Dicyclomine%252525252525252525252525252525252525252525252525252525252520hydrochloride

# Dicyclomine Hydrochloride ## Overview Dicyclomine hydrochloride is an anticholinergic and antispasmodic medication. It works by blocking the action of acetylcholine at muscarinic receptors in the gastrointestinal tract, leading to smooth muscle relaxation. ## Primary Indications Dicyclomine is primarily indicated for the relief of symptoms of functional gastrointestinal disorders, often referred to as irritable bowel syndrome (IBS). ## Adult Dosing * **Oral:** * Initial dose: 10 mg to 20 mg given 3 to 4 times daily. * Titration: Dose may be increased as needed and tolerated, not to exceed 80 mg daily. * Maximum dose: 80 mg daily. ## Pediatric Dosing * **Oral:** * Children 6 months to < 2 years: 5 mg to 10 mg given 3 to 4 times daily. * Children 2 years to < 12 years: 10 mg given 3 to 4 times daily. * Maximum pediatric dose information is not well-established. Dosing should be individualized and cautiously administered. ## Dose Adjustments No specific dose adjustments are necessary for patients with renal or hepatic impairment; however, caution is advised due to potential for accumulation and increased anticholinergic effects. ## Contraindications * Hypersensitivity to dicyclomine. * Gastrointestinal obstruction or ileus. * Severe ulcerative colitis. * Glaucoma (angle-closure glaucoma is a specific contraindication). * Myasthenia gravis. * Infants less than 6 months of age due to risk of respiratory depression and potential for adverse effects. * Unstable cardiovascular status in acute hemorrhage. ## Adverse Effects Common adverse effects are anticholinergic in nature and include dry mouth, blurred vision, constipation, urinary retention, dizziness, confusion, drowsiness, and headache. Less common but serious effects include tachycardia, hypotension, nausea, vomiting, and allergic reactions. ## Key Drug Interactions * **Anticholinergic agents:** Additive effects with other drugs having anticholinergic properties (e.g., tricyclic antidepressants, antihistamines, phenothiazines), increasing the risk of adverse effects like dry mouth, constipation, urinary retention, and confusion. * **Corticosteroids:** May increase intraocular pressure. * **MAO inhibitors:** May potentiate anticholinergic effects. * **Prokinetic agents (e.g., metoclopramide):** Dicyclomine may antagonize the effects of prokinetic drugs. ## Monitoring * Monitor for efficacy in symptom relief. * Monitor for adverse effects, particularly anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention, confusion, dizziness). * Monitor vital signs, especially in elderly patients or those with cardiovascular conditions. ## Clinical Pearls * Dicyclomine is generally not recommended for long-term use in functional GI disorders. * Use with caution in the elderly due to increased susceptibility to anticholinergic adverse effects. * Discontinue if signs of adverse reactions occur. * Adequate hydration and stool softeners may help manage constipation. --- **Disclaimer:** This information is intended for healthcare professionals. Always consult the current official prescribing information and relevant literature for complete and up-to-date details before making any clinical decisions.