dicyclomine

Action and Spectrum

Actions and Spectrum: 

dicyclomine is a medication that belongs to the class of anticholinergic drugs, and it acts on the smooth muscles of the gastrointestinal (GI) tract. The actions and spectrum of dicyclomine can be summarized as follows: 

• Antispasmodic effects: dicyclomine works by blocking the action of acetylcholine at muscarinic receptors in the smooth muscles of the GI tract, which leads to relaxation of the muscles and a decrease in spasms. This makes it useful in the treatment of conditions that involve abdominal pain and cramping, such as irritable bowel syndrome (IBS). 
• Anti-secretory effects: dicyclomine can also reduce the secretion of gastric acid, which can be helpful in the treatment of peptic ulcers. 
• Local anesthetic effects: dicyclomine has some local anesthetic effects on the GI tract, which can help to reduce pain and discomfort associated with GI spasms. 

The spectrum of dicyclomine includes its use in the treatment of various GI disorders, such as IBS, functional bowel disorders, diverticulitis, and peptic ulcers. dicyclomine is often used in combination with other medications, such as proton pump inhibitors (PPIs), to provide a comprehensive approach to the management of GI disorders. It is important to note that dicyclomine is a prescription medication and should only be used under the guidance of a healthcare professional. 

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Dry mouth  

Dizziness  

Blurred vision 

1-10% 

Nervousness 

Weakness 

Somnolence 

Frequency not defined 

Abdominal distension 

Confusion state 

Cycloplegia 

Delirium 

Dermatitis 

Erythema 

Fatigue 

Hallucinations 

Insomnia 

Malaise 

Palpitation 

Rash 

Syncope 

Black Box Warning

Dicyclomine hydrochloride does not have a black box warning; however, it should be used with caution in individuals with conditions associated with rapid heart rhythms, such as thyrotoxicosis, congestive heart failure, or those undergoing cardiac surgery, as it may further elevate heart rate. Dosage or frequency should not be altered without medical supervision. Additionally, this medication can affect the central nervous system and may cause confusion or disorientation. 

Contraindication / Caution

Contraindication/Caution: 

dicyclomine has several contraindications and precautions that should be considered before use. These include: 

• Hypersensitivity: dicyclomine should not be used in patients who have a known hypersensitivity to the medication or any of its components. 
• Glaucoma: dicyclomine should be used with caution in patients with narrow-angle glaucoma, as it can increase intraocular pressure and exacerbate the condition. 
• Gastrointestinal obstruction: dicyclomine should not be used in patients with obstructive disorders of the GI tract, such as pyloric stenosis or paralytic ileus. 
• Severe ulcerative colitis: dicyclomine should be used with caution in patients with severe ulcerative colitis, as it may lead to toxic megacolon. 
• Myasthenia gravis: dicyclomine should be used with caution in patients with myasthenia gravis, as it can exacerbate muscle weakness. 
• Children: dicyclomine should not be used in children under 6 months of age, as it can cause serious side effects. 
• Pregnancy and breastfeeding: dicyclomine should only be used during pregnancy or breastfeeding if the potential benefits outweigh the potential risks. 

Overall, dicyclomine should be used with caution in patients with certain medical conditions and should only be used under the guidance of a healthcare professional. It is important to inform the healthcare provider of any pre-existing medical conditions or medications being taken before starting dicyclomine therapy. 

Pregnancy / Lactation

Pregnancy consideration:  

Category B 

Breastfeeding warnings: dicyclomine should not be taken by lactating females 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: There is no affirmation of risk to the fetus found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a product in humans; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women. 
• Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

dicyclomine is a medication that belongs to the class of anticholinergic drugs, and it works by blocking the action of acetylcholine at muscarinic receptors in the smooth muscles of the gastrointestinal (GI) tract. This leads to relaxation of the smooth muscles and a decrease in spasms, which can help to reduce abdominal pain and cramping associated with various GI disorders. 

dicyclomine is rapidly absorbed after oral administration, and it reaches peak plasma concentrations within 1 to 1.5 hours. The medication is metabolized in the liver and excreted in the urine and feces. The half-life of dicyclomine is approximately 1.5 to 2 hours, and the duration of action is 4 to 6 hours. 

In addition to its antispasmodic effects, dicyclomine also has some local anesthetic effects on the GI tract, which can help to reduce pain and discomfort associated with GI spasms. dicyclomine can also reduce the secretion of gastric acid, which can be helpful in the treatment of peptic ulcers. 

Pharmacodynamics: 

dicyclomine is an anticholinergic medication that works by blocking the action of acetylcholine at muscarinic receptors in the smooth muscles of the gastrointestinal (GI) tract. This leads to the relaxation of the smooth muscles and a decrease in spasms, which can help to reduce abdominal pain and cramping associated with various GI disorders. 

Acetylcholine is a neurotransmitter that stimulates smooth muscle contraction in the GI tract, and its effects are mediated through muscarinic receptors. dicyclomine competitively inhibits the binding of acetylcholine to muscarinic receptors, leading to reduced smooth muscle contractions and an overall decrease in GI spasms. 

In addition to its antispasmodic effects, dicyclomine also has some local anesthetic effects on the GI tract, which can help to reduce pain and discomfort associated with GI spasms. dicyclomine can also reduce the secretion of gastric acid, which can be helpful in the treatment of peptic ulcers. 

Pharmacokinetics: 

Absorption 

The bioavailability is 67% in an intramuscular injection 

The onset of action is 1-2 hours 

The duration of action is 4 hours 

The peak plasma concentration for oral is achieved in 60-90 min 

Distribution 

The volume of distribution is 3.65 L/kg 

Metabolism 

The drug gets extensively metabolized in the liver 

Elimination and Excretion 

The half-life is 1.8 hours 

The drug is excreted 80% in urine and 8% in feces

Adminstartion

Administration: 

dicyclomine is usually taken orally, and it is available in the form of capsules, tablets, or an oral solution. The medication should be taken with water, and it can be taken with or without food. 

The dosage and frequency of dicyclomine administration depend on the specific condition being treated and the patient’s age, weight, and overall health. Typically, the recommended adult dose of dicyclomine for the treatment of functional bowel/irritable bowel syndrome is 20 mg four times daily, with the maximum dose of 40 mg four times daily. 

For children, the recommended dose of dicyclomine is based on weight and is usually lower than the adult dose. The medication should not be used in children under six months of age. 

dicyclomine should be taken as prescribed by a healthcare professional, and patients should not exceed the recommended dose or frequency of administration. It is important to follow the instructions provided by the healthcare professional and to continue taking the medication for the entire duration of the prescribed treatment. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: dicyclomine 

Pronounced: dye-SYE-kloe-meen 

Why do we use dicyclomine? 

dicyclomine is a medication that is used to treat various gastrointestinal (GI) conditions that involve spasms, cramps, and pain. It is primarily used to treat functional bowel/irritable bowel syndrome, that is characterized by abdominal pain and discomfort, bloating, and changes in bowel habits. 

In addition to functional bowel/irritable bowel syndrome, dicyclomine can also be used to treat other GI conditions, including: 

• Gastric ulcers 
• Gastroesophageal reflux disease (GERD) 
• Intestinal hypermotility 
• Colitis 
• Pancreatitis 
• Diverticulitis 

dicyclomine works by relaxing the smooth muscles in the GI tract, which can help to reduce spasms and pain associated with these conditions. It can also reduce the secretion of gastric acid, which can be helpful in the treatment of peptic ulcers. 

Overall, dicyclomine is a medication that acts on the smooth muscles of the GI tract to reduce spasms and pain associated with various GI disorders. It is important to note that dicyclomine is a prescription medication and should only be used under the guidance of a healthcare professional.