indication

Used to relieve cramps or spasms of the stomach and intestines. It is also useful in treating irritable bowel syndrome (IBS) and similar conditions. It can also be used to help relieve period pain. Alverine citrate is also under investigation to increase the cytotoxic effects of the proteasome inhibitor MG132 on breast cancer cells.

pharmacology

Alverine is a smooth muscle relaxant. Smooth muscle is a type of muscle that is not under voluntary control; it is the muscle present in places such as the gut and uterus. Alverine acts directly on the muscle in the gut, causing it to relax. This prevents the muscle spasms which occur in the gut in conditions such as irritable bowel syndrome and diverticular disease. Diverticular disease is a condition in which small pouches form in the gut lining. These pouches can trap particles of food and become inflamed and painful. In irritable bowel syndrome the normal activity of the gut muscle is lost. The muscle spasms result in symptoms such as heartburn, abdominal pain and bloating, constipation or diarrhoea. By relaxing the gut muscle, alverine citrate relieves the symptoms of this condition. Alverine also relaxes the smooth muscle in the womb (uterus). It is therefore also used to treat painful menstruation, which is caused by muscle spasms in the uterus (dysmenorrhea).

toxicity

Can produce hypotension and atropine-like toxic effects. Fatality has occurred following overdose with very high doses.

biotransformation

Rapidly converted to its primary active metabolite, which is then further converted to two secondary metabolites.

half life

The plasma half-life averages 0.8 hours for alverine and 5.7 hours for the active primary metabolite.

route of elimination

High renal clearance of all metabolites indicating that they are eliminated by active renal secretion.

drug interactions

Donepezil: Possible antagonism of action

Galantamine: Possible antagonism of action