Mebeverine
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Mebeverine: From Irritable Bowel Syndrome to Cauda Equina Syndrome
One-Sentence Summary
Mebeverine is an antispasmodic originally used for irritable bowel syndrome, and the knowledge graph also lists Clostridium difficile colitis and neurocirculatory asthenia as original indications. The TxGNN model predicts it may be effective for cauda equina syndrome. Currently there are 0 clinical trials and 0 publications supporting this prediction, so it rests on model output alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Irritable bowel syndrome (knowledge graph; no approved indication text is listed in the Singapore licences) |
| Predicted New Indication | Cauda equina syndrome |
| TxGNN Prediction Score | 98.01% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 2 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, mebeverine is a gastrointestinal antispasmodic that acts on gut smooth muscle. Its use in irritable bowel syndrome is established, and mechanistically it may relieve smooth muscle spasm in some settings.
Cauda equina syndrome is a neurological emergency caused by compression of the lumbosacral nerve roots. One plausible but unverified link is neurogenic bowel or bladder dysfunction, where smooth muscle spasm could be a symptom. Mebeverine would not address the underlying nerve injury, so at most it could offer symptom relief.
The score may also reflect proximity in the knowledge graph rather than biological relevance. Other predictions for this drug (such as insomnia, rhinitis and mitral valve prolapse) have no clear mechanistic rationale, which suggests caution about the model's output as a whole. Among the ten predictions, gastroduodenitis (score 81.1%) is the closest to mebeverine's current clinical use, but it also has no clinical support.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN09873P | MEBETIN TABLET 135 mg | Tablet, sugar coated | Not listed in the data compiled for this report |
| SIN07666P | DUSPATALIN RETARD CAPSULE 200 mg | Capsule | Not listed in the data compiled for this report |
Both licences are valid single-ingredient products for oral use. Mebetin is made by Sam Chun Dang Pharm Co Ltd. Duspatalin Retard is made by Abbott Biologicals B.V., Mylan Laboratories SAS and Abbott Laboratories GmbH.
Safety Considerations
Please refer to the package insert for safety information. No drug interaction records were found for mebeverine in the data compiled for this report, and no contraindicated diseases were identified from the knowledge graph.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction for cauda equina syndrome is supported only by a model score of 0.98, with no clinical trials or literature. The proposed mechanism is speculative, and mebeverine could at most relieve symptoms without treating the nerve compression. All ten predicted indications are at evidence level L5.
To proceed, the following is needed:
- Mechanism of action data for mebeverine (for example from DrugBank)
- Package insert warnings and contraindications from the HSA website, which are needed before any safety screening
- A literature and trial search specific to mebeverine in neurogenic bowel or bladder dysfunction, and in cauda equina syndrome
- Clarification of the approved indication wording on the two Singapore licences
- Assessment of route compatibility and the clinical need, since cauda equina syndrome is a surgical emergency and any role for mebeverine would be adjunctive symptom control
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.