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Dicyclomine

    Brands

    DEA Class; Rx

    Common Brand Names; Bentyl

    • Anticholinergic Agents

    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

    Indicated for the treatment of irritable bowel syndrome and other functional disturbances of GI motility.

    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)

    • 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

    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 category: B

    Lactation: Enters breast milk; contraindicated

    Adults

    160 mg/day PO; 80 mg/day IM.

    Elderly

    160 mg/day PO

    Adolescents

    160 mg/day PO.

    Children

    40 mg/day PO.

    Infants

    >= 6 months: 20 mg/day PO.

    Dicyclomine hydrochloride

    capsule

    • 10mg

    injectable solution

    • 10mg/mL

    syrup

    • 10mg/5mL

    tablet

    • 20mg