Irritable bowel syndrome (IBS)
Gastrointestinal smooth muscle spasm
Older patients are particularly susceptible to the antimuscarinic effects of antispasmodics.
Mebeverine
Mebeverine 135mg tablets
Hyoscine butylbromide
Hyoscine butylbromide 10mg tablets
Hyoscine butylbromide 20mg/1ml solution for injection ampoules
Peppermint oil capsules should be reserved for patients presenting with symptoms of bloating.
Peppermint
Peppermint oil 0.2ml gastro-resistant capsules
Prescribing Notes:
- Antispasmodics are of limited benefit but are occasionally used for acute exacerbations of irritable bowel syndrome. They should be used in conjunction with other measures such as reassurance, diet, fluid intake, exercise, bulking agents and lifestyle modifications.
- Antimuscarinics relax the oesophageal sphincter and should be used with caution in patients with symptoms of reflux.
- Peppermint oil capsules should not be chewed as they can cause irritation to mouth and/or oesophagus, causing symptoms of heartburn.
History Notes
15/04/2026
Regional formulary chapter launched.
Abdominal pain associated with irritable bowel syndrome
Amitriptyline
Amitriptyline 10mg tablets
Nortriptyline
Nortriptyline 10mg tablets
Nortriptyline 25mg tablets
History Notes
15/04/2026
Regional formulary chapter launched.
Pharmacy First – Gastrointestinal smooth muscle spasm
Hyoscine butylbromide
Hyoscine butylbromide 10mg tablets
History Notes
15/04/2026
Regional formulary chapter launched.
Pharmacy First – Irritable bowel syndrome
Mebeverine
Mebeverine 135mg tablets
History Notes
15/04/2026
Regional formulary chapter launched.