followed by small-intestinal release peppermint oil, fluoxetine, and vortioxetine. Imipramine was most effective for depressive symptoms (SMD -9.40; 95%CI -10.29 to -8.51), followed by venlafaxine, flupentixol-melitracen, desipramine, and vortioxetine. Amitriptyline was the only agent to show significant improvement in IBS-SSS scores (SMD -23.70; 95%CI -43.27 to -4.13). The largest gains in QoL were associated with otilonium bromide (SMD 30.90; 95%CI 26.62 to 35.18), followed by venlafaxine, amitriptyline, and cumin sofouf.ConclusionsImipramine and alverine/simethicone were superior for reducing abdominal pain, whereas flupentixol-melitracen, peppermint oil, fluoxetine, and vortioxetine demonstrated the strongest anxiolytic effects. Effective options for depression included imipramine, venlafaxine, flupentixol-melitracen, desipramine, and vortioxetine. Notably, amitriptyline uniquely improved overall IBS severity scores, while otilonium bromide, venlafaxine, amitriptyline, and cumin sofouf provided the greatest benefits for QoL. These findings clarify comparative efficacy and may guide tailored pharmacotherapy strategies for IBS patients.

Abstract licence: CC BY-NC-ND

BackgroundMany patients with IBS suffer on-going symptoms. The evidence base is poor for IBS drugs but they are widely prescribed and advised in Guidelines. Cognitive Behavioural Therapy (CBT) can be helpful, but availability is poor in the NHS. We developed a web-based CBT self-management programme (Regul8) in partnership with patients and trialled it and common IBS medications in an exploratory factorial RCT to test trial procedures and provide information for a larger trial.MethodsPatients, 16 to 60 years, with IBS symptoms fulfilling Rome III criteria were recruited via GP practices and randomised to over-encapsulated mebeverine, methylcellulose or placebo for 6 weeks and to 1 of 3 website conditions: Regul8 with a nurse telephone session and email support, Regul8 with minimal email support, or no website.Results135 patients recruited from 26 GP practices. Mean IBS SSS score 241.9 (sd 87.7), IBS-QOL 64 (sd 20) at baseline. 91% follow-up at 12 weeks. Mean IBS SSS decreased by 35 points from baseline to 12 weeks. There was no significant difference in IBS SSS or IBS-QOL score between medication or website groups at 12 weeks, or in medication groups at 6 weeks, or IBS-QOL in website groups at 6 weeks. However, IBS SSS at 6 weeks was lower in the No website group than the website groups (IBS SSS no website =162.8 (95% CI 137.4-188.3), website 197.0 (172.4 - 221.7), Website + telephone support 208.0 (183.1-233.0) p = 0.037).Enablement and Subjects Global Assessment of relief (SGA) were significantly improved in the Regul8 groups compared to the non-website group at 12 weeks (Enablement = 0 in 56.8% of No website group, 18.4% website, 10.5% Website + support, p = 0.001) (SGA; 32.4% responders in No website group, 45.7% website group, 63.2% website + support group, p = 0.035).ConclusionsThis exploratory study demonstrates feasibility and high follow-up rates and provides information for a larger trial. Primary outcomes (IBS SS and IBS QOL) did not reach significance at 6 or 12 weeks, apart from IBS SSS being lower in the no-website group at 6 weeks - this disappeared by 12 weeks. Improved Enablement suggests patients with access to the Regul8 website felt better able to cope with their symptoms than the non-website group. Improved SGA score in the Regul8 groups may indicate some overall improvement not captured on other measures.Trial registrationClinicalTrials.gov Identifier (NCT number): NCT00934973.

Abstract licence: CC BY 2.0

Introduction: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Treatment can improve symptoms and social functioning in the patients. This study was designed to assess the effect of adding Luvos supplementation to mebeverine on improving symptoms and quality of life (QOL) in patients with diarrhea-predominant irritable bowel syndrome. Methods: Eighty patients with diarrhea-predominant IB, ages 18-65, were diagnosed by the Rome IV criteria and randomly assigned to the study. Forty patients (group A) received mebeverine (135 mg) twice a day (bid) plus Luvos®Healing Earth (1 sachet, bid). The other 41 patients (group B) received mebeverine (135 mg) bid for 4 weeks. Basic demographic data, Bristol score, symptom severity score, and QOL questionnaire were recorded at the start and completion of treatment. The data were analyzed by SPSS version 22. Results: Seventy one of the patients (35 and 36 patients in groups A and B, respectively) completed the study. The majority of the patients were young males, unmarried and highly educated. Diarrhea and QOL were both significantly improved in group A when compared to group B (P=0.036 and P=0.028, respectively). We did not find a significant difference (improvement) in abdominal pain or overall symptom score between group A (mebeverine + Luvos) compared to group B (mebeverine alone) (P=0.096 and P=0.071, respectively). Mild and tolerable adverse effects were observed in 2.8% (2/71) of the patients. Conclusion: According to our results, Luvos supplementation is safe, effective and well-tolerated in diarrhea-predominant irritable bowel syndrome patients. Further study with a larger sample size is recommended to evaluate the efficacy of this natural clay-like medicine.

Abstract licence: CC BY 4.0