Dicyclomine

Dicyclomine is used to treat a certain type of intestinal problem called irritable bowel syndrome. It helps to reduce the symptoms of stomach and intestinal cramping. This medication works by slowing the natural movements of the gut and by relaxing the muscles in the stomach and intestines. Dicyclomine belongs to a class of drugs known as anticholinergics/antispasmodics.

Dicyclomine must not be used in children younger than 6 months old because of the risk of serious side effects.

Dicyclomine is available under the following different brand names: Bentyl.

Dosages of Dicyclomine:

Adult and Pediatric Dosage Forms and Strengths

Capsule

• 10 mg

Injectable Solution

• 10 mg/mL

Syrup

• 10 mg/5 mL

Tablet

• 20 mg

Dosage Considerations – Should be Given as Follows:

Irritable Bowel Syndrome

Pediatric (Off-label)

• 20 mg orally every 6 hours; may increase up to 40 mg every 6 hours; if efficacy not achieved in 2 weeks or adverse effects require dose less than 80 mg/day, therapy should be discontinued; safety data not available for doses greater than 80 mg/day for periods longer than 2 weeks
• 10-20 mg intramuscularly (IM) every 6 hours; not to exceed 80 mg/day IM

Dosing considerations

• IM use should not be longer than 1-2 days; replace IM with oral as soon as possible
• Do not use intravenously (IV)
• Infants older than 6 months: 5 mg orally every 6-8 hours; not to exceed 20 mg/day orally
• Children: 10 mg orally every 6-8 hours; not to exceed 40 mg/day orally
• Geriatric: 10-20 mg orally every 6 hours; may gradually increase as needed; not to exceed 160 mg/day

Administration

• Take 30-60 minutes before a meal

Dosing considerations

• Geriatric: High incidence of anticholinergic effects; avoid except in short-term situations to decrease secretions (Beers Criteria)
• Do not use IM in geriatric patients

Side effects associated with the use of Dicyclomine, include the following:

• Dizziness
• Dry mouth
• Blurred vision
• Drowsiness
• Nervousness
• Weakness

Other side effects of dicyclomine include:

• Bloating
• Confusion
• Cycloplegia
• Delirium
• Dermatitis
• Fainting or lightheadedness
• Fatigue
• Feeling unwell (malaise)
• Hallucinations
• Insomnia
• Palpitations
• Rash
• Redness

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Severe Interactions of dicyclomine include:

• None

Serious Interactions of dicyclomine include:

• pramlintide

Dicyclomine has moderate interactions with at least 106 different drugs.

Mild Interactions of dicyclomine include:

• desipramine
• dimenhydrinate
• donepezil
• galantamine
• tacrine
• trazodone

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains dicyclomine. Do not take Bentyl if you are allergic to dicyclomine or any ingredients contained in this drug
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

• Hypersensitivity to dicyclomine or any anticholinergic drugs
• Closed-angle glaucoma
• Myasthenia gravis
• Hemorrhage with cardiovascular instability
• Paralytic ileus
• Breastfeeding
• Intestinal atony of elderly/debilitated patients
• Toxic megacolon
• GI obstruction
• Obstructive uropathy
• Severe ulcerative colitis
• Reflux esophagitis
• Infants aged under 6 months (reports of seizure, respiratory failure, death)

Effects of Drug Abuse

• No information provided

Short-Term Effects

• See "What Are Side Effects Associated with Using Dicyclomine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Dicyclomine?"

Cautions

• Caution in renal/hepatic impairment
• Caution in benign prostatic hyperplasia
• Caution in congestive heart failure
• Caution in tachycardia secondary to cardiac insufficiency or thyrotoxicosis, hypertension, coronary artery disease, chronic obstructive pulmonary disease, hiatal hernia, mitral stenosis, brain damage or spastic paralysis in children, salivary secretion disorder, down syndrome, autonomic neuropathy, hyperthyroidism
• Tachyarrhythmia; assess before administration
• Toxin-mediated diarrhea
• Elderly (Beers Criteria)
• May cause drowsiness; avoid alcohol
• For intramuscular (IM) injection only; intravenous (IV) injection may result in thrombosis or thrombophlebitis and injection-site reactions
• Heat prostration can occur (fever and heat stroke due to decreased sweating)
• Psychosis in patients sensitive to anticholinergic drugs reported (e.g., elderly, mentally ill individuals); signs and symptoms resolve within 12-24 hours after discontinuation
• Incomplete intestinal obstruction: Diarrhea may be an early symptom, especially in patients with ileostomy or colostomy
• Salmonella dysenteric patients: Due to risk of toxic megacolon
• Use caution in patients with mild-moderate ulcerative colitis
• Effects may be potentiated when used with other sedative drugs or ethanol
• Serious respiratory reactions, CNS symptoms, and deaths were reported following administration to infants

Pregnancy and Lactation

• Dicyclomine may be acceptable for use during pregnancy
• Either animal studies show no risk but human studies are not available, or animal studies showed minor risks, and human studies were done and showed no risk.
• Dicyclomine enters breast milk; its use is contraindicated if breastfeeding