dicyclomine

Contraindicated in:

Hypersensitivity;
Obstruction of the GI or genitourinary tract;
Reflux esophagitis;
Severe ulcerative colitis (↑ risk of paralytic ileus);
Unstable cardiovascular status;
Glaucoma;
Myasthenia gravis;
Lactation: Lactation;
Pedi: Infants <6 mo.

Use Cautiously in:

High environmental temperatures (risk of heat prostration);
Renal impairment;
Hepatic impairment;
Autonomic neuropathy;
Cardiovascular disease;
Prostatic hyperplasia;
OB: Safety not established in pregnancy;
Geri: Appears on Beers list. ↑ risk of adverse reactions in older adults due to anticholinergic effects. Avoid use in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

CV: palpitations, tachycardia

Derm: ↓sweating

EENT: ↑intraocular pressure, blurred vision

Endo: ↓lactation

GI: constipation, heartburn, ↓salivation, dry mouth, nausea, PARALYTIC ILEUS, vomiting

GU: erectile dysfunction, urinary hesitancy, urinary retention

Local: pain/redness at IM site

Neuro: confusion, delirium, drowsiness, light-headedness (IM only), psychosis

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

Additive anticholinergic effects with other anticholinergics, including antihistamines, quinidine, and disopyramide.
May alter the absorption of other orally administered drugs by slowing motility of the GI tract.
Antacids or adsorbent antidiarrheals↓ the absorption of anticholinergics.
May ↑ GI mucosal lesions in patients taking oral potassium chloride tablets.

Availability ⬆ ⬇

(Generic available)

Tablets: 10 mg; 20 mg
Capsules: 10 mg
Oral solution cherry flavor: 10 mg/5 mL
Solution for injection: 10 mg/mL

Route/Dosage ⬆ ⬇

PO (Adults ): 10–20 mg 3–4 times daily (up to 160 mg/day).
PO (Children ≥2 yr): 10 mg 3–4 times daily, adjusted as tolerated.
PO (Children 6 mo–2 yr): 5–10 mg 3–4 times daily, adjusted as tolerated.
IM (Adults ): 20 mg every 4–6 hr, adjusted as tolerated.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

May have a direct and local effect on GI smooth muscle, reducing motility and tone.

Therapeutic effects:

Decreased GI motility.

Classifications ⬆ ⬇

Therapeutic Classification: antispasmodics

Pharmacologic Classification: anticholinergics

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed after oral and IM administration.

Distribution: Unknown.

Metabolism/Excretion: 80% eliminated in urine, 10% in feces.

Half-Life: 9–10 hr.

Time/Action Profile ⬆ ⬇

(antispasmodic effect)

ROUTE	ONSET	PEAK	DURATION
PO, IM	unknown	unknown	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication. Advise patient to read Patient Information before starting therapy. Instruct patient to take exactly as directed and not to take more than the prescribed amount. Take missed doses as soon as remembered if not just before next dose.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
Medication may cause drowsiness and blurred vision. Caution patient to avoid driving or other activities requiring alertness until response to the medication is known.
Caution patient to avoid extremes of temperature. This medication ↓ the ability to sweat and may ↑ the risk of heat stroke. Advise patient to stay in temperature-controlled rooms. Fever and extremes of heat may cause confusional state, disorientation, amnesia, hallucinations, dysarthria, ataxia, coma, euphoria, fatigue, insomnia, agitation and mannerisms, inappropriate affect, psychosis, and delirium. Usually resolves 12–24 hr after discontinuation of dicyclomine.
Inform patient that frequent oral rinses, sugarless gum or candy, and good oral hygiene may help relieve dry mouth. Consult health care professional regarding use of saliva substitute if dry mouth persists for >2 wk.
Advise patient receiving dicyclomine to make position changes slowly to minimize the effects of drug-induced orthostatic hypotension.
Advise patient to notify health care professional immediately if eye pain or ↑ sensitivity to light occurs. Emphasize the importance of routine eye exams throughout therapy.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇