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Dicyclomine
From WikEM
Contents
General
- Type: antispasmodic, anticholinergics (antimuscarinic)
- Indication: FDA approved for irritable bowel syndrome. Used off-label for cramping associated with opioid withdrawal
- Dosage Forms: PO, IM
- DO NOT GIVE IV
- Common Trade Names: Bentyl®
Adult Dosing
- 10-20 mg PO or IM q6 prn
Pediatric Dosing
Safety/efficacy not established
Contraindications
- Allergy to class/drug
- Age <6 mo
- Breastfeeding
- GI obstruction
- Obstructive uropathy
- Reflux esophagitis
- Severe ulcerative colitis
- Myasthenia gravis
- Glaucoma
- Unstable hemodynamics
Adverse Reactions
Serious
- See Anticholinergic toxicity
- Syncope, poor muscle tone
- Dyspnea, apnea, respiratory arrest
- Anaphylaxis, angioedema
- Seizure, coma
- Impaired sweating/thermoregulation
- Paralytic ileus, intestinal perforation, pseudo-obstruction, toxic megacolon
- Psychosis
Common
- Nausea, xerostomia
- Asthenia, dizziness, somnolence, nervousness
- Blurred vision
Special Populations
- Pregnancy Rating: B
- Lactation: Infant risk has been demonstrated
- Renal Dosing: not defined
- Hepatic Dosing: not defined
Pharmacology
- Half-life: ~2 hours
- Excretion: Urine ~80%, ~10% feces
- Mechanism of Action: antimuscarinic, direct smooth muscle antagonism of bradykinin and histamine-induced muscular spasms, which atropine does not
Sources
- McAuley DF. GlobarlRPh Inc. ANTISPASMOTICS - Bowel spasm / cramping / IBS / Hypermotility. Last updated 12/04/2016. http://www.globalrph.com/antispasmotic.htm#Dicyclomine_.
