Meftal Spas Tablet: Uses, Composition, Side Effects & FAQs

Meftal Spas is a tablet for period pain and for cramping pain that comes in waves, such as bowel colic. In India it is a prescription-only medicine, so take it only if a doctor has prescribed it for you. Each tablet has two active ingredients. Mefenamic acid is a painkiller that also settles swelling, and dicyclomine relaxes tight, cramping muscle.

Meftal Spas is a combination of two medicines in one tablet: a painkiller and an antispasmodic. The "Spas" in the name points to its second job, easing muscle spasm in the gut. There is also a double-strength version, Meftal Spas DS, and this article is about the regular 250 mg tablet.

The same brand also comes as oral drops. This article does not cover the drops. If your child has been prescribed them, follow the leaflet inside that pack.

Think of it as a two-part plan for a cramping abdomen:

1. Settle the ache: Mefenamic acid blocks the enzymes that make prostaglandins, the body's own period-pain chemicals. With fewer of them, the womb contracts less forcefully and the ache eases.
2. Release the spasm: Dicyclomine blocks the signal that tells gut muscle to stay contracted, and relaxes the muscle itself, so the cramp lets go.

One ingredient works on the pain, the other on the spasm, so together they cover both halves of the problem.

Doctors usually prescribe Meftal Spas for:

• Period pain (dysmenorrhoea), the cramping ache low in the belly before or during a period
• IUCD-related cramps, the pain and spasm some women get after an intrauterine device is fitted
• Abdominal colic, waves of cramping pain in the abdomen
• Biliary colic, pain when the bile duct goes into spasm
• Renal colic, the wave-like pain of a stone passing down the tube from the kidney to the bladder

Meftal Spas does not treat the cause of the pain. It does not kill germs, so it will not settle a stomach infection, and it does not dissolve a kidney stone.

1. Swallow the tablet whole with a full glass of water.
2. Have it with a meal or straight after food, never on an empty stomach.
3. Keep to the same times each day.
4. Do not crush, split or chew the tablet unless your doctor says it is fine.
5. Do not continue it for more than 7 days at a stretch without asking your doctor.
6. Do not share your strip with anyone else.

Your doctor decides the dose based on your age, your symptoms and how well your stomach and kidneys are working. For adults and adolescents, the usual dose is 1 to 2 tablets three times a day, taken with or after food.

For period pain, treatment usually starts when the bleeding and cramps begin, and is needed for about 3 to 5 days. Do not continue it for longer than 7 days at a time. Meftal Spas DS is usually 1 tablet three times a day.

Never increase the dose on your own. A larger dose does not ease the cramp any faster, but it does raise the chance of stomach irritation, dizziness and drowsiness.

This tablet is not for children under 14. It is meant for adults and teenagers aged 14 and over.

Taking too much can cause nausea, vomiting, stomach pain, dizziness, drowsiness, blurred vision, wide pupils and a dry mouth. A large overdose can bring stomach bleeding, fits, a fast heartbeat, or deep drowsiness that is hard to wake from.

Go straight to the nearest hospital emergency department. Carry the strip or pack with you, so the doctor can see exactly what was taken. In India, call 112 for emergency help, or 108 for an ambulance.

Take the missed dose as soon as you remember it. If your next dose is almost due, skip the missed one and carry on with your usual schedule. Never take two doses together to make up for a missed one.

This medicine is started at the first sign of bleeding or cramping, rather than once the pain has built up. If your pain is no better after a day, or is getting worse, see your doctor. Do not take extra tablets.

Keep the tablets in their original strip, tightly closed, in a cool, dry place away from heat and direct sunlight — not in the bathroom. Keep them out of reach of children, do not freeze them, and do not use them after the expiry date.

Most people take Meftal Spas for a few days without any trouble. When side effects do happen, they are usually mild and settle once the medicine is stopped.

Common and mild:

• Nausea or an unsettled stomach
• Heartburn or indigestion
• Loose motions or diarrhoea
• Constipation
• Dry mouth
• Dizziness, drowsiness or blurred vision
• Headache or ringing in the ears

Rare but serious (stop the medicine and see a doctor right away):

• Blood in your stool, black tarry stools, or vomit that looks like coffee grounds
• Sudden or lasting stomach pain, or yellowing of the eyes or skin
• Swelling of the face, lips or tongue, or trouble breathing or swallowing
• A spreading rash with fever, blisters or peeling skin
• Chest pain, breathlessness, weakness in an arm or leg, or slurred speech

Like other NSAID painkillers, mefenamic acid can raise the risk of a heart attack or stroke. Do not take it around the time of heart bypass surgery.

The dry mouth, dizziness, blurred vision and drowsiness come from dicyclomine, and are more likely at a higher dose or with other drying medicines. The stomach upset, loose motions and bleeding risk come from mefenamic acid, and are more likely if you are older, take a blood thinner, or drink alcohol.

The Indian Pharmacopoeia Commission flagged mefenamic acid in November 2023 for a rare and serious whole-body reaction called DRESS syndrome. If you get a rash with fever after starting this medicine, stop it and contact your doctor.

• Allergy to mefenamic acid, dicyclomine or any tablet ingredient
• Asthma, or a past bad reaction to aspirin or another NSAID
• An active ulcer, gut bleeding or long-term gut inflammation
• Severe ulcerative colitis, or kidney disease
• Glaucoma, myasthenia gravis (a muscle-weakness illness), or a blocked bowel or urinary tract
• From about 20 weeks of pregnancy onward, or while breastfeeding
• Heart bypass surgery, recent or planned

Tell your doctor before taking Meftal Spas if you have:

• Kidney or liver disease (both ingredients are cleared through these organs)
• Heart failure, high blood pressure, or a past heart attack or stroke (NSAIDs add to heart and blood pressure problems)
• A blocked or runny nose with small growths inside it (nasal polyps), which can travel with aspirin sensitivity
• Diabetes (mefenamic acid can affect blood sugar in some people)
• An enlarged prostate or trouble passing urine (dicyclomine can make this harder)
• Dengue fever, or any illness with bleeding gums or nosebleeds (NSAIDs raise bleeding risk)
• Pregnancy, or if you are trying for a baby (avoid it from about 20 weeks onward)
• Being 65 or over, or drinking alcohol regularly (higher risk of stomach bleeding and confusion)

This tablet only eases the symptom. See a doctor quickly if you have:

• Pain that is getting worse, or that does not settle
• A fever along with the pain
• Bleeding gums, nosebleeds, or blood in your stool or urine
• Very heavy or unusual period bleeding
• Chest pain, breathlessness, or weakness in an arm, leg or face

Meftal Spas suits short bouts of cramping pain — period cramps, or colic from the bowel, bile duct or kidney. Keep to the dose your doctor advises, and ask for a review if the pain has not settled in a few days. Dry mouth, dizziness and mild stomach upset are the usual complaints; they settle once you stop.