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KARBETOCIN-FARMAK

KARBETOCIN-FARMAK

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Doctor

Nuno Tavares Lopes

Family medicine18 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use KARBETOCIN-FARMAK

INSTRUCTIONS for medical use of the medicinal product DUSPATALIN® RETARD 200

Composition

active substance: mebeverine hydrochloride; 1 capsule contains mebeverine hydrochloride 200 mg; excipients: magnesium stearate, methacrylic acid copolymer dispersion, talc, hypromellose, polyacrylate dispersion, glycerol triacetate; solid gelatin capsule (size No. 1): titanium dioxide (E 171), gelatin.

Pharmaceutical form

Prolonged-release capsules, hard.

Main physical and chemical properties

Opaque white hard gelatin capsules, size No. 1, with corresponding marking 245, containing granules from white to almost white color.

Pharmacotherapeutic group

Drugs used for functional gastrointestinal disorders. Synthetic anticholinergic drugs, esterified tertiary amines. Mebeverine. ATC code A03AA04.

Pharmacological properties

Pharmacodynamics
Mechanism of action and pharmacodynamic effects

Mebeverine is a myotropic spasmolytic with selective action on the smooth muscles of the gastrointestinal tract. It eliminates spasms without suppressing normal intestinal motility. Since this action is not mediated by the autonomic nervous system, typical anticholinergic side effects are absent.

Clinical efficacy and safety

The clinical efficacy and safety of various mebeverine formulations have been studied in over 1,500 patients. Significant relief of predominant symptoms of irritable bowel syndrome (such as abdominal pain, bowel habits) was usually observed in reference and controlled clinical trials.

All mebeverine formulations were generally safe and well-tolerated at the recommended dosage regimen.

Children

Clinical trials of tablet or capsule administration were conducted only in adults. Data on clinical efficacy and safety obtained from clinical trials and post-marketing experience with mebeverine suspension in patients aged 3 years and older demonstrated that mebeverine is an effective and safe medicinal product, well-tolerated.

Clinical trials of mebeverine suspension showed that the drug is effective in relieving symptoms of irritable bowel syndrome in children. Further open-controlled clinical trials of mebeverine suspension confirmed the efficacy of the drug.

Pharmacokinetics
Absorption

Mebeverine is rapidly and completely absorbed after oral administration in tablet form. Due to the prolonged release of the drug from the capsule, it can be taken twice a day.

Distribution

With repeated use of Duspatalin® Retard 200, no significant accumulation occurs.

Metabolism

Mebeverine hydrochloride is mainly metabolized by esterases, which in the first stage of metabolism cleave the ether bonds to form veratric acid and mebeverine alcohol. In plasma, demethylcarboxylic acid (DMCA) is the main metabolite. The half-life of DMCA at steady state is 5.77 hours. With repeated use of capsules (200 mg twice daily), Cmax for DMCA was 804 ng/mL, and tmax was approximately 3 hours. The relative bioavailability of prolonged-release capsules was optimal, with a mean ratio of 97%.

Excretion

Mebeverine is not excreted unchanged; it is completely metabolized, and its metabolites are excreted almost entirely. Veratric acid is excreted in the urine. Mebeverine alcohol is also excreted by the kidneys, partly as the corresponding carboxylic acid (CA) and partly as demethylcarboxylic acid (DMCA).

Children

Pharmacokinetic studies in children have not been conducted.

Clinical characteristics

Indications

Adults and children aged 10 years and older:

  • Symptomatic treatment of abdominal pain and spasms, bowel disorders, and discomfort in the bowel area in irritable bowel syndrome;
  • Treatment of gastrointestinal spasms of secondary genesis caused by organic diseases.
Contraindications

Hypersensitivity to the active substance or to any of the excipients of the drug, as specified in the "Composition" section.

Interactions with other medicinal products and other types of interactions

Interaction studies have not been conducted, except for the interaction with alcohol. In vitro and in vivo studies in animals have demonstrated the absence of any interaction between Duspatalin® Retard 200 and ethanol.

Special warnings and precautions for use

None.

Use during pregnancy or breastfeeding
Pregnancy

There are only very limited data on the use of mebeverine in pregnant women. Reproductive toxicity studies conducted in animals are insufficient. Duspatalin® Retard 200 is not recommended during pregnancy.

Breastfeeding

It is unknown whether mebeverine or its metabolites are excreted in human breast milk. Excretion of mebeverine in breast milk of animals has not been studied. Duspatalin® Retard 200 should not be used during breastfeeding.

Fertility

Clinical data on the effect on male or female fertility are not available; however, available animal studies do not indicate a harmful effect of Duspatalin® Retard 200.

Ability to influence the reaction rate when driving vehicles or operating machinery

Studies on the effect on the ability to drive a car and work with mechanical devices have not been conducted. The pharmacodynamic and pharmacokinetic profile, as well as post-marketing experience, do not indicate any harmful effect of mebeverine on the ability to drive a car and work with mechanical devices.

Method of administration and dosage

For oral administration.

Capsules should be taken with a sufficient amount of water (at least 100 mL). It is not recommended to chew, as the capsule coating is designed to ensure a prolonged release mechanism.

Adults and children aged 10 years and older should take 1 capsule twice a day (in the morning and evening).

The duration of use is not limited. If one or more doses are missed, the patient should take the next dose as scheduled. The missed dose(s) should not be taken in addition to the regular dose.

Special populations

Dosing studies in elderly patients, patients with impaired renal and/or hepatic function have not been conducted. Based on available post-marketing data, no specific risk has been identified for elderly patients, patients with impaired renal and/or hepatic function. Dose adjustment for these patient groups is not considered necessary.

Children

Duspatalin® Retard 200 should not be used in children under 3 years of age due to the lack of clinical data for this age group. Duspatalin® Retard 200, 200 mg capsules, should not be used in children aged 3 to 10 years due to the high content of the active substance.

Overdose

Symptoms. Theoretically, in case of overdose, central nervous system stimulation is possible. In cases of overdose, symptoms were absent or mild and usually resolved quickly. Overdose symptoms observed were of neurological or cardiovascular origin.

Treatment. A specific antidote is unknown. Symptomatic treatment is recommended. Gastric lavage is recommended only in case of intoxication with multiple drugs diagnosed within 1 hour of taking the medicinal product. Measures to reduce absorption are not necessary.

Adverse reactions

The following adverse reactions have been reported spontaneously during post-marketing use. The frequency cannot be accurately determined from the available data.

Allergic reactions were observed mainly, but not exclusively, on the skin.

Disorders of the skin and subcutaneous tissue:

  • urticaria, angioedema, facial edema, rash.

Disorders of the immune system:

  • hypersensitivity (anaphylactic reactions).

Shelf life

3 years.

Storage conditions

Store in the original packaging at a temperature not exceeding 25 °C. Do not store at a temperature below 5 °C. Store in a place inaccessible to children.

Packaging

10 capsules in a blister pack, 3 blister packs in a carton, or 15 capsules in a blister pack, 1, 2, or 4 blister packs in a carton.

Release category

Prescription only.

Manufacturer

Mylan Laboratoires SAS/Mylan Laboratories SAS.

Manufacturer's location and address

Route de Belleville, Lieu dit Maillard, 01400, Chatillon-sur-Chalaronne, France.

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Online doctors for KARBETOCIN-FARMAK

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for KARBETOCIN-FARMAK – subject to medical assessment and local rules.

5.0(48)
Doctor

Nuno Tavares Lopes

Family medicine18 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Duarte Meneses

Family medicine5 years of experience

Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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Anastasiia Shalko

Family medicine13 years of experience

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Tomasz Grzelewski

Dermatology21 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Andreea Mateescu

Pediatrics8 years of experience

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
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Katia Benko

Pediatrics10 years of experience

Dr Katia Benko is a paediatrician with over 9 years of clinical experience and international training. She completed her medical education and residency in Argentina and is fully licensed to practise in Spain. Her work spans newborns, children and adolescents, with a focus on whole-person care that integrates physical, emotional and developmental health.

Areas of expertise:

  • online consultations for newborns, children and teens
  • evaluation and treatment of acute symptoms: fever, cough, infections, bronchiolitis, earache, etc.
  • long-term care for chronic paediatric conditions
  • preventive care at every stage of growth and development
  • child wellness visits and routine health check-ups
  • vaccination guidance according to standard and special schedules
  • assessment of neurodevelopment in infants and toddlers
  • feeding concerns: picky eating, food refusal, healthy habits, eating disorders
  • parental support in everyday health, emotional wellbeing and prevention
  • guidance for teenagers on healthy habits, self-care and risk prevention
Dr Benko sees paediatrics as a space for partnership with families – not only to treat illness, but to guide each child’s health journey with clarity, empathy and trust. Her goal is for every family to feel supported in making confident, informed decisions for their child’s wellbeing.
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Salome Akhvlediani

Pediatrics12 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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Lina Travkina

Family medicine13 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Iryna Reznychenko

Gynecology26 years of experience

Dr Iryna Reznychenko is an obstetrician-gynaecologist, paediatric gynaecologist, and certified lactation consultant. She provides online consultations for women at all stages of life – from adolescence to menopause. Her work combines medical care for gynaecological conditions with dedicated support for breastfeeding challenges, both physical and emotional.

Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
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Dmytro Horobets

Family medicine7 years of experience

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

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