The relief of smooth muscle spasm, in conditions such as irritable bowel syndrome, painful diverticular disease of the colon and primary dysmenorrhoea.

Posology:

Adults and the elderly:

1 or 2 capsules one to three times daily.

Children below the age of 12 years:

not recommended.

Method of administration

For oral use.

- Paralytic ileus

- Intestinal obstruction.

- Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

Additional warnings to be included in the Patient Information Leaflet:

If this is the first time you have had these symptoms, consult your doctor before using any treatment.

If any of the following apply do not use this medicinal product; it may not be the right treatment for you. See your doctor as soon as possible if:

- you are aged 40 years or over

- you have passed blood from the bowel

- you are feeling sick or vomiting

- you have lost your appetite or lost weight

- you are looking pale and feeling tired

- you are suffering from severe constipation

- you have a fever

- you have recently travelled abroad

- you are or may be pregnant

- you have abnormal vaginal bleeding or discharge

- you have difficulty or pain passing urine.

Consult your doctor if you have developed new symptoms, or if your symptoms worsen, or if they do not improve after 2 weeks treatment.

None stated.

Although no teratogenic effects have been reported, use during pregnancy or lactation is not recommended as evidence of safety in preclinical studies is limited.

May cause dizziness. Do not drive or use machinery if affected.

Within the system organ classes, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories:

Very common (≥1/10); Common (≥1/100 to <1/10); Uncommon (≥1/1,000 to <1/100); Rare (≥1/10,000 to <1/1,000); Very rare (<1/10,000); Not known (cannot be estimated from the available data)

The following undesirable effects were observed:

Immune system disorders:

Not known: anaphylaxis, allergic reaction

Nervous system disorders:

Not known: dizziness, headache

Respiratory, thoracic and mediastinal disorders

Not known: dyspnoea and/or wheezing

Gastrointestinal disorders:

Not known: nausea

Hepatobiliary disorders:

Not known: jaundice due to hepatitis (typically resolves on cessation of alverine), liver function test abnormal

Skin and subcutaneous tissue disorders:

Not known: rash, itching

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme website www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Symptoms:

Can produce hypotension and atropine-like toxic effects such as dizziness, tachycardia, mydriasis, blurred vision, dry mouth and throat, dyspnoea or dysuria.

Management:

Management is as for atropine poisoning with supportive therapy for hypotension.

Fatality has occurred following overdose with very high doses.

Pharmacotherapeutic group: Other drugs for functional gastrointestinal disorders, ATC code: A03AX08

Alverine citrate is an antispasmodic with a direct action on smooth muscle.

Alverine citrate is a spasmolytic, which has a specific action on the smooth muscle of the alimentary tract and uterus, without affecting the heart, blood vessels and tracheal muscle at therapeutic doses.

After oral administration, alverine is rapidly converted to its primary active metabolite, which is then further converted to two secondary metabolites. There is a high renal clearance of all metabolites indicating that they are eliminated by active renal secretion. The peak plasma level of the most active metabolite occurs between 1 and 1½ hours after oral dosing.

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

Although preclinical data are limited, those available indicate that alverine citrate has no significant potential for toxicity at the proposed dose level

Alverine citrate acts selectively on gut and uterine muscle, only affecting the heart, blood vessels and tracheal muscle at considerably higher doses.

Starch (maize) pregelatinised

Magnesium stearate (E572)

Capsule shell

Gelatin

Titanium dioxide (E171)

Not applicable.

3 years.

This medicinal product does not require any special storage conditions.

Blister packs consisting of PVC/Aluminium.

Pack sizes of 3, 10, 12, 20, 30, 60, 90 or 100 white hard capsules.

Not all pack sizes may be marketed.

No special requirements.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.