1.2. Antispasmodics and other drugs altering gut motility
Other than in the early phase of irritable bowel disease, the place in therapy of antispasmodics is questionable. Reassurance, diet, fluids, exercise, bulking agents and lifestyle modifications achieve best resultsPrescribing Notes:
In April 2014, following a Europe-wide review, the MHRA issued advice to healthcare professionals relating to the use of domperidone, restricting its use to relief or nausea and vomiting, advising that it should be used at the lowest effective dose for the shortest possible time, and highlighting changes to the contraindications, dosing and duration of treatment of the medicine.
Domperidone is no longer licensed in patients weighing less than 35 kg because of a lack of evidence for benefit.
The full advice from the MHRA and details of the 2019 post-publication note can be accessed here.
Restrictions:
Excludes modified-release preparations
Prescribing Notes:
Where possible, the tablets should be used as the oral suspension is significantly more expensive
Restrictions:
Restricted to initiation by, or on advice of, a specialist.
Prescribing Notes:
Hyoscine butylbromide injection can cause serious adverse effects including tachycardia, hypotension, and anaphylaxis
These adverse effects can result in a fatal outcome in patients with underlying cardiac disease, such as those with heart failure, coronary heart disease, cardiac arrhythmia, or hypertension
Hyoscine butylbromide injection should be used with caution in patients with cardiac disease.
For the full MHRA review details (February 2017) please click here