dicyclomine


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Related to dicyclomine: dicyclomine hydrochloride

dicyclomine

 [di-si´klo-mēn]
an anticholinergic and antimuscarinic with effects similar to those of atropine; the hydrochloride salt is used as a gastrointestinal antispasmodic.

dicyclomine (dicycloverine (UK))

Bentyl, Bentylol (CA), Diclophen (CA), Formulex (CA), Lomine (CA), Merbentyl (UK), Protylol (CA)

Pharmacologic class: Anticholinergic

Therapeutic class: Antispasmodic

Pregnancy risk category B

Action

Thought to exert direct effect on GI smooth muscle by inhibiting acetylcholine at receptor sites, thereby reducing GI tract motility and tone

Availability

Capsules: 10 mg

Solution for injection: 10 mg/ml

Syrup: 10 mg/5 ml

Tablets: 20 mg

Indications and dosages

Irritable bowel syndrome in patients unresponsive to usual interventions

Adults: 20 mg P.O. or I.M. q.i.d.; may increase up to 160 mg/day

Contraindications

• Hypersensitivity to drug

• GI or genitourinary tract obstruction

• Severe ulcerative colitis

• Reflux esophagitis

• Unstable cardiovascular status

• Glaucoma

• Myasthenia gravis

• Breastfeeding

• Infants younger than 6 months

Precautions

Use cautiously in:

• hepatic or renal impairment, autonomic neuropathy, cardiovascular disease, prostatic hypertrophy

• elderly patients

• pregnant patients (safety not established).

Administration

• Give 30 to 60 minutes before meals; give bedtime dose at least 2 hours after evening meal.

Don't administer by I.V. route.

• Don't give by I.M. route for more than 2 days.

Adverse reactions

CNS: confusion, drowsiness, light-headedness (with I.M. use), psychosis

CV: palpitations, tachycardia

EENT: blurred vision, increased intraocular pressure

GI: nausea, vomiting, constipation, heartburn, decreased salivation, dry mouth, paralytic ileus

GU: urinary hesitancy or retention, erectile dysfunction, decreased lactation

Skin: decreased sweating, rash, itching, urticaria

Other: pain and redness at I.M. site, allergic reactions including anaphylaxis

Interactions

Drug-drug. Adsorbent antidiarrheals, antacids: decreased dicyclomine absorption

Cyclopropane anesthetics: increased risk of cardiovascular adverse reactions

Oral drugs: altered absorption of these drugs

Potassium (oral): increased GI mucosal lesions

Other anticholinergics (including antihistamines, disopyramide, quinidine): additive anticholinergic effects

Drug-diagnostic tests. Gastric acid secretion test: antagonism of pentagastrin and histamine (testing agents)

Patient monitoring

Stay alert for anaphylaxis.

• Monitor vital signs and fluid intake and output. Ask patient about palpitations.

Assess for light-headedness, confusion, and rash after I.M. injection.

• Evaluate patient's vision, particularly for blurring and other signs and symptoms of increasing intraocular pressure.

• Assess bowel pattern, particularly for signs and symptoms of paralytic ileus.

Patient teaching

• Instruct patient to take drug 30 to 60 minutes before meals and to take bedtime dose at least 2 hours after evening meal.

• Advise patient not to take antacids or adsorbent antidiarrheals within 2 hours of dicyclomine.

Urge patient to promptly report rash, abdominal pain, decreased urinary output, or absence of bowel movements.

• Caution patient to avoid driving or other hazardous activities until he knows how drug affects concentration, vision, and alertness.

Instruct patient to avoid exposure to high temperatures and to immediately notify prescriber if fever and decreased sweating occur in high environmental temperature.

• Advise patient to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

dicyclomine

/di·cy·clo·mine/ (-si´klo-mēn) an anticholinergic, used as the hydrochloride salt as a gastrointestinal antispasmodic.

dicyclomine

(dī-sī′klə-mēn′)
n.
An anticholinergic drug, C19H35NO2, used in its hydrochloride form to relax smooth muscle and as an antispasmodic in the treatment of irritable bowel syndrome and other gastrointestinal disorders.

dicyclomine

an anticholinergic; the hydrochloride is used as a gastrointestinal antispasmodic.
References in periodicals archive ?
While dicyclomine has been shown to be effective for colic, there are significant concerns about its safety, and the manufacturer has contraindicated its use in this population.
Of the drugs covered in this series, misoprostol and tetracycline cause structural defects, castor oil can induce labor, and mesalamine-containing agents and dicyclomine have caused toxicity in nursing infants.
The agents--available under numerous trade names--include atropine, belladonna, dicyclomine, glycopyrrolate, L-hyoscyamine, mepenzo-late, methscopolamine, propantheline, and scopolamine.
Interventions with some evidence of effectiveness for infantile colic include hypoallergenic diets and formula, soy formula, decreased infant stimulation, herbal tea, and dicyclomine (Bentyl).
Surveillance studies with dicyclomine have noted an increased incidence of birth defects, but because there is no clustering of specific defects, there may be no association, and the risk is considered low.
The agents--available under many trade names--include atropine, belladonna, dicyclomine, glycopyrrolate, L-hyoscyamine, mepenzolate, methscopolamine, propan-theline, and scopolamine.
Misoprostol is contraindicated during pregnancy and dicyclomine is contraindicated for nursing women.
The antispasmodic agents hyoscyamine and dicyclomine may give symptomatic relief of cramps and diarrhea, but there are insufficient data to make a recommendation about their use.