Dicyclomine, commonly known by the brand name Bentyl, is a medication primarily prescribed to manage the symptoms of irritable bowel syndrome (IBS). It belongs to a class of drugs called anticholinergics or antispasmodics. Dicyclomine helps relieve belly cramps by relaxing the gut muscles and slowing their natural movements. It is approved for use in the United States and internationally.
What is Dicyclomine Used For?
Dicyclomine is commonly used to treat irritable bowel syndrome (IBS). It is prescribed to help manage IBS and works by relaxing the stomach and intestinal muscles, calming the natural movements in the digestive tract to prevent cramping and other symptoms. Doctors may recommend dicyclomine to treat irritable bowel syndrome (IBS) because it can effectively relieve symptoms such as abdominal pain and spasms.
Dicyclomine may also be used for other conditions as determined by your healthcare provider.
IBS is a chronic condition of the digestive system that causes constipation, bloating, and diarrhea. It is one of the most common disorders affecting the gastrointestinal tract. According to the American College of Gastroenterology, many treatment options for IBS improve individual symptoms, but only a few improve overall symptoms.
How Dicyclomine Works
Dicyclomine helps relieve belly cramps by relaxing the gut muscles and slowing their natural movements. Doctors may recommend dicyclomine, sold under the brand name Bentyl, to treat irritable bowel syndrome (IBS) because it can effectively relieve symptoms such as abdominal pain and spasms. It acts as an anticholinergic, blocking the action of acetylcholine, a neurotransmitter that transfers signals among cells in the body. Additionally, as an antispasmodic, it can relax the smooth muscles of the intestines and inhibit the involuntary muscle movement of the digestive system that IBS can cause.
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Dicyclomine functions by inhibiting the action of acetylcholine, a neurotransmitter that triggers muscle contractions in the gastrointestinal tract. This inhibition relaxes the muscles in the stomach and intestines, thus alleviating muscle spasms and cramping associated with irritable bowel syndrome (IBS).
Dicyclomine relaxes muscle spasms by directly acting on smooth muscle and also by indirectly blocking the actions of acetylcholine, a neurotransmitter. Dicyclomine belongs to the class of drugs known as anticholinergics. Dicyclomine Hydrochloride is used to treat irritable bowel syndrome, slowing the natural movements of the gut and thereby helping to relieve muscle spasms in the gastrointestinal tract.
Dosage and Forms
Dicyclomine is available as Bentyl and generic dicyclomine supplied in the following dosage forms that are taken by mouth:
- 10 mg oral capsules
- 20 mg oral tablets
- 10 mg/5 mL oral liquid
Dicyclomine is also available in an injectable form.
Bentyl is available in the following forms: capsule, tablet, syrup, injection.
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All forms (capsules, tablets, liquid and injectables) are widely available and typically covered by insurance.
A person can take Bentyl by mouth as directed by a doctor, usually four times per day. They can take it either with food or on an empty stomach. To reduce the risk of side effects, a doctor will start a person on a low dose and gradually increase the dose while monitoring their symptoms.
A doctor can start a person on 20 mg of Bentyl four times per day. After a week of treatment with the starting dose, the doctor may increase the dose to 40 mg four times per day. The doctor will adjust an individual’s dosage to meet their needs. However, the doctor may not increase a person’s dose if they have side effects. For people who cannot take medication orally, health experts recommend intramuscular injections of 10 to 20 mg four times daily.
Some doctors prescribe Bentyl up to four times a day (or at least 30 minutes to one hour before meals) to help people avoid abdominal cramping, diarrhea and bloating, per the Cleveland Clinic.
Bentyl is absorbed quickly after you take it, reaching peak values in the body within 60 to 90 minutes, per the National Institutes of Health.
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Storage Instructions
Dicyclomine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from excessive heat or freezing. Protect from light. Throw away any unused medication after the expiration date.
Common Side Effects
The most common side effects of dicyclomine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Dizziness
- Dry mouth
- Blurred vision
- Nausea
- Sleepiness
- Feeling unusually weak or tired
- Nervousness
There may be other side effects of dicyclomine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345. Side effects are usually transient and eventually resolve although some people may require dosage reduction. 9% of people discontinue dicyclomine because of side effects.
Dry mouth is one of the most common side effects of taking Bentyl. Blurred vision is a possibility when taking Bentyl for IBS, which is another reason you should avoid driving until you're aware of how this medication affects you. Bentyl can make you feel nauseous, like many other prescription meds.
Serious Side Effects and Precautions
While less common, the most serious side effects of dicyclomine are described below, along with what to do if they happen.
- Nervous System Effects. Taking dicyclomine may affect parts of the nervous system. It can also cause less sweating, which may lead to fever or heat stroke in high temperatures. Call your healthcare provider right away if you have any of the following symptoms.
- Dry mouth and trouble swallowing, talking, or peeing
- Increased thirst
- Dry skin or flushing
- Dilated pupils and sensitivity to light
- Changes in your heartbeat or heart rhythm
- Constipation
- Confusion or disorientation
- Memory problems
- Seeing or hearing things that others do not see or hear
- Trouble speaking
- Trouble with balance or coordination
- A feeling of intense excitement and happiness
- Tiredness
- Trouble sleeping
- A feeling of restlessness
Dicyclomine may cause heat exhaustion, particularly in hot climates (dicyclomine decreases the ability to sweat). May cause psychosis in some people; symptoms include confusion, disorientation, short-term memory loss, hallucinations, insomnia, and agitation. Symptoms usually resolve within 12-24 hours of drug discontinuation. May cause breathing difficulties or other serious effects (such as seizures or pulse fluctuations) in infants.
If you experience a fever, confusion, dry skin, nausea and vomiting, shortness of breath and rapid heart rate, you could be having a heatstroke, per the Mayo Clinic. Call 911 or visit the nearest emergency room for immediate medical care. In the meantime, stay in the shade, remove excess clothing and put cold water or ice packs on your body to cool down.
Who Should Not Use Dicyclomine?
Allergies to Ingredients. People who are allergic to any of the following should not take dicyclomine.
- Dicyclomine
- Bentyl
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific dicyclomine products they stock.
Infants Under 6 Months of Age. Giving dicyclomine to infants under 6 months has led to cases of severe breathing problems, seizures, fainting, changes in heart rate, muscle weakness, coma, and death. Dicyclomine should not be used in infants under 6 months.
Breastfeeding. Do not take dicyclomine if you are breastfeeding. You must either stop breastfeeding or stop dicyclomine.
Myasthenia Gravis. Myasthenia gravis is a condition that can cause muscle weakness. Dicyclomine can make this condition worse. It should not be used in people who have a history of this condition.
Glaucoma. Glaucoma is a condition that may lead to trouble seeing or blindness because of damage to the optic nerve in your eye. Dicyclomine can make this condition worse or can block the effects of medicines used to treat glaucoma. It should not be used if you have glaucoma.
Blockage of the Urinary Tract. Dicyclomine should not be used if you have a blockage in your urinary tract, also called obstructive uropathy. Dicyclomine can make this condition worse.
Blockage of the Gut. Dicyclomine should not be used if you have a blockage of your gut. Dicyclomine can make this worse.
Severe Ulcerative Colitis. Ulcerative colitis is an inflammatory bowel disease that can cause pain and sores in the lining of your large intestine. Dicyclomine should not be used if you have severe ulcerative colitis. It may slow down the movement in your gut and lead to problems such as severe swelling or a hole in the intestines.
Inflammation of the Esophagus Due To Acid Reflux. Acid reflux can lead to inflammation of the esophagus, sometimes called reflux esophagitis. Dicyclomine should not be used if you have reflux esophagitis.
Other conditions: May not be suitable for some people including those with certain gastrointestinal conditions (such as severe ulcerative colitis, reflux esophagitis, an obstruction), liver or kidney disease, heart disease, prostate, or urinary problems.
Important Considerations Before Using Dicyclomine
- Do not take dicyclomine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
- Do not share dicyclomine with other people, even if they have the same condition as you. It may harm them.
- Keep dicyclomine out of the reach of children.
- Dicyclomine can affect your alertness or coordination. It can also cause blurred vision, dizziness, or drowsiness. Do not drive or do other activities that require alertness or coordination until you know how dicyclomine affects you.
- People who are age 65 and older can be at greater risk for some side effects from dicyclomine. Talk to your healthcare provider about your risks if you are in this age group.
- Dicyclomine may impair your thinking and reaction time, so exercise caution if you're doing anything that requires you to be alert.
What to Tell Your Healthcare Provider Before Using Dicyclomine
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if dicyclomine is right for you.
In particular, make sure that you discuss any of the following.
- Current and Past Health Conditions. Tell your healthcare provider if you have any of the following health conditions.
- Kidney problems
- Liver problems
- High blood pressure
- An enlarged prostate, also called benign prostatic hyperplasia (BPH)
- Ulcerative colitis
- Heart Conditions or a Fast Heartbeat. Tell your healthcare provider if you have a history of a fast or irregular heartbeat. Also tell your doctor if you have heart failure, heart disease, or too much thyroid hormone. Dicyclomine may cause a fast or irregular heartbeat or palpitations, which may worsen some symptoms of these conditions.
- Nerve Damage. Tell your healthcare provider if you have a condition caused by a certain type of nerve damage called autonomic neuropathy. Dicyclomine can affect certain nerves in your body, and it should be used cautiously if you have autonomic neuropathy.
- Partial Blockage of the Gut. Tell your healthcare provider if you have a partial blockage of your gut, or if you have an ileostomy or colostomy (openings made in the belly to collect poo). Dicyclomine should not be used and may be harmful if you have a gut blockage.
- Infectious Diarrhea. Tell your healthcare provider if you have a stomach infection or food-related illness. Taking dicyclomine while you have an illness from certain bacteria, sometimes called salmonella dysentery, may lead to severe swelling or a hole in the intestines.
- Mental Health Problems. Tell your healthcare provider about any recent and current mental health problems, especially if you have had symptoms such as losing touch with reality or seeing, hearing, or believing things that aren’t real, also called hallucinations.
- Other Medicines and Supplements. Dicyclomine may interact with other medicines and supplements. Before using dicyclomine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
- Pregnancy. It is not known if or how dicyclomine could affect pregnancy or harm an unborn baby. It should be used during pregnancy only if clearly needed. Tell your healthcare provider if you are or plan to become pregnant.
- Breastfeeding. Dicyclomine passes into breast milk and may harm a breastfed infant. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop dicyclomine or stop breastfeeding.
Interactions with Food, Drink, and Other Medications
There are no known interactions between dicyclomine and foods or drinks. It is unknown if drinking alcohol will affect dicyclomine. The risk of dizziness, blurred vision, or sleepiness may be increased if you drink alcohol while taking dicyclomine. Alcohol reduces its effectiveness. Because Bentyl affects your nervous system, doctors typically recommend you avoid drinking alcohol while taking the medication. Alcohol could worsen side effects like drowsiness and reduce the effectiveness of the medication, Dr. Robbins warns.
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using dicyclomine.
- Any other medicine that causes dizziness and sleepiness (e.g., prescription pain medicines, sleep medicines, and medicines for anxiety)
- A medicine used to treat an eye condition called glaucoma
- An anticholinergic medicine, which includes antihistamines and certain medicines for overactive bladder, Parkinson’s disease, stomach problems, motion sickness, and others
- An antacid, which is a medicine that neutralizes the acid in your stomach to relieve indigestion and heartburn, such as calcium carbonate and magnesium hydroxide
- A medicine that affects motility in the gut, such as metoclopramide (Reglan, Gimoti)
Bentyl can affect the activity of some medications, including:
- Antiglaucoma agents
- Antacids
- Other anticholinergic agents
Dicyclomine may affect the absorption of some other medicines. Take products with antacids in them at a different time of day than this medication. Take antacids 2 hours BEFORE or 2 hours AFTER this medication. Take other medications at least an hour or two before taking dicyclomine.
The most common drug interactions with Bentyl include the following, per the Cleveland Clinic:
- Antacids
- Allergy and cold medications
- Anxiety or sleeping medications
- Mental health medications (such as antidepressants or antipsychotics)
- Diarrhea medication
- Pain medications
Medicines that interact with dicyclomine may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with dicyclomine. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Dicyclomine and Weight Loss
There is no evidence to support that dicyclomine causes weight loss. Dicyclomine is prescribed to treat the symptoms of IBS by relaxing the muscles in the gut, which can relieve abdominal pain and cramping. It does not directly affect metabolism or fat storage, which are the primary factors in weight loss.
Alternatives to Dicyclomine for IBS
While dicyclomine can be effective for managing IBS symptoms, it is not the only treatment option available. Other approaches include:
- Dietary Changes: A low FODMAP diet can reduce gastrointestinal symptoms in IBS. FODMAPs can trigger digestive symptoms such as gas, bloating, stomach pain, and altered bowel habits in people with IBS.
- Other IBS Medications: A doctor may recommend some FDA-approved medications for IBS, such as alosetron (Lotronex), eluxadoline (Viberzi), lubiprostone (Amitiza), rifaximin (Xifaxan), and linaclotide (Linzess).
- Psychotherapy: Hypnotherapy and cognitive behavioral therapy may reduce symptoms of IBS flares.
- Fiber Supplements: Fiber supplements such as psyllium (Metamucil) can help people manage IBS symptoms.
- Antidiarrheal Medication: Loperamide (Imodium), an antidiarrheal agent, may help improve stool consistency, pain, and frequency.
- Antidepressants: Off-label use of tricyclic antidepressants such as desipramine can relieve IBS symptoms.
- Anticonvulsants: Pregabalin may be beneficial for IBS symptoms such as bloating and diarrhea.
- Herbal Remedies: Peppermint may help manage abdominal pain from IBS.
For individuals seeking natural remedies to manage gastrointestinal symptoms such as those associated with irritable bowel syndrome (IBS), several alternatives may help alleviate abdominal pain, cramping, and discomfort. While these natural options may offer relief, they are not direct substitutes for dicyclomine or other prescribed medications.