Mefenamic Acid-Dicyclomine

What Is Mefenamic Acid-Dicyclomine?

Mefenamic acid-dicyclomine is a fixed-dose combination tablet. It contains two medicines in one tablet:

• Mefenamic acid, a nonsteroidal anti-inflammatory drug (NSAID). It reduces pain and inflammation.
• Dicyclomine, an anticholinergic (antispasmodic) medicine. It relaxes the smooth muscle of the gut and other organs and helps ease cramping.

Availability and Regulatory Status

This combination tablet is sold in some countries. It is not an FDA-approved product in the United States. In the U.S., mefenamic acid and dicyclomine are approved and sold as separate medicines. Availability, labeling, and approved uses of the combination tablet depend on the country and the manufacturer. Always follow the product label that comes with the medicine you are prescribed.

Approved and Common Prescribed Uses

Where it is approved, this combination is generally used for:

• Cramping pain from muscle spasms, such as abdominal or stomach cramps
• Painful periods (dysmenorrhea) with cramping

For reference, the separate medicines in the U.S. are approved for these uses:

• Mefenamic acid capsules: short-term relief of mild to moderate pain and treatment of primary dysmenorrhea
• Dicyclomine: treatment of functional bowel or irritable bowel syndrome

Available Formulations and Strengths

Form	Common Strengths (mefenamic acid / dicyclomine)
Oral tablet	Mefenamic Acid-Dicyclomine 250mg-10mg

Other strengths may exist in some countries. Brand names vary by region.

What Is the Recommended Dosage of Mefenamic Acid-Dicyclomine?

There is no single dose that fits everyone. A licensed healthcare provider decides the dose and schedule based on several factors:

• The condition being treated and the severity of pain. Treatment is usually short term and taken only when needed.
• Age. The medicine is for adults and older teens when directed by a provider. It is not for young children. Dicyclomine should not be used in infants.
• Body weight. This may be considered in some cases.
• Kidney function. Mefenamic acid can harm the kidneys. The combination may not be safe in people with significant kidney disease.
• Liver function. Provider review is important for people with liver disease.
• Other medicines and health conditions. Stomach problems, heart disease, glaucoma, prostate problems, and bowel conditions all affect safety.

Dosage Forms

• Tablets taken by mouth, usually with food or milk to reduce stomach upset

Important Note

Always follow the exact directions on your prescription label and from your specialist. Do not change your dose, take it for longer than directed, or stop treatment without talking to your provider. This page does not give exact doses because they must be set for each person. Use the lowest effective dose for the shortest time needed.

How Mefenamic Acid-Dicyclomine Works

The two medicines work in different ways.

• Mefenamic acid blocks enzymes called COX-1 and COX-2, which make chemicals called prostaglandins. Prostaglandins contribute to pain, inflammation, and uterine cramping. Lowering them can ease pain.
• Dicyclomine blocks acetylcholine, a chemical messenger that tells smooth muscle to contract. Blocking it helps relax muscle in the stomach, intestines, and sometimes the uterus, which reduces spasms and cramping.

Together, the combination helps manage cramping pain while it is being used. It does not treat the cause of the pain, such as infection, bowel disease, endometriosis, or other conditions. Ongoing or severe pain should be checked by a provider. Symptoms may return when treatment is stopped.

Is a Prescription Required to Buy Mefenamic Acid-Dicyclomine Online?

Yes, in most countries where it is sold, this combination is prescription-only. Both medicines carry important risks. In the United States, the combination tablet is not an approved product, so it should not be obtained from sources that claim to ship it without proper review.

Who Should You Talk To?

• A gastroenterologist for stomach or bowel cramping
• A gynecologist or obstetrician-gynecologist (OB-GYN) for painful periods
• A primary care provider may also help with first steps

Buying Safely

• Only use pharmacies that are licensed and require a valid prescription. In the U.S., you can check a pharmacy’s status with your state board of pharmacy or look for pharmacy verification programs.
• Be careful of websites that sell this medicine without a prescription, offer unusually low prices, or ship from unclear locations. These products may be counterfeit, expired, contaminated, or the wrong strength.
• Do not use products labeled for animals (veterinary products). They are not made or tested for human use.
• Check that the label, name, strength, and tablet appearance match what your provider prescribed. Ask your pharmacist if anything looks different.

Side Effects of Mefenamic Acid-Dicyclomine

Everyone reacts differently. Many people have mild effects or none.

Common Side Effects

• Dry mouth
• Dizziness, drowsiness, or lightheadedness
• Nausea, vomiting, or upset stomach
• Stomach pain, heartburn, or indigestion
• Diarrhea or constipation
• Blurred vision
• Headache
• Tiredness or weakness
• Nervousness
• Reduced sweating

Taking the tablet with food may help with stomach side effects. Tell your provider if these are bothersome or do not go away.

Serious Side Effects

Serious problems are uncommon but possible. They include:

• Stomach or intestinal bleeding, ulcers, or holes in the stomach lining. NSAIDs like mefenamic acid carry this risk, which can occur without warning.
• Heart attack, stroke, or blood clots. NSAIDs carry this risk.
• Severe diarrhea, which is a known effect of mefenamic acid and may require stopping the medicine
• Trouble passing urine (urinary retention)
• Heat stroke or overheating from reduced sweating, especially in hot weather or with exercise
• Fast or irregular heartbeat
• Confusion, memory problems, hallucinations, or agitation, especially in older adults
• Severe constipation or blocked bowel, with belly swelling or vomiting
• Increased eye pressure or eye pain, especially in people with narrow-angle glaucoma
• Kidney problems, such as less urine, swelling, or sudden weight gain
• Liver problems, such as yellowing of the skin or eyes, dark urine, or severe tiredness
• High blood pressure or fluid retention
• Severe allergic reactions or serious skin reactions (such as rash, blisters, or peeling)
• Worsening asthma in people sensitive to NSAIDs

When to Get Medical Help Right Away

Call emergency services or go to the nearest emergency room if you have:

• Chest pain or pressure, or sudden shortness of breath
• Sudden weakness, numbness, trouble speaking, or confusion
• Vomiting blood, or material that looks like coffee grounds
• Black, tarry, or bloody stools
• Swelling of the face, lips, tongue, or throat, or trouble breathing
• A very high body temperature with hot, dry skin
• Sudden eye pain or loss of vision
• Inability to urinate
• A very fast heartbeat or fainting

Contact your provider promptly for yellow skin or eyes, severe belly pain, rash, ongoing diarrhea, trouble urinating, or confusion.

Drug Interactions

Some medicines and products can change how this combination works or raise the chance of side effects.

Major Interaction Categories

• Other anticholinergic medicines, including some antihistamines (such as diphenhydramine), tricyclic antidepressants, some antipsychotics, bladder medicines, and some Parkinson’s disease medicines. These can add to dry mouth, constipation, confusion, and urinary problems.
• Other NSAIDs and aspirin (such as ibuprofen, naproxen, diclofenac). Taking more than one NSAID raises the risk of stomach bleeding and kidney problems.
• Blood thinners (such as warfarin, heparin, apixaban, rivaroxaban). NSAIDs raise bleeding risk.
• Blood pressure medicines, including ACE inhibitors, ARBs, and diuretics. NSAIDs can weaken their effect and may strain the kidneys.
• Lithium and methotrexate. NSAIDs can raise their levels and increase side effects.
• Corticosteroids and some antidepressants (SSRIs and SNRIs). These may increase the chance of stomach bleeding when used with NSAIDs.
• Antacids. They may reduce how well dicyclomine is absorbed. Ask your pharmacist about timing.
• Medicines that slow stomach emptying or affect gut movement, such as opioid pain medicines, and medicines that speed gut movement, such as metoclopramide. Dicyclomine may reduce the effect of the latter.
• Digoxin and certain slow-release products. Dicyclomine can change how much of these is absorbed.
• Cyclosporine and other medicines that affect the kidneys.

Over-the-Counter (OTC) Medicines

Do not take extra NSAID pain relievers (such as ibuprofen, naproxen, or aspirin) unless your provider says it is safe. Tell your provider about allergy, cold, flu, and sleep products, since many contain antihistamines or pain relievers.

Supplements and Herbal Products

• Supplements that may affect bleeding, such as high-dose fish oil, ginkgo, garlic, and ginger, may add to bleeding risk.
• Herbal products with calming or sedating effects may add to drowsiness.
• Do not start or stop any supplement without checking with your provider or pharmacist.

What You Should Do

Give your licensed healthcare provider and pharmacist a full, up-to-date list of everything you take: prescriptions, OTC medicines, vitamins, supplements, and herbal products. Keep this list current and carry a copy.

Safety & Important Considerations

Important Safety Warnings

• NSAID boxed warning (mefenamic acid). NSAIDs carry an FDA boxed warning for a higher risk of serious heart and blood vessel problems, including heart attack and stroke, and for serious stomach and intestinal bleeding, ulcers, and perforation. These risks can happen at any time, may increase with longer use, and are higher in older adults and in people with a history of stomach ulcers or heart disease.
• Anticholinergic effects (dicyclomine). These can cause drowsiness, dizziness, blurred vision, and confusion. Use caution when driving or doing tasks that need alertness.
• Not for use before heart bypass surgery or right after it (NSAID warning).

Liver and Kidney

• Mefenamic acid and other NSAIDs can harm the kidneys. People with advanced kidney disease should generally not use the combination.
• Liver function should be reviewed in people with liver disease.

Pregnancy and Breastfeeding

• This medicine is not meant for use during pregnancy. NSAIDs can harm an unborn baby, especially in the second half of pregnancy, and can cause low amniotic fluid and kidney problems in the baby. They should be avoided from about 20 weeks of pregnancy unless a provider directs otherwise, and should not be used in the last 3 months of pregnancy.
• Dicyclomine may pass into breast milk and is not recommended during breastfeeding by its U.S. label. It may also reduce milk supply. Talk with your provider before using this medicine while breastfeeding.
• NSAIDs may make it harder for some people to become pregnant. Tell your provider if you are trying to conceive.

Age Considerations

• Children: Not recommended for young children. Dicyclomine should not be used in infants under 6 months.
• Older adults: Higher risk of stomach bleeding, kidney problems, confusion, constipation, urinary problems, and falls. Use should be reviewed carefully.

Monitoring

Your provider may recommend:

• Evaluation of the cause of ongoing belly pain or period pain
• Kidney and liver function tests for some patients
• Blood counts if there are signs of bleeding
• Blood pressure checks
• Eye pressure checks if you have glaucoma risk
• Tracking of pain, bowel habits, urination, and side effects

Other Points to Know

• Take with food or milk to protect the stomach.
• Avoid alcohol, since it raises the risk of stomach bleeding with NSAIDs and can add to drowsiness.
• Stay hydrated and avoid getting overheated, since dicyclomine can reduce sweating.
• Do not drive or use machinery until you know how this medicine affects you.
• Tell your provider before surgery or dental procedures.
• Seek care if belly pain is severe, comes with fever, vomiting, or blood in the stool, or does not improve.

Who This Medication Is For

This combination is for people whose healthcare providers decide it fits their needs. Typical patients include:

• Adults with cramping abdominal pain caused by muscle spasm, after a provider has checked for other causes
• People with painful periods that include cramping
• People who need short-term treatment and do not have conditions that make NSAIDs or anticholinergic medicines unsafe

Only a licensed healthcare provider can decide whether it is right for you.

Who Should Not Take Mefenamic Acid-Dicyclomine

Do not use this medicine if you:

• Are pregnant or think you may be pregnant
• Are breastfeeding
• Have active stomach or intestinal ulcers or bleeding, or a history of bleeding related to NSAIDs
• Have advanced kidney disease or severe liver disease
• Have severe heart failure
• Have a history of asthma, hives, or allergic reactions after taking aspirin or other NSAIDs
• Will have or recently had heart bypass surgery (CABG)
• Have glaucoma (especially narrow-angle)
• Have trouble passing urine from an enlarged prostate or other blockage
• Have a blocked or obstructed bowel, or severe ulcerative colitis, or paralytic ileus
• Have myasthenia gravis
• Have severe reflux disease (reflux esophagitis), if your label advises against use
• Have unstable heart conditions, such as a rapid heart rate from heart failure or acute bleeding
• Are giving it to an infant
• Are allergic to mefenamic acid, dicyclomine, or any ingredient in the tablet

Precautions

Use extra care and talk with your provider if you have:

• High blood pressure or heart disease
• A history of stomach problems, such as ulcers or reflux
• Kidney or liver problems
• An overactive thyroid
• Autonomic nerve problems or a fast heart rate
• A history of confusion or dementia
• Hiatal hernia
• Asthma
• A habit of drinking alcohol
• Plans to become pregnant
• Exposure to hot weather or strenuous activity

What to Do If You Miss a Dose

• Take the missed tablet as soon as you remember, with food.
• If it is almost time for your next dose, skip the missed one and go back to your normal schedule.
• Do not take two doses at once to make up for a missed dose.
• This medicine is often used only when needed for pain. If you are using it on a schedule and miss several doses, or you are unsure what to do, contact your licensed healthcare provider or pharmacist.
• Do not take extra tablets if pain continues. Call your provider instead.

When in doubt, call your specialist or pharmacist.

Related medications to Mefenamic Acid-Dicyclomine

Other treatments may be used for cramping pain and painful periods. Which one fits depends on the cause, your health history, and your goals.

• NSAIDs alone, such as mefenamic acid, ibuprofen, or naproxen, for period pain or general pain
• Dicyclomine alone, or other antispasmodics such as hyoscyamine, which are used for irritable bowel syndrome
• Other medicines for irritable bowel syndrome, depending on symptoms (such as fiber, peppermint oil, or other prescription options chosen by a specialist)
• Hormonal treatments, such as combined birth control pills, progestin-only medicines, or a levonorgestrel intrauterine device (IUD), for painful periods
• Non-medicine approaches, such as heat therapy, exercise, dietary changes, and stress management

Each option has its own benefits and risks. Do not switch, stop, or combine treatments on your own. Talk with a licensed specialist before making any change.

Storage Instructions

• Store at room temperature, generally 68°F to 77°F (20°C to 25°C), unless the label says otherwise. Some products allow storage up to 86°F (30°C), so follow your product label.
• Keep the tablets in the original blister pack or container.
• Protect from moisture and heat. Do not store them in a bathroom.
• Protect from light. Keep the container in a dry place away from direct sunlight.
• Check the expiration date. Do not use tablets that are expired, discolored, or damaged.
• Keep out of the sight and reach of children and pets. Consider a locked cabinet or storage box.
• Ask your pharmacist about safe disposal of unused or expired medicine.

Disclaimer:

This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Patients must consult a licensed gastroenterologist, gynecologist, or other relevant licensed medical specialist (depending on the reason for use) before starting, changing, or stopping treatment. Treatment decisions must be based on a full clinical evaluation by a qualified specialist. Always follow the prescribing information and the instructions from your healthcare provider and pharmacist. If you think you are having a medical emergency, call your local emergency number immediately.