Dicyclomine, commonly known by the brand name Bentyl, is a medication prescribed to alleviate the symptoms of irritable bowel syndrome (IBS), a chronic disorder affecting the gastrointestinal tract. IBS is characterized by constipation, bloating, and diarrhea, making it a common and often disruptive condition. While various treatment options exist to manage individual IBS symptoms, only a few effectively address the overall symptom picture.
What is Dicyclomine?
Dicyclomine, an anticholinergic and antispasmodic drug, effectively reduces abdominal pain and spasms associated with IBS. The Food and Drug Administration (FDA) initially approved it in the United States in 1996 for treating peptic ulcer disease. It is now more commonly prescribed for IBS. Dicyclomine functions by blocking acetylcholine, a neurotransmitter responsible for transmitting signals between cells in the body. Additionally, it relaxes the smooth muscles of the intestines and inhibits involuntary muscle movements in the digestive system that can be triggered by IBS.
Dicyclomine is available in several forms:
- Capsules
- Tablets
- Syrup
- Injection
It is crucial to consult a healthcare professional before starting dicyclomine.
How Dicyclomine Helps with IBS
IBS often leads to painful contractions of the gut muscles, resulting in cramps and irregular bowel movements. Dicyclomine helps alleviate these involuntary muscle spasms and other related symptoms. It can be prescribed as a short-term or long-term treatment for IBS, with many individuals experiencing relief within hours of taking the medication.
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A 2015 review indicated that dicyclomine effectively relieves intestinal spasms and accompanying pain in individuals with IBS.
In a 1981 study, administering 40 mg of hydrochloride four times daily, researchers found that dicyclomine was more effective than a placebo in improving abdominal pain, gastrointestinal tenderness, bowel function, and overall IBS symptoms. However, most participants taking dicyclomine experienced side effects such as dry mouth, dizziness, and blurred vision.
How to Take Dicyclomine
Dicyclomine is typically taken orally, as directed by a doctor, usually four times a day, with or without food. To minimize the risk of side effects, a doctor may start with a low dose and gradually increase it while monitoring symptoms.
Dosage
A typical starting dose is 20 mg of dicyclomine four times daily. After a week, the doctor may increase it to 40 mg four times daily, adjusting the dosage based on individual needs and tolerance. The doctor may not increase the dose if side effects occur. For those unable to take oral medication, intramuscular injections of 10 to 20 mg four times daily may be recommended.
Potential Drug Interactions
Dicyclomine can interact with several medications, affecting their activity or increasing the risk of side effects:
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- Antiglaucoma agents: Anticholinergics can cause adverse reactions and increase pressure inside the eyes when taken with antiglaucoma eye drops like latanoprost, dorzolamide, and timolol.
- Antacids: Combining antacids with dicyclomine is not recommended, as antacids can interfere with the absorption of anticholinergic agents.
- Other anticholinergic agents: Taking dicyclomine with other anticholinergic agents, such as diphenhydramine (Benadryl), solifenacin (Vesicare), and oxybutynin (Ditropan XL), can amplify side effects.
- Digoxin: Taking dicyclomine with digoxin can lead to more side effects from digoxin, including confusion, irregular heartbeat, nausea, vomiting, diarrhea, and blurry or cloudy vision.
- Metoclopramide: Dicyclomine can reduce or even cancel the effects of metoclopramide, which is used to increase or ease the movement of food down the digestive tract.
Contraindications
Dicyclomine is not recommended for:
- Infants younger than 6 months
- Nursing mothers
- Individuals with glaucoma, obstructive uropathy, reflux esophagitis, severe ulcerative colitis, obstructive disease of the gastrointestinal tract, or myasthenia gravis
Alternative IBS Treatments
While dicyclomine can effectively manage IBS symptoms, it is essential to explore other treatment options. Since there is no cure for IBS, the goal is to manage symptoms and improve quality of life.
Other treatment options include:
- Diet: A low FODMAP diet, which restricts fermentable oligo-, di-, and monosaccharides and polyols, can reduce gastrointestinal symptoms.
- Other IBS medications: FDA-approved medications such as alosetron (Lotronex), eluxadoline (Viberzi), lubiprostone (Amitiza), rifaximin (Xifaxan), and linaclotide (Linzess).
- Psychotherapy: Hypnotherapy and cognitive-behavioral therapy may reduce IBS flare-ups.
- Fiber supplements: Psyllium (Metamucil) can help manage IBS symptoms.
- Antidiarrheal medication: Loperamide (Imodium) may improve stool consistency, pain, and frequency.
- Antidepressants: Tricyclic antidepressants like desipramine can relieve IBS symptoms.
- Anticonvulsants: Pregabalin may alleviate bloating and diarrhea.
- Herbal remedies: Peppermint may help manage abdominal pain.
Dicyclomine Side Effects
Dicyclomine can cause several side effects. Common side effects include dry mouth, upset stomach, vomiting, constipation, stomach pain, gas or bloating, loss of appetite, dizziness, tingling, headache, drowsiness, weakness, and blurred vision.
Serious side effects include:
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- Hot, flushed, dry skin
- Confusion
- Forgetfulness
- Hallucinations
- Unsteadiness
- Coma
- Anxiety
- Excessive tiredness
- Difficulty falling asleep or staying asleep
- Excitement
- Inappropriate mood
- Muscle weakness
- Rapid or pounding heartbeat
- Fainting
- Hives
- Skin rash
- Itching
- Difficulty breathing or swallowing
If you experience any of these serious side effects, seek immediate medical attention.
Important Precautions
- Allergy: Dicyclomine can cause a severe allergic reaction. Seek immediate medical help if you experience trouble breathing or swelling of the throat or tongue.
- Alcohol: Avoid alcohol, as it can increase drowsiness when taken with dicyclomine.
- Heat Stroke: Dicyclomine reduces sweating, increasing the risk of heat stroke in hot weather. Take precautions to avoid overheating.
- Central nervous system effects: Dicyclomine may affect your brain and may cause you to become confused or disoriented.
- Intestinal obstruction: This drug may make any blockage in your intestines worse.
- Driving and Operating Machinery: Dicyclomine may cause drowsiness or blurred vision. Avoid driving or operating machinery until you know how it affects you.
- Pregnancy and Breastfeeding: Dicyclomine should be used during pregnancy only if clearly needed. It passes into breast milk and may harm a breastfed infant.
Dicyclomine Generic and Brand Names
Dicyclomine is available as a generic drug and under the brand name Bentyl. Generic drugs usually cost less than brand-name versions.
Dicyclomine Storage Instructions
- Store dicyclomine at room temperature, between 68°F and 77°F (20°C to 25°C).
- Keep away from light and protect from freezing.
- Do not store in moist or damp areas, such as bathrooms.
- Keep out of reach of children.
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