Drugs List

Therapeutic Indications

Uses

Gastro-intestinal spasm
Irritable bowel syndrome

Contraindications

Children under 15 years

Precautions and Warnings

Children aged 15 to 18 years
Gastroesophageal reflux
Hereditary fructose intolerance
Pregnancy

Not all available brands are licensed for all age groups
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some products contain arachis (peanut) oil, soya or soya derivative
Indigestion remedies should not be taken at the same time
May aggravate gastro-oesophageal reflux
Concurrent alcohol may rarely precipitate allergic side effects
Advise IBS patients to consult Dr if symptoms continue for more than 2weeks
Advise patients with IBS to consult a doctor if pattern of symptoms changes

Pregnancy and Lactation

Pregnancy

Use with caution in pregnancy.

Manufacturers advise against use. Briggs advises that recommended doses of oral products should not be a concern due to the long standing use of ingested peppermint. However, large doses should be avoided due to a risk of possible emmenagogue and abortifacient effects.

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

Use with caution in breastfeeding.

Manufacturers advise against use. Briggs advises that recommended doses of oral products should not be a concern due to the long standing use of ingested peppermint.

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

Ataxia
Bradycardia
Burning sensation (local)
Dyspepsia
Erythematous rash
Gastroesophageal reflux
Headache
Heartburn
Hypersensitivity reactions
Nausea
Perianal irritation
Tremor
Vomiting

Presentation

Capsules containing peppermint oil

Drugs List

Therapeutic Indications

Uses

Gastro-intestinal spasm
Irritable bowel syndrome

Dosage

Adults

Elderly

Children

Contraindications

Children under 15 years

Precautions and Warnings

Children aged 15 to 18 years
Gastroesophageal reflux
Hereditary fructose intolerance
Pregnancy

Not all available brands are licensed for all age groups
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some products contain arachis (peanut) oil, soya or soya derivative
Indigestion remedies should not be taken at the same time
May aggravate gastro-oesophageal reflux
Concurrent alcohol may rarely precipitate allergic side effects
Advise IBS patients to consult Dr if symptoms continue for more than 2weeks
Advise patients with IBS to consult a doctor if pattern of symptoms changes

Pregnancy and Lactation

Pregnancy

Use with caution in pregnancy.

Manufacturers advise against use. Briggs advises that recommended doses of oral products should not be a concern due to the long standing use of ingested peppermint. However, large doses should be avoided due to a risk of possible emmenagogue and abortifacient effects.

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

Use with caution in breastfeeding.

Manufacturers advise against use. Briggs advises that recommended doses of oral products should not be a concern due to the long standing use of ingested peppermint.

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

Ataxia
Bradycardia
Burning sensation (local)
Dyspepsia
Erythematous rash
Gastroesophageal reflux
Headache
Heartburn
Hypersensitivity reactions
Nausea
Perianal irritation
Tremor
Vomiting

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: October 2015

Reference Sources

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

Joint Formulary Committee. British National Formulary(online) London: BMJ Group and Pharmaceutical Press [Accessed on 19 October 2015]

Summary of Product Characteristics: Colpermin IBS Relief capsules. McNeil products Ltd. Revised June 2015.

Summary of Product Characteristics: Mintec. Almirall Limited. Revised July 2014.