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Meftal, a painkiller, popularly used to treat menstrual cramps, has come under the radar of the Indian Pharmacopoeia Commission (IPC), with the body recently issuing a drug safety alert advising healthcare professionals and patients to watch for adverse reactions caused by the drug.
Does this mean you have to stop taking the drug? What are some symptoms of adverse effects to watch out for?
FIT spoke to experts to break it down.
What's driving the news: The IPC – an autonomous arm of the Ministry of Health and Family Welfare, set up to keep a check on the standard of drugs manufactured and sold in India – in its alert, issued on 30 November, said that a preliminary analysis for adverse reactions at the Pharmacovigilance Programme of India (PvPI) database linked the drug to eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome.
The IPC, in their alert, has said, in case of an adverse reaction, people should immediately report to the national coordination centre of the PvPI by filing a form on their website, or through their Helpline number: 1800-180-3024.
It must be noted that adverse reactions like DRESS syndrome are rare complications that can occur with nearly all clinically approved drugs, and does not mean the drug is not safe to use.
In a recent statement, Blue Cross Laboratories, the parent company that manufactures Meftal, said that the "safety, efficacy and high quality of the brands are established and supported by clinical studies and real-world evidence."
Meftal Spas, Its Uses, and Misuses
Meftal comes in two forms. Meftal (salt) – a non-steroid anti-inflammatory drug (NSAID) – is used for any inflammatory pain, joint pain, headache or injury-related pain.
Meftal Spas, on the other hand, is the brand name for a combination drug composed of an anti-inflammatory and an antispasmodic (mefenamic acid and dicyclomine), and is prescribed for any spasmodic pain, including menstrual cramps, abdominal pain linked to intestines, stomach and even urinary tract.
According to Dr Dhruv Bibra, Pain Management specialist at Delhi Pain Management Centre, as an NSAID, Meftal is useful in treating mild to moderate pain, given it is taken as prescribed.
However, like other NSAIDs, in India, Meftal is widely available over the counter, without a prescription. Which means, it's often taken without medical supervision.
"This is unfortunate," says Dr Bibra, adding, "Even if it is prescribed, people often go beyond the prescription."
"These are drugs that do have side effects so our long-term unsupervised use can cause them to flare up later."Dr Dhruv Bibra, Pain Management specialist
Speaking of these side effects, Dr Sonali Gupta, the HOD of Obstetrics and Gynaecology at Greater Noida's Fortis Hospital says, "If you're taking it without any supervision, it can cause gastric issues, nausea, and in the long term, indiscriminate use can lead to kidney damage."
Meftal also has a specific allergic reaction unique to it, adds Dr Bibra.
"It can cause skin rashes, itching, and sometimes it can trigger an immune response causing small nodular bumps all over the body."Dr Dhruv Bibra, Pain management specialist
‘Treat the Cause, Not the Symptom’
"Some pain during menstruation is normal. This happens because of the release of Prostaglandins – hormone-like substances that are responsible for the initiation of pain," explains Dr Sonali Gupta.
However, it should be noted, that this pain should be mild and manageable with household management like rest and hot fomentation.
According to Dr Gupta, if it is bad enough for you to need medicine to manage menstrual cramps, and you have to take it frequently, it could be associated with some other underlying issue like fibroids, endometriosis, or even some micro-nutritional deficiency.
"You must investigate the underlying cause of the pain. So that you can diagnose and treat the cause, and not just the symptoms."Dr Sonali Gupta, the HOD of Obstetrics and Gynaecology at Greater Noida's Fortis Hospital
Dr Dhruv Bibra, agrees, saying, "Acute pain is always a symptom. So, we need to find out what is the cause. If you ignore the cause, it can fester over time and lead to further complications."
Still Need the Drug? Keep These Dos and Don'ts in Mind
As a one off case, if you still need to take it sporadically, here are some Dos and Dont's to keep in mind according to both the experts we spoke to:
Do not take it on an empty stomach.
Make sure you're well hydrated.
Only take it as prescribed. Do not take more than one, or at the most, two a day a day.
"I see my patients often pop multiple of them a day, and I tell them, if the first two didn't work, the third isn't going to either. In fact, what you are going to get is the side effects."Dr Dhruv Bibra
Do not take it with alcohol.
Do not take it with other painkillers.
Discontinue use if you notice symptoms of allergic reactions.
Dr Gupta reiterates, "If you have acute pain and you need medication in every cycle, consult a doctor to figure out the cause."
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