Dicyclomine [Bentyl]
DRUG CLASS AND MECHANISM: Dicyclomine is an anticholinergic drug, a medication
that reduces the effect of acetylcholine, a chemical released from nerves that
stimulates muscles, by blocking the receptors for acetylcholine on smooth
muscle (a type of muscle). It also has a direct relaxing effect on smooth
muscle. It is used to treat or prevent spasm in the muscles of the
gastrointestinal tract in the irritable bowel syndrome. Dicyclomine was
approved by the FDA in 1950.
DRUG INTERACTIONS: Additive anticholinergic effects may be seen with some
antihistamines [carbinoxamine (Rondec), clemastine (Tavist), diphenhydramine
(Benadryl), promethazine (Phenergan)], some phenothiazines
[e.g. thioridazine (Mellaril), triflupromazine (Stelazine)], some tricyclic
antidepressants [e.g. amitriptyline (Elavil), amoxapine (Asendin),
clomipramine (Anafranil), protriptyline (Vivactil)], clozapine (Clozaril),
cyclobenzaprine (Flexeril), and disopyramide (Norpace). The added effects
of these drugs lead to a greater incidence of dry mouth, blurred vision,
confusion, agitation, increased heart rate, heart palpitations, constipation,
urinary retention, and seizures than when dicyclomine is used alone.
Narcotics [e.g., oxycodone (Percocet, Percodan), hydrocodone (Vicodin)] can
interact with dicyclomine and result in greater depression of the muscles of
the bowel and bladder resulting in greater constipation and difficulty
urinating than may been seen with dicyclomine alone.
Dicyclomine adds to the sedating effects of alcohol and other drugs that cause
sedation such as the benzodiazepine class of anti-anxiety drugs (e.g.,
Valium, Ativan, Klonopin, Xanax), the narcotic class of pain medications
and its derivatives (e.g., Percocet, Vicodin, Dilaudid, Codeine, Darvon), the tricyclic class of antidepressants (e.g., Elavil, Tofranil, Norpramin), and certain antihypertensive medications (e.g., Catapres, Inderal).
Dicyclomine can reverse the effects of cisapride (Propulsid) or metoclopramide
(Reglan) on gastrointestinal motility. Conversely, these latter two drugs
can reverse the effects of dicyclomine.
Antacids and absorbent anti-diarrheals (e.g., Kaopectate) can decrease the
absorption of dicyclomine. Therefore, doses of antacids or absorbent
anti-diarrheals should be separated by at least 2 hours from doses of
dicyclomine.
PREGNANCY: Between 1956 and 1976, dicyclomine was one of the components of
Benedictin, a combination of medications used to treat pregnancy-associated
nausea. Benedictin was reformulated in 1976, and dicyclomine was removed
when it was shown that it did not contribute to the nausea suppressing effect
of Benedectin. Dicyclomine appears to be safe during pregnancy in both animal
studies and in extensive human use.
NURSING MOTHERS: Dicyclomine is excreted into breast milk. Since there have
been reports of apnea (cessation of breathing) when dicyclomine has been
given to children, it should probably not be used by nursing mothers.
This drug acts on the muscle in the wall of the gut and also the urinary
bladder. It relaxes the muscle and prevents spasms from occurring.
It also can slightly reduce the production of stomach acid.
The main role of this drug is to prevent painful spasm of the gut and urinary
bladder. The following conditions may be helped: diarrhea, irritable or
spastic bowel, diverticulosis, colic and bladder spasm. It is seldom used in
treating peptic ulcers since there are much better drugs now available to reduce stomach acid and heal ulcers.
Most females now know that, if possible, no drug, including alcohol, should
be taken during pregnancy or lactation. The potential danger, of course, is
an injury to the baby. However, some drugs are much safer than others in
this regard. So, the FDA has a grading system for each drug which reflects
what is known medically. It ranks drugs from A, where medical studies show
no evidence for danger to the fetus or mother, to B, C, D and X, where the
medical evidence indicates that the risk to the fetus outweighs any benefit
to the mother. Dicyclomine is ranked B. Always consult your physician before
taking any drug during or when planning pregnancy.
Who should not take dicyclomine?
Do not take dicyclomine if you have
· a blockage of your urinary tract (difficulty urinating);
· a blockage in your intestines;
· reflux disease;
· glaucoma; or
· myasthenia gravis.
• Before taking this medication, tell your doctor if you have
· numbness or tingling in your hands or feet;
· liver disease;
· kidney disease;
· ulcerative colitis;
· thyroid problems;
· high blood pressure, an irregular heartbeat, or any type of heart disease;
· hiatal hernia; or
· enlargement of the prostate.
• Dicyclomine is in the FDA pregnancy category B. This means
that it is unlikely to harm an unborn baby. Do not take dicyclomine without
first talking to your doctor if you are pregnant.
• Do not take dicyclomine if you are breast-feeding a baby.
Dicyclomine can cause serious breathing problems in infants younger than 6
months of age.
Many other drugs may increase the side effects of dicyclomine. Before taking
this medication, tell your doctor if you are taking any of the following
medicines:
· amantadine (Symmetrel);
· quinidine (Quinaglute, Cardioquin, Quinora, Quinidex);
· antihistamines such as diphenhydramine (Benadryl, many others), brompheniramine (Dimetapp, Bromfed, many others), triprolidine (Actifed, others), and chlorpheniramine (Chlor-Trimeton, others), which are found in many over-the-counter and prescription cough, cold, and allergy medications;
· decongestants and appetite suppressants such as phenylpropanolamine (Dexatrim, others), phenylephrine (Neo-Synephrine, others), and pseudoephedrine (Sudafed, others), which are also found in many over-the-counter and prescription products;
· phenothiazines such as chlorpromazine (Thorazine) and prochlorperazine (Compazine);
· other commonly used phenothiazines, including fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril), trifluoperazine (Stelazine), and promazine (Sparine);
· benzodiazepines (sleep and anxiety medications) such as alprazolam (Xanax) and diazepam (Valium);
· other commonly used benzodiazepines, including chlordiazepoxide (Librium), clorazepate (Tranxene), clonazepam (Klonopin), estazolam (Prosom), flurazepam (Dalmane), halazepam (Paxipam), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion);
· monoamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan), tranylcypromine (Parnate), and phenelzine (Nardil);
· narcotic analgesics such as codeine (Tylenol #3, and many other prescription pain relievers), morphine (MS Contin, Roxanol, Astramorph, Duramorph), hydrocodone (Vicodin), and propoxyphene (Darvocet, Darvon, Wygesic);
· nitrates such as isosorbide dinitrate (Isordil, Sorbitrate) and isosorbide mononitrate (Imdur, ISMO);
· tricyclic antidepressants such as amitriptyline (Elavil, Endep), doxepin (Sinequan), and nortriptyline (Pamelor); or
· other commonly used tricyclic antidepressants, including: amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), protriptyline (Vivactil), and trimipramine (Surmontil).
• Dicyclomine may increase the level of digoxin
(Lanoxin, Lanoxicaps) in your blood. Tell your doctor if you are taking
digoxin so that your digoxin levels can be monitored and changes in your
dosage can be made if necessary.
• Do not take antacids at the same time as dicyclomine.
They may decrease its absorption.
• Drugs other than those listed here may also interact with
dicyclomine. Talk to your doctor and pharmacist before taking any prescription
or over-the-counter medicines.
Side Effects:
Check with your doctor if any of the following side effects continue or are
bothersome:
constipation
decreased sweating
dryness of mouth, nose, throat, or skin
Less frequent or rare:
Check with your doctor if any of the following side effects continue or are
bothersome:
Bloated feeling
blurred vision
decreased flow of breast milk
difficult urination
difficulty in swallowing
drowsiness
headache
increased sensitivity of eyes to light
lightheadedness (with injection)
loss of memory
nausea or vomiting
redness or other signs of irritation at place of injection
unusual tiredness or weakness
Always Notify Doctor:
Rare
confusion
continuous dizziness
eye pain
skin rash
Symptoms of an Overdose
Blurred vision (continuing) or changes in near vision
clumsiness or unsteadiness
confusion
convulsions (seizures)
difficulty in breathing, muscle weakness (severe), or tiredness (severe)
dizziness
drowsiness (severe)
dryness of mouth, nose, or throat (severe)
fast heartbeat
fever
hallucinations (seeing, hearing, or feeling things that are not there)
slurred speech
unusual excitement, nervousness, restlessness, or irritability
unusual warmth, dryness, and flushing of skin
Other side effects not listed above may also occur in some patients.
If you notice any other effects, check with your doctor. This information is
meant only as a guideline - always consult a physician or pharmacist for
complete information about prescription medications.
On behalf of learning, and use as teaching tools for those of us who need to
know about our disease, I have tried to supply you with as much information as
I could find on all of the drugs, treatments and disorders associated with
Inflammatory Bowel Diseases. I have tried to blend all facts supported by research
and also from personal experiences of other IBD sufferers into one readable webpage, and any and all information presented here is not entirely
from one source. Most information contained within these pages is found in the public domain.
At times you may find information used from another site, and as with all copyrighted materials you may find on these pages,
I claim fair use under sections 107 through 118 of the Copyright Act (title 17, U.S. Code). Click here for more info
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