Mepenzolate (Cantil) suppresses the secretion of pepsin and reduces colonic motility. It is used in the management of peptic ulcer disease in combination with other medications like proton pump inhibitors (omeprazole, pantoprazole, esomeprazole, lansoprazole, and dexlansoprazole)

Mepenzolate Uses:

• It is indicated for the management of peptic ulcer disease along with other agents.
• It does not have any major effect on healing of peptic ulcers, prevention of complications and avoiding recurrence.

Mepenzolate (Cantil) Dose in Adults:

Mepenzolate (Cantil) Dose in the treatment of Peptic ulcer disease:

• Oral: 25-50 mg 4 times/day

Use in Children:

Not indicated.

Pregnancy Risk Factor B

• No adverse effects reported in animal studies.

Use during breastfeeding:

• Lactation can be inhibited due to anticholinergic effects.

Dose in Kidney Disease:

No dose adjustment required.

Dose in Liver disease:

No dose adjustment required.

Side effects of Mepenzolate (Cantil):

• Cardiovascular:

  • Palpitations
  • Tachycardia

• Central Nervous System:

  • Confusion
  • Dizziness
  • Drowsiness
  • Headache
  • Insomnia
  • Nervousness

• Dermatologic:

  • Hypohidrosis
  • Urticaria

• Gastrointestinal:

  • Ageusia
  • Bloating
  • Constipation
  • Delayed Gastric Emptying
  • Nausea
  • Vomiting
  • Xerostomia

• Genitourinary:

  • Decreased Lactation
  • Impotence
  • Urinary Hesitancy
  • Urinary Retention

• Hypersensitivity:

  • Anaphylaxis

• Neuromuscular & Skeletal:

  • Weakness

• Ophthalmic:

  • Blurred Vision
  • Cycloplegia
  • Increased Intraocular Pressure
  • Mydriasis

Contraindications to Mepenzolate (Cantil):

• Mepenzolate hypersensitivity has been documented.
• glaucoma
• Obstructive Uropathy (i.e. bladder neck obstruction caused by prostatic hyperplasia).
• Obstructive gastrointestinal Disease (e.g. pyloroduodenal, achalasia).
• Paralytic ileus
• Debilitated and elderly patients may experience a bowel atony.
• Background of GI bleed and hemodynamic instability
• Ulcerative colitis and toxic megacolon
• Myasthenia gravis

Warnings and precautions

• CNS effects

  • It can cause central nervous system depression, blurred vision, and drowsiness.

• Diarrhea:

  • If diarrhea occurs, stop using the product as it could indicate partial intestinal obstruction.

• Heat prostration:

  • High temperatures may cause severe reactions.

• Psychosis:

  • Certain patients may be more susceptible to developing psychosis from the anticholinergic effect.

• Cardiovascular disease

  • Before using, rule out tachycardia. Prevent cardiac failure, heart disease, hypertension, arrhythmias, or tachycardia.

• Gastric ulcer treatment

  • Gastric emptying can be delayed when used to treat gastric ulcers.

• Hepatic impairment

  • Take care when you have hepatic dysfunction.

• Hiatal hernia

  • This can exacerbate the symptoms of hiatal hernia or reflux esophagitis.

• Hyperthyroidism:

  • Prevent hyperthyroidism by taking care.

• Neuropathy:

  • Prevent autonomic neuropathy by using caution.

• Prostatic hyperplasia

  • Patients with BPH should be used with care

• Renal impairment

  • Prevent renal dysfunction.

• Ulcerative colitis

  • May cause toxic megacolon. In the presence of ulcerative collitis, be cautious.

Mepenzolate: Drug Interaction

Monitoring Parameters:

None mentioned.

How to administer Mepenzolate (Cantil)?

Take with food, preferably at night.

Mechanism of action of Mepenzolate (Cantil):

• It causes decreased gastric acid production and increased pepsin secretion by blocking the postganglionic parasympathetic nerves. 
• It also inhibits colonic movement.

Absorption when administered orally: Low

Excretion:

• Urine (3% to 22%);
• feces

International Brand Names of Mepenzolate:

• Cantil
• Colibantil
• Eftoron
• Mepenzol
• Tralanta
• Trancolon
• Trancolon P

Mepenzolate Brand Names in Pakistan:

No Brands Available in Pakistan.