Introduction
- Generic Name: Dicyclomine
- Brand Names: Bentyl, Dibent, Dicycloverine
- Pharmacological Class: Anticholinergic agent
- Mechanism of Action: Blocks acetylcholine at muscarinic receptors in the smooth muscles of the gastrointestinal tract, reducing muscle spasms and pain.
Indications
- Primary Use: Treatment of irritable bowel syndrome (IBS) and the relief of smooth muscle spasms in the gastrointestinal tract.
- Other Uses: Occasionally used to manage bladder spasms.
Dosage
- Adults: 20 mg four times daily before meals and at bedtime, may be adjusted based on response up to 40 mg four times daily.
- Elderly: Start with a lower dose due to increased sensitivity to anticholinergic effects.
- Children: Not generally recommended for children under 18 years due to insufficient data on safety and efficacy.
Administration
- Method: Oral intake.
- Precautions: Should be taken 30 minutes before meals to maximize effectiveness.
Forms Available
- Tablets: 20 mg
- Capsules: 10 mg
- Syrup: 10 mg/5 mL
- Injection: 10 mg/mL for hospital use only
Side Effects
- Common: Dry mouth, dizziness, blurred vision, nausea.
- Less Common: Constipation, headache, sleepiness.
- Rare but Serious: Severe constipation, difficulty urinating, palpitations, confusion.
Warnings
- Heat Prostration: Due to decreased sweating, heat prostration can occur in hot environments.
- Contraindications: Myasthenia gravis, severe ulcerative colitis, and obstructive uropathy.
Precautions
- General: Monitor for symptoms of anticholinergic CNS effects, such as sedation or delirium.
- Health Conditions: Use with caution in patients with hepatic or renal impairment.
Interactions
- Medications: Increased anticholinergic effects with other anticholinergic drugs, decreased gastric absorption of other medications due to reduced gastric motility.
- Food: Avoid alcohol as it can intensify side effects.
Monitoring Parameters
- Gastrointestinal Symptoms: Assess symptom control and occurrence of adverse GI effects.
- Mental Status: Monitor for cognitive impairment or hallucinations, especially in elderly patients.
Use in Children
- Guidelines: Not recommended for children under 18 years of age due to lack of safety data.
Use in Pregnancy
- FDA Category: B. No proven risk in humans, but should only be used if clearly needed.
Use in Elderly
- Recommendations: Use caution, start with a lower dose, and monitor closely for CNS and anticholinergic side effects.
Use in Kidney Disease
- Adjustments: May require dose adjustments based on renal function.
Use in Liver Disease
- Caution: May require dose adjustments; monitor liver function.
Patient Counselling Points
- Medication Use: Importance of taking medication exactly as prescribed and not to exceed recommended doses.
- Side Effects: Watch for and report any difficulty in urinating, severe constipation, or other significant side effects.
- Lifestyle: Advise avoiding driving or operating machinery if they experience dizziness or blurred vision.
Table of Brand Names, Manufacturer, and Prices in USD
| Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
|---|---|---|---|
| Bentyl | Actavis | 20 mg Tablet | $0.80 |
| Dibent | Generic Brand | 10 mg Capsule | $0.50 |
| Dicycloverine | Generic Brand | 10 mg/5 mL Syrup | $0.45 |
15 FAQs with Answers
- What is Dicyclomine used for? – Mainly to treat irritable bowel syndrome (IBS) and related gastrointestinal spasms.
- Can Dicyclomine cause dizziness? – Yes, dizziness is a common side effect.
- How should Dicyclomine be taken? – 30 minutes before meals to maximize effectiveness.
- What are the serious side effects of Dicyclomine? – Can include severe constipation, difficulty urinating, and palpitations.
- Is Dicyclomine safe during pregnancy? – It is FDA Category B, considered safe but should only be used if clearly needed.
- Can Dicyclomine be taken with alcohol? – Alcohol should be avoided as it can increase side effects.
- What does Dicyclomine interact with? – It can interact with other anticholinergic drugs and affect the absorption of various medications.
- What should I avoid while taking Dicyclomine? – Avoid driving or using machinery if experiencing dizziness or blurred vision.
- What are signs of a Dicyclomine overdose? – Symptoms may include severe dizziness, dry mouth, difficulty breathing, and confusion.
- Is Dicyclomine addictive? – No, it does not have addictive properties.
- Should I stop taking Dicyclomine suddenly? – Consult with your healthcare provider before making any changes to how you take your medication.
- What are the rare but serious side effects of Dicyclomine? – Includes heart palpitations, confusion, and severe constipation.
- What other medications interact with Dicyclomine? – Increased effects with other anticholinergics, and can interfere with the absorption of many drugs.
- Who should not take Dicyclomine? – People with myasthenia gravis, severe ulcerative colitis, or obstructive uropathy.
- How does Dicyclomine work to treat IBS? – It relaxes the smooth muscles in the gut, reducing spasms and discomfort.
