dicyclomine (Rx)

Brand and Other Names:Bentyl

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 10mg

injectable solution

  • 10mg/mL

syrup

  • 10mg/5mL

tablet

  • 20mg

Irritable Bowel Syndrome

20 mg PO q6hr; may increase up to 40 mg q6hr; if efficacy not achieved in 2 weeks or adverse effects require dose <80 mg/day, therapy should be discontinued; safety data not available for doses > 80 mg/day for periods > 2 weeks

10-20 mg IM q6hr; not to exceed 80 mg/day IM

Dosing considerations

  • IM use should not be longer than 1-2 days; replace IM with PO as soon as possible
  • Do not use IV

Administration

Take 30-60 minutes before a meal

Dosage Forms & Strengths

capsule

  • 10mg

injectable solution

  • 10mg/mL

syrup

  • 10mg/5mL

tablet

  • 20mg

Irritable Bowel Syndrome (Off-label)

Infants >6 months: 5 mg PO q6-8hr; not to exceed 20 mg/day PO

Children: 10 mg PO q6-8hr; not to exceed 40 mg/day PO

Administration

Take 30-60 minutes before a meal

Irritable bowel syndrome

10-20 mg PO q6hr; may gradually increase PRN; not to exceed 160 mg/day

Dosing considerations

High incidence of anticholinergic effects; avoid except in short-term situations to decrease secretions (Beers Criteria)

Do not use IM in geriatric patients

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Interactions

Interaction Checker

and dicyclomine

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              Serious - Use Alternative (7)

              • glucagon

                glucagon increases toxicity of dicyclomine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glucagon intranasal

                glucagon intranasal increases toxicity of dicyclomine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, dicyclomine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • pramlintide

                pramlintide, dicyclomine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

              • revefenacin

                revefenacin and dicyclomine both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

              • secretin

                dicyclomine decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.

              • umeclidinium bromide/vilanterol inhaled

                dicyclomine, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Concomitant use with other anticholinergic-containing drugs may lead to additive anticholinergic adverse effects.

              Monitor Closely (96)

              • abobotulinumtoxinA

                abobotulinumtoxinA increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

              • aclidinium

                dicyclomine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amantadine

                dicyclomine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

              • amitriptyline

                dicyclomine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

              • amoxapine

                dicyclomine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • aripiprazole

                dicyclomine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

                aripiprazole increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • atracurium

                atracurium and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine

                atropine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine IV/IM

                atropine IV/IM and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna alkaloids

                belladonna alkaloids and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna and opium

                dicyclomine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • benperidol

                dicyclomine decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                benperidol increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • benztropine

                benztropine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • bethanechol

                bethanechol increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • buprenorphine, long-acting injection

                buprenorphine, long-acting injection increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of buprenorphine with anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • carbachol

                carbachol increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cevimeline

                cevimeline increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpromazine

                dicyclomine decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

                chlorpromazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cisatracurium

                cisatracurium and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clomipramine

                dicyclomine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clozapine

                dicyclomine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

                clozapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cyclizine

                cyclizine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • cyclobenzaprine

                cyclobenzaprine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • darifenacin

                darifenacin and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • diphenhydramine

                dicyclomine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • donepezil

                donepezil increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • donepezil transdermal

                donepezil transdermal, dicyclomine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

              • dosulepin

                dicyclomine and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • doxepin

                dicyclomine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • droperidol

                dicyclomine decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                droperidol increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • echothiophate iodide

                echothiophate iodide increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fesoterodine

                dicyclomine and fesoterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • flavoxate

                dicyclomine and flavoxate both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • fluphenazine

                dicyclomine decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                fluphenazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • galantamine

                galantamine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glycopyrrolate

                dicyclomine and glycopyrrolate both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • glycopyrrolate inhaled

                dicyclomine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • haloperidol

                dicyclomine decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                haloperidol increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • henbane

                dicyclomine and henbane both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • homatropine

                dicyclomine and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • huperzine A

                huperzine A increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hyoscyamine

                dicyclomine and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • hyoscyamine spray

                dicyclomine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • iloperidone

                dicyclomine decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                iloperidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • imipramine

                dicyclomine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ipratropium

                dicyclomine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

              • levodopa

                dicyclomine, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

              • lofepramine

                dicyclomine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • loxapine

                dicyclomine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

                loxapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • loxapine inhaled

                loxapine inhaled increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                dicyclomine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

              • maprotiline

                dicyclomine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • meclizine

                dicyclomine and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • methscopolamine

                dicyclomine and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • metoclopramide intranasal

                dicyclomine will decrease the level or effect of metoclopramide intranasal by Other (see comment). Use Caution/Monitor. Coadministration of metoclopramide intranasal with drugs that impair GI motility may decrease systemic absorption of metoclopramide. Monitor for reduced therapeutic effect.

              • neostigmine

                neostigmine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nortriptyline

                dicyclomine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • olanzapine

                dicyclomine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

                olanzapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • oliceridine

                dicyclomine increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

              • onabotulinumtoxinA

                onabotulinumtoxinA and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • orphenadrine

                dicyclomine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin

                dicyclomine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin topical

                dicyclomine and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin transdermal

                dicyclomine and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • paliperidone

                dicyclomine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                paliperidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • pancuronium

                dicyclomine and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • perphenazine

                dicyclomine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                perphenazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • physostigmine

                physostigmine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pilocarpine

                pilocarpine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pimozide

                dicyclomine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

                pimozide increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • prabotulinumtoxinA

                dicyclomine, prabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • pralidoxime

                dicyclomine and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • prochlorperazine

                dicyclomine decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                prochlorperazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • promethazine

                dicyclomine decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

                promethazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • propantheline

                dicyclomine and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • protriptyline

                dicyclomine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • pyridostigmine

                pyridostigmine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quetiapine

                dicyclomine decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

                quetiapine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rapacuronium

                dicyclomine and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • risperidone

                dicyclomine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                risperidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rocuronium

                dicyclomine and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • scopolamine

                dicyclomine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • solifenacin

                dicyclomine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • succinylcholine

                succinylcholine increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • thioridazine

                dicyclomine decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

                thioridazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • thiothixene

                dicyclomine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • tiotropium

                dicyclomine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • tolterodine

                dicyclomine and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trifluoperazine

                dicyclomine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                trifluoperazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • trihexyphenidyl

                dicyclomine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

              • trimipramine

                dicyclomine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trospium chloride

                dicyclomine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • umeclidinium bromide

                umeclidinium bromide and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents

              • vecuronium

                dicyclomine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ziprasidone

                dicyclomine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

                ziprasidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • zotepine

                dicyclomine decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                dicyclomine decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

              Minor (5)

              • desipramine

                dicyclomine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.

              • dimenhydrinate

                dimenhydrinate increases toxicity of dicyclomine by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              • donepezil

                donepezil decreases effects of dicyclomine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • galantamine

                galantamine decreases effects of dicyclomine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • trazodone

                dicyclomine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Dizziness (40%)

              Xerostomia (33%)

              Blurred vision (27%)

              1-10%

              Somnolence (9%)

              Nervousness (6%)

              Weakness (7%)

              Frequency Not Defined

              Abdominal distension

              Confusional state

              Cycloplegia

              Delirium

              Dermatitis

              Erythema

              Fatigue

              Hallucinations

              Insomnia

              Malaise

              Palpitation

              Rash

              Syncope

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              Warnings

              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)

              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 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

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              Pregnancy & Lactation

              Pregnancy category: B

              Lactation: Enters breast milk; contraindicated

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Anticholinergic/antispasmodic; no effect on acid secretion, but direct smooth muscle relaxant effects; blocks the action of ACh at parasympathetic sites in smooth muscle, secretory glands, and CNS

              Absorption

              Bioavailability: PO (67% of IM)

              Onset: 1-2 hr

              Duration: <4 hr

              Peak plasma time: PO (60-90 min)

              Distribution

              Vd: 3.65 L/kg

              Metabolism

              Extensive

              Elimination

              Half-life: 1.8 hr

              Excretion: Urine (80%); feces (8%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Bentyl intramuscular
              -
              10 mg/mL solution
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              10 mg/5 mL solution
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              10 mg/5 mL solution
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine oral
              -
              20 mg tablet
              dicyclomine oral
              -
              10 mg capsule
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL solution
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial
              dicyclomine intramuscular
              -
              10 mg/mL vial

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              dicyclomine oral

              DICYCLOMINE - ORAL

              (dye-SYE-kloe-meen)

              COMMON BRAND NAME(S): Bentyl

              USES: 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.This medication must not be used by children younger than 6 months old because of the risk of serious side effects.

              HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually 4 times a day. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Mix the dose of liquid with an equal amount of water before taking it.Antacids lower the absorption of dicyclomine. Do not take this medication at the same time as antacids. If you are taking an antacid, take it after meals and take dicyclomine before meals.The dosage is based on your age, medical condition, and response to treatment.Do not increase your dose or take this drug more often without your doctor's approval. Your condition will not improve any faster and the risk of serious side effects may increase.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Dizziness, drowsiness, lightheadedness, weakness, blurred vision, dry eyes, dry mouth, nausea, constipation, and abdominal bloating may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute. To relieve dry eyes, consult your pharmacist for artificial tears or other eye lubricants.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: decreased sweating, dry/hot/flushed skin, fast/irregular heartbeat, loss of coordination, trouble speaking, mental/mood changes (such as confusion, hallucinations, agitation, nervousness, unusual excitement), difficulty urinating, decreased sexual ability.Get medical help right away if you have any very serious side effects, including: eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking dicyclomine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of glaucoma (angle-closure type), difficulty urinating (such as due to an enlarged prostate), other stomach/intestinal problems (such as slow gut, blockage, ulcerative colitis, infection, little/no stomach acid, ileostomy/colostomy patients with diarrhea), overactive thyroid, heart problems (such as coronary artery disease, angina, heart failure, fast/irregular heartbeat, heart problems due to severe bleeding), high blood pressure, heartburn problems (such as acid reflux, hiatal hernia, esophagus problems), certain nervous system problem (autonomic neuropathy), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), myasthenia gravis, liver problems, kidney problems.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, unusual excitement, constipation, fast heartbeat, and urination problems. Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. The manufacturer recommends that you do not breast-feed while using this drug. Consult your doctor for more details.

              DRUG INTERACTIONS: See also the How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: potassium tablets/capsules, drugs that are affected by slowed gut movement (such as pramlintide).Dicyclomine may affect the absorption of other products such as levodopa, certain azole anti-fungal drugs (ketoconazole, itraconazole), slowly-dissolving forms of digoxin, among others. If you are taking either ketoconazole or itraconazole, take it at least 2 hours before dicyclomine.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products, diet aids) because they may contain ingredients that cause drowsiness or a fast heartbeat. Ask your pharmacist about using those products safely.This medication may interfere with certain lab tests (such as gastric secretion tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: large pupils, hot/dry skin, fever, severe dizziness, severe thirst, difficulty swallowing, mental/mood changes (such as confusion, unusual excitement), fast/irregular heartbeat, muscle weakness, inability to move (paralysis), slowed breathing, fainting, seizures.

              NOTES: Do not share this medication with others.Management of digestive disorders may include lifestyle changes such as stress reduction programs, exercise, stopping smoking, and dietary changes, in addition to medication. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.