Buscopan (hyoscine butylbromide) and Mebeverine are two drugs commonly used for the symptomatic treatment of irritable bowel syndrome (IBS). Both drugs can be prescribed or purchased in small quantities over the counter. Buscopan vs Mebeverine lists similarities and differences between both drugs and their role in the management of IBS according to the treatment guide on irritable bowel syndrome.
Table of Contents
What is IBS? (video)
Buscopan vs Mebeverine: mechanism of action
Buscopan and mebeverine are not the same drugs despite their similar treatment use. Buscopan is a brand name for a drug called hyoscine butylbromide. Over the counter Buscopan is sold under two names Buscopan Cramps and Buscopan IBS Relief (same drug, different names and sale restrictions). The active ingredient found in Buscopan (hyoscine butylbromide) can also be prescribed in its generic form.
Mebeverine is the name of the drug, which is also known as Colofac (branded prescription-only drug) and Colofac IBS (over the counter mebeverine). Generic versions of prescription-only mebeverine are also available.
Both drugs contain the same active ingredients regardless of whether they are prescribed or purchased over the counter:
- Each Buscopan tablet contains 10mg of hyoscine butylbromide.
- Each Colofac or mebeverine tablet contains 135mg of mebeverine hydrochloride.
Mebeverine is available in higher-strength capsules. A higher strength, modified-release mebeverine capsules are prescription-only medicine which contains 200mg of mebeverine per capsule.
Buscopan vs Mebeverine: symptoms control (mechanism of action)
Irritable bowel syndrome (IBS) is a condition characterised by a range of symptoms including stomach cramps, stomach pain, bloating and changes in bowel habits including diarrhoea or constipation. Hyoscine butylbromide and mebeverine are two different medications used to treat gastrointestinal issues.
Buscopan work by relieving spasms of the smooth muscle (antispasmodic agent) which forms part of the gastrointestinal (GI), biliary and genito-urinary tracts which ‘counteracts’ some of the symptoms experienced by IBS patients. Hyoscine belongs to a group of drugs called anticholinergics.
Hyoscine butylbromide is mainly prescribed to relieve symptoms associated with irritable bowel syndrome (IBS) and other gastrointestinal conditions such as abdominal pain, bloating, and cramping.
Mebeverine exercises have 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. Like hyoscine butylbromide, it is used to treat symptoms of irritable bowel syndrome (IBS) such as abdominal pain, cramping, and bloating.
Antispasmodic drugs should theoretically improve the symptoms of IBS by reducing muscle contractions and spasms (Chang, 2014).
In summary, both hyoscine butylbromide and mebeverine are antispasmodic medications used to treat gastrointestinal disorders, particularly irritable bowel syndrome (IBS) and related symptoms. They function by relaxing the smooth muscles in the gastrointestinal tract, thereby reducing pain and discomfort. Although both drugs produce the same end effect, at the cellular level, the mechanism of action of both drugs 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 (p) can only be purchased from the pharmacy counters, including online chemists. General sale medicines (GSL) can be sold in any retail outlets including supermarkets and off the shelf from pharmacies (available for customer self-selection).
| Brand name | Colofac IBS | Buscopan Cramps | Buscopan IBS Relief |
| Active drug | Mebeverine hydrochloride | Hyoscine butylbromide | Hyoscine butylbromide |
| Availability | Pharmacy only | Pharmacy only | GSL item |
| Age restrictions | Adults 18 years of age and over | Adults and children over 6 years of age | Adults and children over 12 years of age |
GSL item: available from shops, supermarkets and pharmacies.
Buscopan Cramps vs IBS what is the difference?
Both products contain the same drug – hyoscine butylbromide and both are of the same strength. The only difference comes in licensing of both products, which means Buscopan IBS Relief can be sold in pharmacies and supermarkets with minimum age restrictions for use set to 12 years of age. Buscopan Cramps is a pharmacy-only medication with age restrictions set to a minimum of 6 years of age.
Can you get Buscopan or mebeverine prescribed?
GPs sometimes recommended Buscopan or mebeverine to purchase over the counter. Patients who need to use either of the drugs regularly may get them 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 a few days of treatment.
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 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 management 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.
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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 for 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 or reduced sweating.
Mebeverine can cause skin rashes (red & itchy), and less likely severe allergic reaction which is characterised by difficulty in breathing, and swelling on the 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 drugs which have similar mechanisms of action.
Buscopan vs mebeverine: 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 incline towards mebeverine as a first choice in IBS treatment, however, patients may need to trial both drugs to see if the control of symptoms is improved. Patients need to remember the importance of contacting their GP if symptoms are ongoing and no previous of the condition was done by a doctor.
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 29/09/2022
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 29/09/2022
OpenPrescribing.net, EBM DataLab, University of Oxford, 2017. Search GP prescribing data. Available at: https://openprescribing.net/analyse/ Accessed on 30/09/2022
Tytgat, G.N. Hyoscine Butylbromide. Drugs 67, 1343–1357 (2007). Available at: https://doi.org/10.2165/00003495-200767090-00007 Accessed on 30/09/2022
