Over the counter IBS treatment: Buscopan vs mebeverine
Drug reviews

Buscopan vs Mebeverine | OTC IBS treatment

Buscopan and mebeverine are two common drugs used for symptomatic treatment of irritable bowel syndrome (IBS). Both drugs can be prescribed by a doctor or purchased over the counter from pharmacies and in case of Bucopa IBS relief from supermarkets. Buscopan vs Mebeverine lists similarities and differences between both drugs. I will review their role in the management of IBS in accordance with the treatment guidelines on irritable bowel syndrome. You may find a related post also helpful – 14 best IBS medication available over the counter. In this post I will  discuss the following:

  • Mechanism of action and symptoms control
  • Buscopan vs Mebeverine: where to buy it from? over the counter availability (OTC)
  • Age restrictions on the use of both drugs
  • Which drug is more popular? The number of prescriptions issued in the NHS.
  • Buscopan vs Mebeverine: common side effects
  • Alternative options for IBS

What is IBS? (video)


 

Buscopan vs Mebeverine: mechanism of action and symptoms control

Although used in the symptomatic treatment of the same condition, Buscopan and mebeverine are not the same drugs.

  • Buscopan is a brand name for a drug called hyoscine butylbromide. Over the counter, Buscopan is sold as Buscopan Cramps and Buscopan IBS Relief (same drug, different names and availability).
  • Mebeverine, on the other hand, is a generic name of the drug, which is also known as Colofac (brand name).

Both products contain the same active ingredients regardless of whether they are prescribed or purchased over the counter:

  • Each Buscopan tablets contains 10mg of hyoscine butylbromide.
  • Each Colofac or mebeverine tablet contains 135mg of mebeverine hydrochloride.

Symptoms control (mechanism of action)

Irritable bowel syndrome (IBS) has a range of side effects including:

  • stomach cramps,
  • stomach pain,
  • bloating and
  • changes in bowel habit including diarrhoea or constipation.

Buscopan works by relieving spasms of the smooth muscle which forms part of the gastrointestinal (GI), biliary and genitourinary tracks. Smooth muscle relaxation ‘counteracts’ some of the symptoms experienced by IBS patients. Hyoscine belongs to a group of drugs called anticholinergics.

Mebeverine exercises the same effect on the smooth muscle of the GI tract. Mebeverine belongs to a group of drugs called antispasmodics, which relax the smooth muscle.

Antispasmodics drugs should theoretically improve the symptoms of IBS by reducing muscle contractions and spasm (Chang, 2014).

Although both drugs exhibit the same end effect, at a cellular level, their mechanism of action is different.

Buscopan vs Mebeverine over the counter availability and age restrictions

The table below summarises over the counter availability of both drugs and age restrictions associated with each brand. Pharmacy-only medicines can only be purchased from the pharmacy counters, including online chemist. General sale medicines (GSL) can be sold in any retail outlets, commonly sold in supermarkets (e.g. Tesco) and off the shelf from pharmacies (available for self-selection by patients)

Brand name

Colofac IBS

Buscopan Cramps

Buscopan IBS Relief

Active drugMebeverine hydrochlorideHyoscine butylbromideHyoscine butylbromide
AvailabilityPharmacy-onlyPharmacy-onlyGSL item
Age restrictionsAdults 18 years of age and overAdults and children over 6 years of ageAdults and children over 12 years of age

 GSL item: available from shops, supermarket and pharmacies

From the above table, it can be deduced that mebeverine (Colofac IBS) is only available from behind the pharmacy counter.

In contrast, whereas Buscopan can be purchased both from a pharmacy counter and other shops. 

Buscopan IBS Relief vs Buscopan Cramps: what is the difference?

Both products contain the same drug – hyoscine butylbromide. The only difference comes in licensing of both products, which are reflected, for example by the broader availability of Buscopan IBS Relief and more stringent age restrictions for the product.

Can you buy Buscopan over the counter?

Buscopan IBS relief can be purchased off the shelf in any retail, outlets, and online (see the link below), whereas Buscopan Crams only from a pharmacy counter.

Sale
Buscopan IBS Relief, Pack of 40 Tablets
2,984 Reviews
Buscopan IBS Relief, Pack of 40 Tablets
  • Buscopan IBS Relief effectively relieves cramping abdominal pain and discomfort associated with IBS
  • Different from analgesics, it is specifically designed to target the source of pain and cramps
  • The active ingredient, hyoscine butylbromide works by relaxing the smooth muscle in the bowel and thus relieving the cramp that causes the pain

The cheapest treatment option

Although both Buscopan and mebeverine are available over the counter and sometimes recommended by a GPs to purchase, the patient may be better off if a larger quantity of the drug is prescribed. Both drugs come in larger, prescription-only packs, which can provide for up to a month of treatment. Over the counter, hyoscine butylbromide and mebeverine will provide only for a few days of treatment only.

Patients who experience symptoms of IBS should not take over the counter Buscopan or mebeverine ongoingly without speaking to their GP.

Which drug is more commonly prescribed in the treatment of IBS?

In NHS, mebeverine is more commonly prescribed than hyoscine butylbromide (Buscopan) – last 12 months 1.99 mln prescriptions were issued for mebeverine, whereas hyoscine butylbromide was prescribed 1.55 mln times (OpenPrescribing.net, 2020).

The above prescribing data reflect the guidelines on the management of IBS as detailed in the next paragraph.

Ongoing treatment of irritable bowel syndrome

Drug treatment can be considered on a trial basis alongside dietary and lifestyle adjustments, such as eating regular, healthy and well-balanced meals. Symptoms of diarrhoea and constipation can be managed with different drugs which are not reviewed in this post.

Healthy diet plays important role in the management of IBS symptoms

Antispasmodic drugs such as mebeverine can be considered in the management of IBS when ongoing symptoms of abdominal pain or spasm are present. Mebeverine is the preferred drug of choice over antimuscarinic drugs such as hyoscine butylbromide (Buscopan), as it is less likely to cause side effects (BNF, 2017).

When recommending treatment, NICE looks at existing evidence from clinical trials to support prescribing decision making. Small studies suggest that antispasmodics (mebeverine) may help with IBS symptoms such as pain and bloating.

Several studies found hyoscine butylbromide effective and beneficial in the abdominal pain caused by cramping, making it a valuable treatment of IBS (Tytgat, 2007).

Buscopan vs Mebeverine: possible side effects

Both drugs are generally well tolerated with no common side effects listed for either of them.

  • Uncommonly (less than 1 in 100 people) Buscopan may cause dry mouth, abnormal or reduced sweating.  
  • Mebeverine can cause skin rashes (red & itchy), and less likely severe allergic reaction which is characterised by difficulty in breathing, swelling on face, tongue, or throat.

Can you take Buscopan and mebeverine together?

Although no specific interactions between both drugs exist, generally speaking, it is not recommended to take medications which have similar mechanisms of action.

Conclusion

Buscopan (hyoscine butylbromide) and Colofac IBS (mebeverine hydrochloride) are products which can be purchased over the counter for the management of IBS symptoms. Although both products have a similar effect in controlling IBS symptoms, the active ingredients found in Buscopan and Colofac are different.

In the UK, the guidelines on the management of IBS inclines towards mebeverine as a first choice in IBS treatment; however, patients may need to trial both drugs to see if control of symptoms is improved. Patients need to remember about the importance of contacting their GP if symptoms are persistent, and the previous diagnosis of the condition was made by a doctor.     

FAQ

Is Buscopan the same as Mebeverine?

Although both drugs can be used in the symptomatic management of IBS, Buscopan and Mebeverine are not the same. Buscopan is a brand name for a drug called hyoscine butylbromide, whereas Mebeverine is a generic name of a drug, also known as Colofac. Both drugs produce a similar effect in the management of IBS.

Can Mebeverine make IBS worse?

Mebeverine is generally well tolerated with no common side effects listed. Product information does not indicate that mebeverine can make IBS worse.

What is the difference between Buscopan and Colofac?

Buscopan and Colofac are brand names of generic drugs used in the treatment of IBS. Buscopan contains hyoscine butylbromide whereas Colofac contains mebeverine hydrochloride as an active ingredient.

References

BNF 73 (2017) British National Formulary. 73rd edn. London: British Medical Association and Royal Pharmaceutical Society. Irritable bowel syndrome: Antispasmodic drugs. Available at: https://cks.nice.org.uk/topics/irritable-bowel-syndrome/prescribing-information/antispasmodic-drugs/ Accessed on 29/09/2020

Chang, L., Lembo, A. and Sultan, S. (2014) American Gastroenterological Association Institute Technical Review on the pharmacological management of irritable bowel syndrome. Gastroenterology 147(5), 1149-1172. Available at: https://doi.org/10.1053/j.gastro.2014.09.002 Accessed on 29/09/2020

OpenPrescribing.net, EBM DataLab, University of Oxford, 2017. Search GP prescribing data. Available at: https://openprescribing.net/analyse/ Accessed on 29/09/2020

Tytgat, G.N. Hyoscine Butylbromide. Drugs 67, 1343–1357 (2007). Available at: https://doi.org/10.2165/00003495-200767090-00007 Accessed on 29/09/2020

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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