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Dicyclomine (dicycloverine): Pediatric drug information

Dicyclomine (dicycloverine): Pediatric drug information
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For additional information see "Dicyclomine (dicycloverine): Drug information" and "Dicyclomine (dicycloverine): Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Bentyl [DSC]
Brand Names: Canada
  • JAMP-Dicyclomine HCl;
  • Protylol [DSC];
  • RIVA-Dicyclomine
Therapeutic Category
  • Anticholinergic Agent;
  • Antispasmodic Agent, Gastrointestinal
Dosing: Pediatric
GI motility disorders/irritable bowel

GI motility disorders/irritable bowel: Very limited data available:

Note: Despite frequent reported use, current American College of Gastroenterology guidelines do not recommend use in patients with irritable bowel syndrome (Ref).

Adolescents: Oral: 10 to 20 mg 3 to 4 times daily. If efficacy not achieved in 2 weeks, therapy should be discontinued (Ref).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Dosing: Adult

(For additional information see "Dicyclomine (dicycloverine): Drug information")

Irritable bowel syndrome–associated pain

Irritable bowel syndrome–associated pain:

Note: American College of Gastroenterology (ACG) guidelines recommend against use of antispasmodics such as dicyclomine for the treatment of global symptoms of IBS (Ref); however, some experts consider as-needed use beneficial for relief of abdominal pain associated with IBS (Ref).

Oral: Initial: 20 mg up to 4 times daily; some experts recommend only administering as needed or in anticipation of a stressor that triggers abdominal pain (Ref); intended for short-term use; scheduled dosing for >2 weeks has not been studied (Ref).

According to the manufacturer's labeling, may titrate dose after 1 week, based on response and tolerability, up to 40 mg 4 times daily; however, some experts do not recommend doses >20 mg due to anticholinergic adverse effects (Ref).

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: The pharmacokinetics of dicyclomine have not been fully determined; the principal route of excretion is via the urine (80% of the dose [% eliminated unchanged and activity of metabolites (ie, active or inactive) unknown]).

Altered kidney function: Oral: There is insufficient evidence to provide specific dosage adjustment recommendations (has not been studied); however, use with caution and at the lowest effective dose, particularly in patients with more severe impairment (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be significantly dialyzable (large Vd): Oral: There is insufficient evidence to provide specific dosage adjustment recommendations (has not been studied); use with caution and at the lowest effective dose (Ref).

Peritoneal dialysis: Oral: Unlikely to be significantly dialyzable (large Vd): Oral: There is insufficient evidence to provide specific dosage adjustment recommendations (has not been studied); use with caution and at the lowest effective dose (Ref).

CRRT: Oral: There is insufficient evidence to provide specific dosage adjustment recommendations (has not been studied); use with caution and at the lowest effective dose (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Oral: There is insufficient evidence to provide specific dosage adjustment recommendations (has not been studied); use with caution and at the lowest effective dose (Ref).

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Adverse Reactions (Significant): Considerations
Anticholinergic effects

Dicyclomine causes anticholinergic effects, such as blurred vision, dizziness, dry mouth (xerostomia), and impaired cognitive function (eg, confusion) (Ref). Other effects include (but are not limited to) drowsiness, constipation, delirium, and hallucination. Anticholinergic effects may require dose reductions or discontinuation (Ref); resolution typically occurs within 12 to 24 hours after discontinuation.

Mechanism: Dose-related; related to the pharmacologic action (ie, antimuscarinic) (Ref).

Onset: Rapid; adverse reactions may occur within 2 hours of administration (Ref).

Risk factors:

• Higher doses (>80 mg/day) (Ref)

• Age >65 years (Ref)

• Concurrent use of other medications with anticholinergic effects

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Gastrointestinal: Nausea (14%), xerostomia (33%) (table 1)

Dicyclomine: Adverse Reaction: Xerostomia

Drug (Dicyclomine)

Placebo

Dose

33%

5%

40 mg four times a day

Nervous system: Dizziness (40%) (table 2)

Dicyclomine: Adverse Reaction: Dizziness

Drug (Dicyclomine)

Placebo

Dose

40%

5%

40 mg four times a day

Ophthalmic: Blurred vision (27%) (table 3)

Dicyclomine: Adverse Reaction: Blurred Vision

Drug (Dicyclomine)

Placebo

Dose

27%

2%

40 mg four times a day

1% to 10%:

Nervous system: Drowsiness (9%) (table 4), nervousness (6%)

Dicyclomine: Adverse Reaction: Drowsiness

Drug (Dicyclomine)

Placebo

Dose

9%

1%

40 mg four times a day

Neuromuscular & skeletal: Asthenia (7%)

Postmarketing:

Cardiovascular: Facial edema, palpitations, syncope, tachyarrhythmia

Dermatologic: Allergic dermatitis, erythema of skin, skin rash

Gastrointestinal: Abdominal distention, abdominal pain, constipation, dyspepsia, gastrointestinal pseudo-obstruction (colonic), vomiting

Genitourinary: Lactation insufficiency

Hypersensitivity: Anaphylactic shock, angioedema

Nervous system: Agitation, amnesia (including transient global amnesia), confusion (Kay 2005), delirium, delusion, dementia (pseudodementia), fatigue, hallucination (including visual hallucination), headache, insomnia, malaise, mania, mood changes

Ophthalmic: Cycloplegia, mydriasis

Respiratory: Dyspnea, nasal congestion

Contraindications

Obstructive diseases of the GI tract; severe ulcerative colitis; reflux esophagitis; unstable cardiovascular status in acute hemorrhage; obstructive uropathy; glaucoma; myasthenia gravis; breastfeeding; infants <6 months of age.

Canadian labeling: Additional contraindications (not in US labeling): Known idiosyncrasy to dicyclomine or any component of the formulation; paralytic ileus and intestinal atony.

Warnings/Precautions

Concerns related to adverse effects:

• Diarrhea: May be a sign of incomplete intestinal obstruction, treatment should be discontinued if this occurs.

• Heat prostration: May occur in the presence of increased environmental temperature; use caution in hot weather and/or exercise.

• Psychosis/delirium: Has been reported in patients with an extreme sensitivity to anticholinergic effects or at excessive dosages, such as the elderly or patients with mental illness.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with coronary artery disease, tachyarrhythmias, heart failure, or hypertension; evaluate tachycardia prior to administration.

• Hepatic impairment: Use with caution in patients with hepatic impairment.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism.

• Neuropathy: Use with caution in patients with autonomic neuropathy.

• Prostatic hyperplasia: Use with caution in patients with prostatic hyperplasia (known or suspected).

• Renal impairment: Use with caution in patients with renal impairment.

• Salmonella dysentery: Do not use anticholinergic agents in patients with salmonella dysentery; toxic dilatation of intestine and intestinal perforation may occur.

• Ulcerative colitis: Use with caution in patients with mild-moderate ulcerative colitis. Use is contraindicated in patients with severe ulcerative colitis.

Concurrent drug therapy issues:

• Sedatives: Effects may be potentiated when used with other sedative drugs or ethanol.

Special populations:

• Pediatric: Serious respiratory reactions, central nervous symptoms, and deaths have been reported following administration to infants; use in infants <6 months of age is contraindicated.

Dosage form specific issues:

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated with hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007).

Other warnings/precautions:

• Appropriate administration: Injectable formulation is for IM administration only; inadvertent IV administration may cause thrombosis/thrombophlebitis and injection site reactions (eg, pain, edema, skin color change, reflex sympathetic dystrophy).

Warnings: Additional Pediatric Considerations

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral, as hydrochloride:

Generic: 10 mg

Solution, Intramuscular, as hydrochloride:

Bentyl: 10 mg/mL (2 mL [DSC]) [pyrogen free]

Generic: 10 mg/mL (2 mL)

Solution, Intramuscular, as hydrochloride [preservative free]:

Generic: 10 mg/mL (2 mL)

Solution, Oral, as hydrochloride:

Generic: 10 mg/5 mL (473 mL)

Tablet, Oral, as hydrochloride:

Generic: 20 mg

Generic Equivalent Available: US

Yes

Pricing: US

Capsules (Dicyclomine HCl Oral)

10 mg (per each): $0.26 - $0.68

Solution (Dicyclomine HCl Intramuscular)

10 mg/mL (per mL): $14.54 - $50.44

Solution (Dicyclomine HCl Oral)

10 mg/5 mL (per mL): $0.30

Tablets (Dicyclomine HCl Oral)

20 mg (per each): $0.36 - $3.60

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral, as hydrochloride:

Protylol: 10 mg [DSC]

Generic: 10 mg

Tablet, Oral:

Generic: 10 mg

Tablet, Oral, as hydrochloride:

Generic: 20 mg

Administration: Pediatric

Oral: Capsule, oral solution: May administer with or without food.

Administration: Adult

Oral: May be taken with or without food.

Injection: There is an injectable formulation for IM administration available intended for short-term use (<2 days) in patients unable to take oral medications; however, severe pain and necrosis have been reported following IM administration (Ref). Do not administer IV (IV administration may result in thrombosis or thrombophlebitis).

Storage/Stability

Capsule, tablet: Store at room temperature, preferably below 30°C (86°F). Protect tablet from direct sunlight.

Oral solution: Store at 20°C to 25°C (68°F to 77°F); protect from excessive heat.

Solution for injection: Store at room temperature, preferably below 30°C (86°F); protect from freezing.

Use

Treatment of functional bowel/irritable bowel syndrome (FDA approved in adults).

Medication Safety Issues
Sound-alike/look-alike issues:

Dicyclomine may be confused with diphenhydrAMINE, doxycycline, dyclonine

Bentyl may be confused with Aventyl, Benadryl, Bontril, Cantil, Proventil, Trental

Older Adult: High-Risk Medication:

Beers Criteria: Dicyclomine is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients ≥65 years (independent of diagnosis or condition) due to its highly anticholinergic properties and uncertain effectiveness as an antispasmodic (Beers Criteria [AGS 2023]).

Dicyclomine is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age). Some disease states of concern include chronic cognitive impairment, delirium, dementia, narrow-angle glaucoma, overactive bladder, urge incontinence, and constipation (O’Mahony 2023).

Pediatric patients: High-risk medication:

KIDs List: Dicyclomine, when used in neonates and infants <6 months of age, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of apnea (strong recommendation; low quality of evidence) (PPA [Meyers 2020]).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Acetylcholinesterase Inhibitors: May decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Acetylcholinesterase Inhibitors. Risk C: Monitor

Aclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Acrivastine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Agents with Clinically Relevant Anticholinergic Effects: May increase anticholinergic effects of Dicyclomine. Risk C: Monitor

Amantadine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Benperidol: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Benperidol. Risk C: Monitor

Benztropine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Benztropine. Risk C: Monitor

Biperiden: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Biperiden. Risk C: Monitor

Bornaprine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bornaprine. Risk C: Monitor

Botulinum Toxin-Containing Products: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Bromperidol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bromperidol. Risk C: Monitor

Buclizine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Buclizine. Risk C: Monitor

Cannabinoid-Containing Products: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of Cannabinoid-Containing Products. Risk C: Monitor

Chlorprothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Chlorprothixene. Risk C: Monitor

Cimetropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Cimetropium. Risk X: Avoid

CloZAPine: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider Therapy Modification

Cyclizine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Darifenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Darifenacin. Risk C: Monitor

Dimethindene (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dimethindene (Systemic). Risk C: Monitor

DroNABinol: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of DroNABinol. Risk X: Avoid

Eluxadoline: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Eluxadoline. Risk X: Avoid

Fesoterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Fesoterodine. Risk C: Monitor

FluPHENAZine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Gastrointestinal Agents (Prokinetic): Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Gastrointestinal Agents (Prokinetic). Risk C: Monitor

Gepotidacin: May decrease anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Glucagon: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor

Glycopyrrolate (Oral Inhalation): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Oral Inhalation). Risk X: Avoid

Glycopyrrolate (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Systemic). Risk C: Monitor

Glycopyrronium (Topical): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Ipratropium (Nasal): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ipratropium (Oral Inhalation): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Itopride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Itopride. Risk C: Monitor

Levosulpiride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Levosulpiride. Risk X: Avoid

Maprotiline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Maprotiline. Risk C: Monitor

Melperone: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Methotrimeprazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methotrimeprazine. Risk C: Monitor

Methscopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methscopolamine. Risk C: Monitor

Mirabegron: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Mirabegron. Risk C: Monitor

Nitroglycerin: Agents with Clinically Relevant Anticholinergic Effects may decrease absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor

OLANZapine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OLANZapine. Risk C: Monitor

Opioid Agonists: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor

Opipramol: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Oxatomide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

OxyBUTYnin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OxyBUTYnin. Risk C: Monitor

Perazine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Perphenazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Perphenazine. Risk C: Monitor

Potassium Chloride: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid

Potassium Citrate: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid

Pramlintide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. These effects are specific to the GI tract. Risk X: Avoid

Promethazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Promethazine. Risk C: Monitor

Propantheline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Propantheline. Risk C: Monitor

Propiverine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

QuiNIDine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ramosetron: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Ramosetron. Risk C: Monitor

Revefenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Revefenacin. Risk X: Avoid

Rivastigmine: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Rivastigmine. Rivastigmine may decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider Therapy Modification

Scopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Scopolamine. Risk C: Monitor

Secretin: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider Therapy Modification

Sincalide: Drugs that Affect Gallbladder Function may decrease therapeutic effects of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Risk D: Consider Therapy Modification

Sofpironium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Sofpironium. Risk X: Avoid

Thiazide and Thiazide-Like Diuretics: Agents with Clinically Relevant Anticholinergic Effects may increase serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor

Thiothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Thiothixene. Risk C: Monitor

Tiapride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Tiapride. Risk C: Monitor

Tiotropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tiotropium. Risk X: Avoid

Tolterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tolterodine. Risk C: Monitor

Topiramate: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Topiramate. Risk C: Monitor

Trimethobenzamide: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trimethobenzamide. Risk C: Monitor

Trospium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trospium. Risk C: Monitor

Umeclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Zuclopenthixol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Zuclopenthixol. Risk C: Monitor

Pregnancy Considerations

Outcome data following maternal use of dicyclomine are available (Heinonen 1977; Zhang 2017). In epidemiologic studies, birth defects were not observed following maternal doses up to 40 mg daily throughout the first trimester; information has not been located when used in pregnant patients at recommended doses for irritable bowel syndrome (IBS) (80 to 160 mg daily).

Treatment for IBS during pregnancy should be made as part of a shared decision-making process (Moosavi 2021). Antispasmodics are generally avoided when treating global symptoms due to lack of data supporting efficacy and risk of adverse events (ACG [Lacy 2021]; ACOG [Ray 2022]).

Monitoring Parameters

Anticholinergic effects, urinary output.

Mechanism of Action

Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands and the CNS

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: 1 to 2 hours

Duration: Up to 4 hours

Absorption: Oral: Rapid and well absorbed

Distribution: Vd: 3.65 L/kg

Metabolism: Extensive

Bioavailability: The IM injection is ~2 times more bioavailable compared to oral administration.

Half-life elimination: Initial phase: ~1.8 hours; Terminal phase: Undetermined, but somewhat longer than the initial phase

Time to peak: Oral: 60 to 90 minutes

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

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Merbentyl;
  • (AU) Australia: Merbentyl;
  • (BD) Bangladesh: Abdorin | Cyclopan | Cyclovin | Diverin | Ibspa | Robentyl | Spalax;
  • (BR) Brazil: Bentyl;
  • (EG) Egypt: Spasmorest;
  • (GB) United Kingdom: Dicycloverine | Merbentyl | Merbentyl old;
  • (HK) Hong Kong: Bental | Bento | Dicymine | Swityl | Uni cycolac;
  • (IE) Ireland: Bentylol | Merbentyl;
  • (IL) Israel: Notensyl;
  • (IN) India: Coligon | Cyclominol | Diospas | Meftal spas inj | Spadic | Trigan-d;
  • (JP) Japan: Bentyl | Dicyclomine hcl hexal | Resporimin | Sawamin;
  • (KE) Kenya: Colicon;
  • (KR) Korea, Republic of: Diclomin | Dicyclomine HCL | Easy | Newgenpharm dicyclomine hcl | Spatomin;
  • (LT) Lithuania: Antispasmin;
  • (LV) Latvia: Antispasmin;
  • (MX) Mexico: Bentyl | Diciclomina | Diclomin | Dicycloverine | Sediclon;
  • (MY) Malaysia: Dicyclomine | Dicyclomine-s | Spasmin;
  • (NG) Nigeria: Baralif | Zubagan;
  • (NZ) New Zealand: Dicyclomine | Merbentyl;
  • (PH) Philippines: Bentyl | Cholijen | Diaciel | Dicol-s | Dicyclo | Dicycloverine | Dicymed | Dicyrine | Dilomin | Dli-dicycloverine hcl | Foramelyn | Gasaide | Medic aid dicycloverine | Myrentyl | Smodic | Spasmed | Spasoma | Ul dicycloverine;
  • (PK) Pakistan: Blisscolic;
  • (PR) Puerto Rico: Bentyl | Dibent | Dicyclomine | Dicyclomine HCL | Dicyclomine hydrochloride;
  • (SG) Singapore: Dicyclomine;
  • (TH) Thailand: Diclomin | Dicomin | Dicyclomine | Dicymine | Med-anspasmic | Spasic | Spasminar;
  • (TW) Taiwan: Bentyl | Cenpyl | Coochil | Diclamin | Dicyclomine | Dicyclomine HCL | Korinti | Kuetonbily | Lututin | Painlax | Resporimin | Soonan | Suwimin | Swemine | Swityl | Toliwei | Tontyl | Vantyl | Wintyl;
  • (VE) Venezuela, Bolivarian Republic of: Bentyl;
  • (ZA) South Africa: Medicyclomine | Merbentyl
  1. 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767 [PubMed 30693946]
  2. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  3. American Academy of Pediatrics Committee on Drugs. "Inactive" ingredients in pharmaceutical products: update (subject review). Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  4. Bentyl (dicyclomine hydrochloride) [prescribing information]. Irvine, CA: Allergan USA Inc; June 2018.
  5. Bentyl (dicyclomine hydrochloride) [prescribing information]. North Chicago, IL: AbbVie Inc; April 2024.
  6. Bentylol tablets, syrup (dicyclomine) [prescribing information]. Mont-St-Hilaire, Quebec: Aptalis Pharma Canada Inc; July 2012.
  7. Dicyclomine hydrochloride capsules and tablets [prescribing information]. Parsippany, NJ: Teva Pharmaceuticals USA Inc; November 2020.
  8. Dicyclomine hydrochloride oral solution [prescribing information]. Eatontown, NJ: Hikma Pharmaceuticals USA Inc; October 2018.
  9. Dicyclomine hydrochloride tablet [prescribing information]. Congers, NY: Chartwell RX, LLC; March 2023.
  10. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  11. Ford AC, Moayyedi P, Lacy BE, et al; Task Force on the Management of Functional Bowel Disorders. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol. 2014;109(suppl 1):S2-26. doi: 10.1038/ajg.2014.187. [PubMed 25091148]
  12. Greenky D, Dixon R. Adolescent with pain and necrosis following intramuscular injection. JAMA Pediatr. 2017;171(10):1008-1009. doi: 10.1001/jamapediatrics.2017.1881. [PubMed 28783814]
  13. Grillage MG, Nankani JN, Atkinson SN, Prescott P. A randomised, double-blind study of mebeverine versus dicyclomine in the treatment of functional abdominal pain in young adults. Br J Clin Pract. 1990;44(5):176-9. [PubMed 2202405]
  14. Heinonen OP, Slone D, and Shapiro S. Birth defects and drugs in pregnancy. Publishing Sciences Group, Inc. 1977.
  15. JAMP-Dicyclomine HCl (dicyclomine hydrochloride) [product monograph]. Boucherville, Québec, Canada: JAMP Pharma Corporation; February 2024.
  16. Kay GG, Wesnes KA. Pharmacodynamic effects of darifenacin, a muscarinic M selective receptor antagonist for the treatment of overactive bladder, in healthy volunteers. BJU Int. 2005;96(7):1055-1062. doi:10.1111/j.1464-410X.2005.05745.x [PubMed 16225528]
  17. Lacy BE, Pimentel M, Brenner DM, et al. ACG clinical guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036 [PubMed 33315591]
  18. Meyers RS, Thackray J, Matson KL, et al. Key Potentially Inappropriate Drugs in Pediatrics: The KIDs List. J Pediatr Pharmacol Ther. 2020;25(3):175-191. [PubMed 32265601]
  19. O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1007/s41999-023-00777-y [PubMed 37256475]
  20. Page JG, Dirnberger GM. Treatment of the irritable bowel syndrome with Bentyl (dicyclomine hydrochloride). J Clin Gastroenterol. 1981;3(2):153-156. doi:10.1097/00004836-198106000-00009 [PubMed 7016973]
  21. Ray J, LaBundy J; American College of Obstetricians and Gynecologists (ACOG). Lower gastrointestinal tract disorders. American College of Obstetricians and Gynecologists (ACOG) clinical updates in women's health care. https://www.acog.org/clinical/journals-and-publications/clinical-updates/2022/06/lower-gastrointestinal-tract-disorders. Published June 2022. Accessed January 17, 2025.
  22. Refer to manufacturer's labeling.
  23. RIVA-Dicyclomine (dicyclomine hydrochloride) [product monograph]. Blainville, Québec, Canada: Laboratoire Riva Inc; December 2017.
  24. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
  25. Wald A. Treatment of irritable bowel syndrome in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed June 3, 2021.
  26. Weinberg DS, Smalley W, Heidelbaugh JJ, Sultan S; American Gastroenterological Association. American Gastroenterological Association Institute Guideline on the pharmacological management of irritable bowel syndrome. Gastroenterology. 2014;147(5):1146-1148. doi: 10.1053/j.gastro.2014.09.001. [PubMed 25224526]
  27. Zar T, Graeber C, Perazella MA. Recognition, treatment, and prevention of propylene glycol toxicity. Semin Dial. 2007;20(3):217-219. [PubMed 17555487]
  28. Zhang R, Persaud N. 8-Way randomized controlled trial of doxylamine, pyridoxine and dicyclomine for nausea and vomiting during pregnancy: restoration of unpublished information. PLoS One. 2017;12(1):e0167609. doi:10.1371/journal.pone.0167609 [PubMed 28052111]
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