Dicyclomine

Antimuscarinic, GI antispasmodic

Dicyclomine

Bentyl

Experience

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Titration strategies

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Effects

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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)

Common uses

Classification(s)

Classes

Antimuscarinic, GI antispasmodic

Pharmacology

Routes

Oral, IM (not for IV)

Onset

1-2 hours PO

Duration

4 hours

Half-life

~1.8 hours (initial); ~10 hours (terminal)

Bioavailability

~67% (oral)

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.