Dicyclomine
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Dicyclomine
Bentyl
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Summary
Classes
Common uses
Irritable bowel syndrome (functional bowel disease)0, Visceral smooth muscle spasm0
Pharmacy
Starting dose
20 mg PO QID (start 10 mg and titrate); IM 20 mg q6h short-term
Preparations
10, 20 mg tablets/capsules; 10 mg/5 mL syrup; 10 mg/mL IM injection
US FDA Max
160 mg/d (rarely tolerated due to anticholinergic effects)
Pharmacology
Routes
Oral, IM (not for IV)
Onset
1-2 hours PO
Duration
4 hours
Half-life
~1.8 hours (initial); ~10 hours (terminal)[1]
Bioavailability
~67% (oral)[1]
Pregnancy
Generally avoided; not first-line.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Dicyclomine non-selectively antagonizes muscarinic receptors on GI smooth muscle, reducing tone and motility; it also has direct local anesthetic-like effects on smooth muscle independent of muscarinic blockade.0 The non-selective antimuscarinic profile produces the characteristic systemic anticholinergic burden (dry mouth, blurred vision, constipation, urinary retention, confusion in elderly). On the AGS Beers list as potentially inappropriate in older adults[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Bentyl (dicyclomine HCl), Allergan, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/007409s044,007783s045lbl.pdf