Trimebutine: abuse, addiction and overdose

Trimebutine, an antispasmodic drug, is used to relieve pain associated with irritable bowel syndrome, despite a lack of proven efficacy. Trimebutine has been shown to act on peripheral opioid receptors. Cases of trimebutine abuse and addiction have been reported in young adults, especially with the injectable form. Cases of serious accidental or intentional trimebutine overdose have been reported in infants and young adults, leading to neurological disorders (loss of consciousness, coma, drowsiness and convulsions) and cardiac disorders (bradycardia, ventricular tachycardia, arterial hypertension). Time to symptom onset was less than 3 hours after trimebutine intake. In practice, trimebutine is by no means a harmless drug, contrary to the impression given by the limited safety data available. Patients with pain due to irritable bowel syndrome should be informed of the adverse effects of trimebutine, and the harm-benefit balance should be reassessed in patients already taking this drug.