How does verine work? Dissecting the mechanisms of mebeverine and drotaverine

October 7, 2025 •

4 min read

The British Society of Gastroenterology recommends antispasmodic agents as a first-line treatment for pain and cramping in irritable bowel syndrome (IBS). Often sold under the brand name 'verine' in different regions, these medications contain varying active ingredients, primarily mebeverine or drotaverine, which work through distinct pharmacological mechanisms to relax smooth muscle and relieve gastrointestinal discomfort.

Quick Summary

This article explains the different pharmacological actions of mebeverine and drotaverine, active ingredients in medications often branded as 'verine', to provide relief from smooth muscle spasms and associated symptoms like those seen in IBS.

Key Points

Not One Drug: 'Verine' is a brand name that most often contains either mebeverine or drotaverine, two distinct antispasmodic medications.
Mebeverine's Action: Mebeverine works directly on the smooth muscles of the gut, blocking ion channels to inhibit contractions and relieve spasms specific to the gastrointestinal tract.
Drotaverine's Action: Drotaverine is a PDE4 inhibitor that causes smooth muscle relaxation by increasing intracellular cAMP levels, affecting multiple body systems beyond just the gut.
Indication Differences: Mebeverine is a primary treatment for IBS, while drotaverine treats a wider range of spasms, including biliary, urinary, and uterine.
Localized vs. Systemic: Mebeverine provides targeted, localized relief with minimal systemic anticholinergic side effects, whereas drotaverine has a broader, more systemic effect.
Side Effects Differ: Although generally mild, potential side effects vary between the two drugs, with allergic reactions noted for mebeverine and nausea/dizziness for drotaverine.
Professional Guidance: Choosing the right medication depends on the condition and requires consultation with a healthcare professional to determine the most appropriate treatment.

While the name 'verine' is common in many regions for antispasmodic medications, it does not refer to a single active ingredient. Instead, it is a brand name that may correspond to either mebeverine or drotaverine, two distinct drugs with different chemical structures and mechanisms of action. Understanding which active ingredient is present is crucial for grasping how the medication functions. Mebeverine, for instance, is primarily used for irritable bowel syndrome (IBS), whereas drotaverine is a broader antispasmodic agent.

The Dual Nature of "Verine": Mebeverine and Drotaverine

Mebeverine: Targeting Gut-Specific Spasms

Mebeverine is a musculotropic antispasmodic agent that specifically targets the smooth muscles of the gastrointestinal (GI) tract. It is primarily indicated for relieving the symptoms of IBS and similar functional digestive disorders, such as spastic constipation and mucous colitis. Its action is localized to the gut, making it a suitable option for targeting intestinal spasms without causing widespread anticholinergic side effects in other parts of the body.

Relaxes Intestinal Smooth Muscle: Mebeverine works directly on the smooth muscle of the intestinal walls to relieve spasms and cramping.
Modulates Ion Channels: Its mechanism is believed to involve blocking voltage-operated sodium channels and inhibiting intracellular calcium accumulation within smooth muscle cells. This action is key to preventing the sustained muscle contractions that cause pain and spasms.
Provides Local Anesthetic Effects: Mebeverine may also contribute to pain relief through a local anesthetic effect within the gut, further alleviating the discomfort associated with IBS.

Drotaverine: A Broader Antispasmodic Action

Drotaverine is a benzylisoquinoline derivative structurally related to papaverine. It is a more general-purpose antispasmodic used to treat smooth muscle spasms from various causes, including spasms of gastrointestinal, biliary, and genitourinary origin, as well as those related to menstruation and headaches. Drotaverine's mechanism differs significantly from mebeverine's and involves inhibiting a specific enzyme.

Inhibits Phosphodiesterase-4 (PDE4): Drotaverine's primary mechanism is the inhibition of the enzyme phosphodiesterase-4 (PDE4). By blocking PDE4, drotaverine causes an increase in intracellular cyclic adenosine monophosphate (cAMP) levels, which triggers smooth muscle relaxation.
Induces Vasodilation: The increase in cAMP and subsequent muscle relaxation also leads to the dilation of blood vessels. This is why drotaverine has a broader range of applications beyond just the digestive tract.

Comparison of Mebeverine and Drotaverine


Feature	Mebeverine	Drotaverine
Active Ingredient	Mebeverine hydrochloride	Drotaverine hydrochloride
Primary Use	Irritable Bowel Syndrome (IBS) and related functional gut disorders	General smooth muscle spasms in the GI, biliary, and genitourinary systems
Mechanism of Action	Musculotropic, acting directly on intestinal smooth muscle by modulating ion channels and local anesthetic effects	Phosphodiesterase-4 (PDE4) inhibitor, increasing cAMP to relax smooth muscle
Target Specificity	Highly specific for the gastrointestinal tract	Less specific, acting on smooth muscles throughout the body
Systemic Effects	Minimal systemic anticholinergic side effects	Broader systemic effects due to its wider action, but still generally well-tolerated
Side Effects	Allergic reactions, rash, dizziness, headache	Nausea, vomiting, dizziness, decreased urine output

Clinical Applications and Therapeutic Differences

The differences in mechanism and specificity directly influence the clinical applications of mebeverine and drotaverine. Mebeverine's targeted action on the gut makes it the preferred choice for treating the core symptoms of IBS, such as abdominal pain and cramps. Its lack of systemic anticholinergic side effects minimizes complications like dry mouth or blurred vision, which can be a concern with other classes of antispasmodics.

In contrast, drotaverine's broad-spectrum antispasmodic effect makes it useful for a wider variety of conditions where smooth muscle relaxation is needed. For instance, its ability to relax uterine smooth muscle makes it effective for alleviating menstrual cramps, and its vasodilatory properties are beneficial in treating conditions like kidney stones and gallstones. However, it is important to note that drotaverine is not universally approved, and its availability and use vary by country. Therefore, a healthcare provider should always be consulted before use.

Safety Profile and Side Effects

Both mebeverine and drotaverine are generally well-tolerated, with side effects typically mild and transient. However, awareness of potential side effects is important.

Mebeverine side effects:

Allergic reactions, such as skin rashes, swelling, or hives.
Dizziness or headache.
Heartburn, indigestion, or bloating.
Diarrhea or constipation.
Very rarely, severe allergic reactions involving breathing difficulties.

Drotaverine side effects:

Nausea and vomiting.
Dizziness.
Decreased urine output.
Injected forms may cause pain or swelling at the injection site.

Patients should always report any persistent or severe side effects to a healthcare professional. In the case of a severe allergic reaction, immediate medical attention is necessary.

Conclusion: Choosing the Right Verine

The brand name 'verine' encompasses two distinct antispasmodic drugs, mebeverine and drotaverine, each with a different pharmacological action. Mebeverine acts directly on the intestinal smooth muscle to provide localized relief for IBS symptoms, while drotaverine inhibits the PDE4 enzyme to relax smooth muscles more broadly throughout the body. The choice between these medications depends on the specific condition being treated, guided by a healthcare provider's recommendation. While both are effective for smooth muscle spasms, their differences in mechanism, specificity, and application highlight why professional medical advice is essential to ensure the correct medication is used for the appropriate condition.

For more detailed information on antispasmodic treatments for IBS, the systematic reviews and clinical trial data available on the NIH website offer further reading.

Frequently Asked Questions

Mebeverine primarily targets and relaxes the smooth muscles of the gastrointestinal tract, making it specific for conditions like IBS. Drotaverine is a broader antispasmodic that works by inhibiting the PDE4 enzyme to relax smooth muscles throughout the body, including the biliary and genitourinary systems.

Mebeverine, sold under the brand name 'verine' in some countries, is the active ingredient most commonly used and recommended for treating the abdominal pain, cramping, and bloating associated with Irritable Bowel Syndrome.

Mebeverine, the primary active ingredient for IBS, does not produce systemic anticholinergic side effects like dry mouth and blurred vision. However, some other anticholinergic antispasmodics can cause these effects, so it is important to know the specific active ingredient.

Mebeverine typically starts to work within 1 to 3 hours, but it may take several days of regular use to experience the full therapeutic benefits. Some people find that taking it about 20 minutes before meals is most effective.

While mebeverine is primarily for gut spasms, drotaverine (another active ingredient sometimes branded as 'verine') is effective for relieving spasms in the genitourinary system, including those associated with menstruation.

Significant side effects are rare, but both medications have potential adverse effects. Mebeverine can cause allergic skin reactions and dizziness, while drotaverine may cause nausea, vomiting, or dizziness. Severe allergic reactions are possible with either, though uncommon.

The key difference is their mechanism of action. Mebeverine directly affects smooth muscle via ion channels, providing localized effects on the gut. Drotaverine inhibits the PDE4 enzyme, leading to broader smooth muscle relaxation and vasodilation across various body systems.