Drugs List

Therapeutic Indications

Uses

Diverticulitis
Dysmenorrhoea (primary)
Irritable bowel syndrome

Contraindications

Children under 12 years
Breastfeeding
Gastrointestinal obstruction
Paralytic ileus
Pregnancy

Precautions and Warnings

Advise patient dizziness may affect ability to drive or operate machinery
Some formulations contain propylene glycol
Advise patient to see doctor if new or worsening symptoms develop
Refer to doctor if symptoms persist after 2 weeks treatment

Pregnancy and Lactation

Pregnancy

Alverine citrate is contraindicated in pregnancy.

At the time of writing there is limited published information regarding the use of alverine citrate during pregnancy. No teratogenic effects have been reported.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Alverine citrate is contraindicated in breastfeeding.

At the time of writing there is limited published information regarding the use of alverine citrate during breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abnormal liver function
Allergic reaction
Anaphylaxis
Dizziness
Dyspnoea
Headache
Hepatitis
Itching
Jaundice
Nausea
Rash
Wheezing

Presentation

Oral formulations of alverine citrate

Drugs List

Therapeutic Indications

Uses

Diverticulitis
Dysmenorrhoea (primary)
Irritable bowel syndrome

Dosage

Adults

Elderly

Children

Contraindications

Children under 12 years
Breastfeeding
Gastrointestinal obstruction
Paralytic ileus
Pregnancy

Precautions and Warnings

Advise patient dizziness may affect ability to drive or operate machinery
Some formulations contain propylene glycol
Advise patient to see doctor if new or worsening symptoms develop
Refer to doctor if symptoms persist after 2 weeks treatment

Pregnancy and Lactation

Pregnancy

Alverine citrate is contraindicated in pregnancy.

At the time of writing there is limited published information regarding the use of alverine citrate during pregnancy. No teratogenic effects have been reported.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Alverine citrate is contraindicated in breastfeeding.

At the time of writing there is limited published information regarding the use of alverine citrate during breastfeeding.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Counselling

Advise patients with the following conditions to seek medical advice before self medicating:
Aged 40 years or over
Passing blood from the bowel
Nauseous or vomiting
Loss of appetite or weight loss
Severe constipation
Feverish
Pale and tired
Recently travelled abroad
Pregnant or may be pregnant
Abnormal vaginal bleeding or discharge
Difficulty or pain passing urine

Side Effects

Abnormal liver function
Allergic reaction
Anaphylaxis
Dizziness
Dyspnoea
Headache
Hepatitis
Itching
Jaundice
Nausea
Rash
Wheezing

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: September 2016

Reference Sources

Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. Accessed on 22 September 2016.

Paediatric Formulary Committee. BNF for Children (online) London: BMJ Group, Pharmaceutical Press, and RCPCH Publications. Accessed on 22 September 2016.

Summary of Product Characteristics: Alverine Citrate 60 mg hard capsules. Dr. Reddy's Laboratories (UK) Ltd. Revised September 2014.

Summary of Product Characteristics: Audmonal 60 mg capsules. Auden Mckenzie (Pharma Division) Ltd. Revised June 2016.

Summary of Product Characteristics: Audmonal Forte 120 mg capsules. Auden Mckenzie (Pharma Division) Ltd. Revised June 2016.

Summary of Product Characteristics: Gielism 60 mg hard capsules. Laboratories Mayoly Spindler. Revised February 2015.

Summary of Product Characteristics: Spasmonal 60 mg capsules. Meda Pharmaceuticals Ltd. Revised September 2014.

Summary of Product Characteristics: Spasmonal Forte 120 mg hard capsules. Meda Pharmaceuticals Ltd. Revised September 2014.