Classes
DEA Class; Rx
Common Brand Names; Bentyl
- Anticholinergic Agents
Description
Parenteral and oral antimuscarinic and anticholinergic agent
Used for diarrhea-predominant irritable bowel syndrome
Boxed warning: do not use in infants less than 6 months of age due to severe side effects
Indications
Indicated for the treatment of irritable bowel syndrome and other functional disturbances of GI motility.
Contraindications
Hypersensitivity to dicyclomine or any anticholinergic drugs
Closed-angle glaucoma
Myasthenia gravis
Hemorrhage with cardiovascular instability
Paralytic ileus
Breast-feeding
Intestinal atony of elderly/debilitated patients
Toxic megacolon
GI obstruction
Obstructive uropathy
Severe ulcerative colitis
Reflux esophagitis
Infants aged <6 months (reports of seizure, respiratory failure, death)
Adverse Effects
- Dizziness (40%)
- Xerostomia (33%)
- Blurred vision (27%)
- Somnolence (9%)
- Nervousness (6%)
- Weakness (7%)
- Abdominal distension
- Confusional state
- Cycloplegia
- Delirium
- Dermatitis
- Erythema
- Fatigue
- Hallucinations
- Insomnia
- Malaise
- Palpitation
- Rash
- Syncope
Warnings
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 IM injection only; 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 (eg, elderly, mentally ill individuals); signs and symptoms resolve within 12-24 hr 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 reported following administration to infants
Pregnancy and Lactation
Pregnancy category: B
Lactation: Enters breast milk; contraindicated
Maximum Dosage
160 mg/day PO; 80 mg/day IM.
160 mg/day PO
160 mg/day PO.
40 mg/day PO.
>= 6 months: 20 mg/day PO.
How supplied
Dicyclomine hydrochloride
capsule
- 10mg
injectable solution
- 10mg/mL
syrup
- 10mg/5mL
tablet
- 20mg
