DicyclomineDicyclomine Hydrochloride

About Dicyclomine

Dicyclomine relieves spasm of the smooth muscle of the bowel; animal studies suggest it works in two ways, by blocking acetylcholine, the nerve signal that makes the muscle contract, and by acting on the muscle directly. The label approves it for functional bowel or irritable bowel syndrome. For adults the label starts at 20 mg four times a day and allows a rise after one week to 40 mg four times a day unless side effects get in the way. It is stopped if it has not helped within two weeks, or if side effects keep the dose below 80 mg a day, and the label notes that safety data are lacking for doses above 80 mg a day taken for more than two weeks. Safety and effectiveness in children have not been established.

There is no boxed warning. Dizziness, dry mouth and blurred vision are the most common side effects, along with nausea, sleepiness, weakness and nervousness, and it can make driving unsafe. It reduces sweating, so in high heat it can bring on fever and heat stroke. Confusion, hallucinations and other signs of psychosis or delirium have occurred in sensitive people, such as older adults and people with mental illness, and usually clear within 12 to 24 hours of stopping. Diarrhea can be an early sign of a partial bowel blockage, especially after an ileostomy or colostomy, and calls for a check rather than more dicyclomine. It is not used with glaucoma, myasthenia gravis, a blocked urinary or digestive tract, severe ulcerative colitis, reflux esophagitis or unstable heart and circulation during acute bleeding, and needs caution with an enlarged prostate, a fast heart rhythm, heart failure, coronary disease, high blood pressure, and liver or kidney disease.

The label forbids it in infants under 6 months and in nursing mothers; it passes into breast milk, and published reports describe serious breathing problems, seizures, fainting, coma and deaths in infants given dicyclomine, although a cause was not established. MedlinePlus asks people 65 or older to talk with the doctor about its risks and benefits, since older adults usually should not take it: it is not as safe or effective as other medicines for the same condition. Bentyl capsules, tablets, syrup and injection are all listed as discontinued; a generic oral solution is approved as equivalent to the discontinued syrup.

Taking Dicyclomine

How to take it

Usually four times a day, at about the same times each day, exactly as prescribed; the prescriber will probably start with a low dose and raise it gradually. Do not drive or operate machinery until you know how it affects you, and take care in very hot weather, when it can cause fever and heat stroke.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature in the original container, tightly closed, away from excess heat and moisture, out of reach of children. Do not flush unused medicine; use a take-back program.

Interactions to know about

Antacids can reduce its absorption, so do not take them at the same time. Other anticholinergic medicines, including some antihistamines, tricyclic antidepressants and antipsychotics, add to its side effects, and alcohol adds to drowsiness. It may raise levels of slowly dissolving forms of digoxin, and it works against glaucoma medicines and metoclopramide. Tell the surgeon or dentist that you take it.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dicyclomine differs from pharmacy to pharmacy

Generic capsules and tablets come from more than one maker, so quotes differ mainly by the pharmacy’s fee and markup. The oral solution is a separate product with its own makers and is priced by the bottle, so it is quoted on its own terms and may need to be ordered in.

The way the dose is written matters too. At 40 mg four times a day, a prescription for 20 mg tablets uses two tablets a dose, while one for 10 mg capsules uses four, and a pharmacy prices each unit it counts out.

Ways to pay less for Dicyclomine without insurance

• Ask whether dicyclomine is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• If your dose is 20 mg or more, ask that the prescription be written for 20 mg tablets rather than several 10 mg capsules.
• Since the label says to stop if it has not helped within two weeks, ask for a short first fill, then a ninety-day supply once it is working.
• If you can swallow tablets or capsules, ask the prescriber whether they would suit you in place of the oral solution.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dicyclomine

1. 1.Is it safe with my glaucoma, prostate, heart or bowel condition?
2. 2.Which of my other medicines add to its drowsiness, dry mouth or constipation?
3. 3.What should I do in hot weather or when I exercise?
4. 4.How will I know within two weeks whether it is working for me?

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