Dicyclomine

What is Dicyclomine?

Dicyclomine, also known as dicycloverine, is a medication used to treat various gastrointestinal disorders, including irritable bowel syndrome (IBS), functional gastrointestinal disorders, and bowel spasms.

Overview: Dicyclomine is an anticholinergic medication that works by relaxing the muscles in the stomach and intestines. It belongs to a class of medications called antispasmodics, which help to reduce muscle spasms and cramps in the gastrointestinal tract. This medication is available in various forms, including tablets, capsules, and syrups.

Generic Name: Dicyclomine Hydrochloride
Brand Names: Bentyl, Dibent, Dicyclocot
Drug Class: Anticholinergics/Antispasmodics
Formulations: Oral capsules, tablets, syrup, and injectable solution
Prescription Status: Rx Only
Administration Route: Oral or intramuscular injection

Dicyclomine was approved by the FDA in 1950 and has since become a standard treatment for conditions involving intestinal hypermotility and spasticity. It is not a cure for IBS or gastrointestinal disorders but is effective in managing acute episodes and chronic symptoms.

Medical Uses

Irritable Bowel Syndrome (IBS)

Dicyclomine is primarily prescribed for IBS, a disorder characterized by abdominal pain, bloating, and alternating episodes of diarrhea and constipation. It works by reducing intestinal muscle spasms and regulating motility, leading to symptom relief.

Functional Bowel Disorders

In patients with non-specific functional gastrointestinal issues (e.g., spastic colon), this medication can help manage painful muscle contractions.

Other Off-label Uses

• Urinary incontinence (off-label)
• Infant colic (used rarely and cautiously)
• Gastrointestinal cramping due to infections or surgery (under medical supervision)

Always consult a healthcare professional before using dicyclo-mine for any off-label purpose.

Dicyclomine acts by blocking acetylcholine, a neurotransmitter responsible for muscle contractions in the gut. By inhibiting the action of acetylcholine on muscarinic receptors in the smooth muscle, it reduces:

• Gastric secretions
• Muscle spasms
• Pain and cramping

This mechanism makes it effective in controlling spasmodic conditions in the gastrointestinal tract.

Dosage and Administration

Adult Dosage for IBS

• Oral: 20 mg four times a day initially
• Maintenance: May be increased to 40 mg four times a day if well tolerated
• Injectable: 10–20 mg four times a day intramuscularly (short-term only)

Pediatric Use

Dicyclo-mine is not recommended for infants under 6 months due to severe side effects, including respiratory difficulties.

Special Populations

• Elderly: Use with caution; start at the lower end of the dosage range
• Renal/Hepatic Impairment: Consult a doctor before use

Always follow your doctor’s instructions and never alter the dose without medical advice.

Side Effects

Like all medications, dicyclomine can cause side effects. These may range from mild to severe.

Common Side Effects

• Dry mouth
• Dizziness
• Blurred vision
• Nausea
• Lightheadedness
• Drowsiness

Less Common Side Effects

• Constipation
• Headache
• Difficulty urinating
• Nervousness or anxiety

Serious Side Effects (Seek Immediate Medical Attention)

• Difficulty breathing
• Severe allergic reactions (rash, itching/swelling)
• Fast or irregular heartbeat
• Mental/mood changes (confusion, hallucinations)
• Seizures

In Infants and Young Children

Due to the risk of breathing problems, seizures, and death, dicyclo-mine should not be used in children younger than 6 months.

If you notice any persistent or bothersome side effects, contact your healthcare provider promptly.

Warnings and Precautions

Contraindications

Dicyclomine should not be used in the following conditions:

• Obstructive uropathy
• Obstructive disease of the gastrointestinal tract
• Severe ulcerative colitis
• Myasthenia gravis
• Glaucoma
• Infants under 6 months of age

Pregnancy and Breastfeeding

• Pregnancy Category B: Animal studies show no harm, but human studies are limited. Use only if clearly needed.
• Lactation: This medication may be excreted in breast milk. Avoid breastfeeding while on this medication unless advised otherwise by a healthcare provider.

Operating Machinery and Driving

Due to drowsiness and blurred vision, avoid operating machinery or driving until you know how dicyclo-mine affects you.

Alcohol Use

Alcohol can enhance the drowsiness caused by dicyclo-mine. Limit or avoid alcohol during treatment.

Drug Interactions

Dicyclomine can interact with other medications, potentially altering its effectiveness or increasing side effects.

Drugs That May Interact

• Antihistamines (e.g., diphenhydramine)
• Antipsychotics (e.g., chlorpromazine)
• Tricyclic antidepressants (e.g., amitriptyline)
• Other anticholinergic drugs (e.g., atropine)
• Potassium supplements (may increase risk of gastrointestinal irritation)
• Narcotic pain relievers (e.g., morphine)

Always provide your doctor with a complete list of medications, including over-the-counter drugs and supplements.

Overdose and Missed Dose

Overdose

Signs of overdose may include:

• Confusion
• Hallucinations
• Irregular heartbeat
• Shallow breathing
• Seizures
• Loss of consciousness

If you suspect an overdose, seek emergency medical attention or call Poison Control immediately.

Missed Dose

If you miss a dose:

• Take it as soon as you remember
• If it is near the time of your next dose, skip the missed dose
• Do not double up to catch up

Storage and Handling

• Store dicyclo-mine at room temperature (20–25°C or 68–77°F)
• Keep away from moisture, heat, and light
• Do not freeze the oral solution or injectable form
• Keep out of reach of children and pets

Alternatives to Dicyclomine

If dicyclomine is not effective or not tolerated, other treatment options include:

• Hyoscyamine (another anticholinergic)
• Peppermint oil (natural remedy for IBS)
• Loperamide (for diarrhea-predominant IBS)
• Fiber supplements (for constipation-predominant IBS)
• Low-FODMAP diet (nutritional approach to IBS)
• Probiotics

Always consult your healthcare provider before switching medications or trying new treatments.

Conclusion

Dicyclomine is a medication used to treat various gastrointestinal disorders, including IBS, functional gastrointestinal disorders, and bowel spasms. While it can cause side effects, it is generally well-tolerated and effective. However, it is essential to use this medication with caution and follow the recommended dosage and precautions to minimize the risk of side effects.

Always follow your healthcare provider’s guidance, disclose all medications you’re taking, and report any side effects promptly. With the right usage, this medication can significantly improve gastrointestinal comfort and quality of life.

For ongoing gastrointestinal issues, consult a gastroenterologist to ensure you’re getting the most comprehensive care possible.

Frequently Asked Questions (FAQs) About Dicyclomine