Spasmomen

Indications

• Irritable bowel syndrome
• Functional gastrointestinal disorders
• Abdominal pain associated with spastic conditions

Dosage

Children: Refer to the BNF for Children for appropriate dosing information for paediatric patients.

Adults: Refer to the BNF for appropriate dosing information, as specific doses vary based on the condition being treated.

Mechanism of action

Otilium bromide works by selectively blocking M1 muscarinic receptors in the smooth muscle of the gastrointestinal tract. This blockade leads to a reduction in the contractility of smooth muscle, thereby decreasing spasms and associated pain. The drug also has a mild local anesthetic effect, which may contribute to its efficacy in treating abdominal discomfort.

Pharmacodynamics

The antispasmodic effects of otilium bromide manifest through its action on muscarinic receptors, which are part of the parasympathetic nervous system. By inhibiting these receptors, otilium reduces the activity of the smooth muscle, leading to relaxation and relief from spasm-induced pain. This mechanism is particularly relevant in conditions like irritable bowel syndrome, where abnormal contractions can lead to significant discomfort.

Pharmacokinetics

Otilium bromide is absorbed relatively quickly following oral administration, with peak plasma concentrations typically occurring within 1 to 2 hours. The drug undergoes hepatic metabolism and is eliminated primarily via the kidneys. Its half-life ranges from 4 to 6 hours, allowing for dosing that can effectively manage symptoms without excessive accumulation in the body.

Contra-indications

• Hypersensitivity to otilonium bromide or any of its components
• Severe ulcerative colitis
• Acute glomerulonephritis
• Myasthenia gravis

Adverse effects

• Dry mouth
• Constipation
• Nausea
• Dizziness
• Headache
• Skin rash

Interactions

• May enhance the effects of other anticholinergic drugs
• Caution with concomitant use of drugs that affect gastrointestinal motility

Precautions

• Use with caution in patients with a history of urinary retention
• Caution in the elderly due to the increased risk of anticholinergic effects
• Monitor for signs of dehydration in patients with significant gastrointestinal disturbances

Pregnancy

Otilium should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult healthcare professionals for advice.

Breast-feeding

It is not known whether otilium is excreted in human milk. Caution should be exercised when administering to breastfeeding women.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Otilonium bromide 40 mg film-coated tablets
• Otilonium bromide 20 mg oral solution

Indications

• Irritable bowel syndrome
• Functional gastrointestinal disorders
• Abdominal pain related to gastrointestinal spasm

Dosage

Children: Refer to the BNF for Children for appropriate dosing information for pediatric patients.

Adults: The usual adult dose is 40 mg taken three times daily, with an increased dose of 80 mg three times daily in more severe cases, as directed by a healthcare professional.

Mechanism of action

Otilonium acts as a selective antagonist of the muscarinic acetylcholine receptors in the gastrointestinal tract. By blocking these receptors, it reduces the influx of calcium ions into smooth muscle cells, leading to relaxation of the muscles and a decrease in spasmodic activity.

Pharmacodynamics

The drug exhibits antispasmodic effects through its action on the muscarinic receptors, particularly M3, which are primarily involved in smooth muscle contraction. Otilonium's anticholinergic properties help to decrease gastrointestinal motility and relieve pain associated with spasms.

Pharmacokinetics

Otilonium is poorly absorbed from the gastrointestinal tract, resulting in minimal systemic levels. Its effects are localized primarily within the bowel. The drug undergoes hepatic metabolism and is excreted predominantly in the feces. The half-life of otilonium is not well characterized due to its limited absorption.

Pregnancy

There is insufficient data on the safety of otilonium during pregnancy. It should only be used if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Otilonium is not recommended during breastfeeding due to lack of data on excretion in human milk.

Storage

Store in a cool, dry place, away from light. Keep out of reach of children.