How long does it take bentyl to work?

Bentyl

WARNINGS

Included as part of the “PRECAUTIONS” Section

PRECAUTIONS

Inadvertent Intravenous Administration

BENTYL solution is for intramuscular administration only. Do not administer by any other route. Inadvertent intravenous administration may result in thrombosis, thrombophlebitis and injection site reactions such as pain, edema, skin color change, and reflex sympathetic dystrophy syndrome .

Cardiovascular Conditions

Dicyclomine hydrochloride needs to be used with caution in conditions characterized by tachyarrhythmia such as thyrotoxicosis, congestive heart failure and in cardiac surgery, where they may further accelerate the heart rate. Investigate any tachycardia before administration of dicyclomine hydrochloride. Care is required in patients with coronary heart disease, as ischemia and infarction may be worsened, and in patients with hypertension .

Peripheral And Central Nervous System

The peripheral effects of dicyclomine hydrochloride are a consequence of their inhibitory effect on muscarinic receptors of the autonomic nervous system. They include dryness of the mouth with difficulty in swallowing and talking, thirst, reduced bronchial secretions, dilatation of the pupils (mydriasis) with loss of accommodation (cycloplegia) and photophobia, flushing and dryness of the skin, transient bradycardia followed by tachycardia, with palpitations and arrhythmias, and difficulty in micturition, as well as reduction in the tone and motility of the gastrointestinal tract leading to constipation .

In the presence of high environmental temperature heat prostration can occur with drug use (fever and heat stroke due to decreased sweating). It should also be used cautiously in patients with fever. If symptoms occur, the drug should be discontinued and supportive measures instituted. Because of the inhibitory effect on muscarinic receptors within the autonomic nervous system, caution should be taken in patients with autonomic neuropathy.

Central nervous system (CNS) signs and symptoms include confusional state, disorientation, amnesia, hallucinations, dysarthria, ataxia, coma, euphoria, fatigue, insomnia, agitation and mannerisms, and inappropriate affect.

Psychosis and delirium have been reported in sensitive individuals (such as elderly patients and/or in patients with mental illness) given anticholinergic drugs. These CNS signs and symptoms usually resolve within 12 to 24 hours after discontinuation of the drug.

BENTYL may produce drowsiness, dizziness or blurred vision. The patient should be warned not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery or performing hazardous work while taking BENTYL.

Myasthenia Gravis

With overdosage, a curare-like action may occur (i.e., neuromuscular blockade leading to muscular weakness and possible paralysis). It should not be given to patients with myasthenia gravis except to reduce adverse muscarinic effects of an anticholinesterase

Intestinal Obstruction

Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. In this instance, treatment with this drug would be inappropriate and possibly harmful .

Rarely development of Ogilvie’s syndrome (colonic pseudo-obstruction) has been reported. Ogilvie’s syndrome is a clinical disorder with signs, symptoms, and radiographic appearance of an acute large bowel obstruction but with no evidence of distal colonic obstruction

Toxic Dilatation Of Intestinemegacolon

Toxic dilatation of intestine and intestinal perforation is possible when anticholinergic agents are administered in patients with Salmonella dysentery.

Ulcerative Colitis

Caution should be taken in patients with ulcerative colitis. Large doses may suppress intestinal motility to the point of producing a paralytic ileus and the use of this drug may precipitate or aggravate the serious complication of toxic megacolon . BENTYL is contraindicated in patients with severe ulcerative colitis .

Prostatic Hypertrophy

BENTYL should be used with caution in patients with known or suspected prostatic enlargement, in whom prostatic enlargement may lead to urinary retention

Hepatic And Renal Disease

BENTYL should be used with caution in patients with known hepatic and renal impairment.

Geriatric Population

Dicyclomine hydrochloride should be used with caution in elderly who may be more susceptible to its adverse effects.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment Of Fertility

Long-term animal studies have not been conducted to evaluate the carcinogenic potential of dicyclomine. In studies in rats at doses of up to 100 mg/kg/day, dicyclomine produced no deleterious effects on breeding, conception, or parturition.

Use In Specific Populations

Pregnancy

Pregnancy Category B

Adequate and well-controlled studies have not been conducted with BENTYL in pregnant women at the recommended doses of 80 to 160 mg/day. However, epidemiologic studies did not show an increased risk of structural malformations amoung babies born to women who took products containing dicyclomine hydrochloride at doses up to 40 mg/day during the first trimester of pregnancy.

Reproduction studies have been performed in rats and rabbits at doses of up to 33 times the maximum recommended human dose based on 160 mg/day (3 mg/kg) and have revealed no evidence of harm to the fetus due to dicyclomine. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nursing Mothers

BENTYL is contraindicated in women who are breastfeeding. Dicyclomine hydrochloride is excreted in human milk. Because of the potential for serious adverse reactions in breast-fed infants from BENTYL, a decision should be made whether to discontine nursing or to discontinue the drug, taking into account the importance of the drug to the mother. .

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

BENTYL is contraindicated in infants less than 6 months of age. There are published cases reporting that the administration of dicyclomine hydrochloride to infants has been followed by serious respiratory symptoms (dyspnea, shortness of breath, breathlessness, respiratory collapse, apnea and asphyxia), seizures, syncope, pulse rate fluctuations, muscular hypotonia, and coma, and death, however; no causal relationship has been established.

Geriatric Use

Clinical studies of BENTYL did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range in adults, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

Renal Impairment

Effects of renal impairment on PK, safety and efficacy of BENTYL have not been studied. BENTYL drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. BENTYL should be administered with caution in patients with renal impairment.

Hepatic Impairment

Effects of renal impairment on PK, safety and efficacy of BENTYL have not been studied. BENTYL should be administered with caution in patients with hepatic impairment.

The practice of Correctional Medicine has many strange differences from medicine outside the walls. It took me a couple of years to get comfortable with the various aspects of providing medical care to incarcerated inmates. Of all of these differences, one that stands out in importance is the fact that many seemingly benign medications are abused in correctional settings.

Of course, the Drug Enforcement Agency (DEA) has established a list of drugs known to have potential for abuse and even addiction. The DEA even ranks these drugs according to the severity of this risk. Schedule I drugs carry the most risk, followed by Schedule II, and so on, all the way down to Schedule V, which are thought to have the least risk.

However, the drugs that we are talking about here are not on the DEA’s list. These are medications that are not abused (or, at least, not thought to be abused) in mainstream medical settings. But these drugs are, in fact, abused and diverted in jails and prisons.

The reasons for this are somewhat complex, but in my mind, it boils down to this: These are drugs that have psychoactive effects that mimic, to some degree, the effects of the drugs on the DEA Schedules. If you are addicted, or even if you just like to get high once in a while, and you can’t obtain your preferred drugs of abuse because you are incarcerated, these are the drugs that can serve as an alternative in a pinch.

It is critically important for medical professionals in corrections to know which seemingly benign drugs have the potential to be abused and diverted. Even if a particular inmate doesn’t care about getting high himself, he can still profit by selling these drugs to others who are. Vulnerable inmates can be (and are) bullied into obtaining these drugs for distribution–if we make them available.

Like all correctional physicians, I myself have wrestled with the problems these drugs cause. Some have little therapeutic value and so are not such a big problem—I just don’t prescribe them. Others do have value but fortunately also have easy substitutes (therapeutic equivalents) that have less risk of abuse. But some drugs that are commonly abused in prisons are real problems because they have definite medicinal value and no ready substitutes. In these cases, practitioners have to weigh the expected benefits of this drug against its potential for abuse, diversion and harm. It is not always an easy decision!

But before we practitioners can make an informed decision about any such prescriptions, we have to know how the risks of many common medications are magnified in correctional settings.

This JailMedicine post categorizes the drugs that have abuse potential behind bars. I have divided the drugs with abuse potential into categories based on their primary psychoactive effect. Some are sedatives. Some are stimulants. Some are mainly sought because of they can produce euphoria, so I am going to call them the “Euphorics.” Of course, some drugs have multiple effects. Trazadone, for example, can be either a sedative or a euphoric, depending on how it is used.

Not all drugs have equivalent abuse potential and so, like the DEA, I have assigned each of these drugs according to its risk. The risk for a particular drug also can vary depending on the particular correctional facility you happen to be in. You might be having major problems with a drug in your facility that has not presented much of a hassle in my jails!

My chart also lists two other relevant facts: Does the drug have significant legitimate medical value? Does the drug have a ready substitute with less abuse potential?

I have NOT listed exactly how each drug is abused. Some methods are quite creative. I do not want to turn this into a “How-To” educational forum! If you find yourself scratching your head and wondering, “How in the world can that be abused?” you certainly may email me for the details that I do not want to list in a public forum.

Remember that no DEA scheduled drugs are listed here (with three special exceptions)—only those drugs that tend to be considered “benign” in outside medicine, but are commonly abused in correctional facilities.

The Sedatives. The sedatives are drugs obtained primarily for their sedative effects. These are drugs commonly sought—and prescribed—as sleeping aids. On the outside, controlled substances such as zolpidem (Ambien) or benzodiazepines are more commonly used as sleeping aids. In the correctional setting, the following drugs are sought after as substitute sleeping aids.
Trazodone. Abuse potential HIGH (+++). Trazodone can be used as a sleeping pill or as a euphoric. It has especially high black market value in correctional settings. Trazodone is a poor antidepressant and can easily be replaced with other, better antidepressants that have much less abuse potential. It should rarely be prescribed.
Quetiapine (Seroquel). Abuse potential HIGH (+++). Seroquel is an good anti-psychotic, but Zyprexa, Risperdal, Abilify and others all have less abuse potential. Seroquel used solely as a sleeping agent can often be recognized by small doses (50-100mg) prescribed only at night.
Skeletal Muscle Relaxers. Abuse potential (++). Despite the name, SMRs do not relax skeletal muscle. They are sedatives only. See my discussion here. Their use should be uncommon, prescribed for acute muscular conditions only, and limited to 7 days or less.
Mirtazepine (Remeron). Abuse potential (++) Remeron is a sedating antidepressant–so sedating, in fact, that it works as a sleeping pill. There are many other antidepressants with less abuse potential.
Amitriptylline (Elavil). Abuse potential (++). Amitriptylline is the most sedating of the cyclic antidepressants. Many other cyclic antidepressants are less sedating and so have less abuse potential.
Doxepine. Abuse potential (+). Doxepine is sedating due to high anticholinergic properties. Its high anticholinergic properties mean it can also be abused as a psychedelic drug, as well. Many other cyclic antidepressants have less abuse potential.
Clonidine. Abuse potential (+). Clonidine is commonly prescribed as a treatment for nightmares, but since it is sedating, it may be sought as a sleeper. Clonidine is an essential drug for opioid withdrawal. It is not an appropriate hypertension medication.

The Stimulants. The stimulants are drugs can mimic the effects of street stimulants like methamphetamine.
Albuterol. Abuse potential (++). Albuterol is an essential drug for the treatment of asthma and COPD. However, it also can cause a serious toxic syndrome. There are no ready substitutes. Clinicians must balance the risk of abuse versus the legitimate benefits. Besides the stimulant effect, albuterol may also be used inappropriately as an “exercise enhancer.”
Pseudoephedrine. Abuse potential (++). Pseudoephedrine and the other decongestants are all poor cold medications. Many better medications for nasal complaints are available and so decongestants rarely need be prescribed.

Euphorics. These drugs are used to get a euphoric “high.”
Gabapentin (Neurontin). Abuse potential HIGH (+++). Gabapentin is commonly prescribed off label for neuropathic pain and other chronic pain syndromes. It unfortunately is often not recognized as a potential drug of abuse in the medical community at large. Duloxetine (Cymbalta) has been shown to be a superior drug for use in treating neuropathic pain. Gabapentin is the single biggest problem drug of abuse in many correctional systems. See my discussion here.
Trazodone. Abuse potential HIGH (+++). Depending on how it is abused, trazodone can be primarily sedating or primarily euphoric. Trazadone is a poor antidepressant and can easily be replaced with many others.
Bupropion (Wellbutrin). Abuse potential HIGH (+++). Wellbutrin is an antidepressant with many acceptable substitutes such as venlafaxine (Effexor) and duloxetine (Cymbalta). Due to its high abuse potential, it should be rarely used.
Loperamide (Imodium). Abuse potential (++). Imodium is a commonly prescribed diarrheal treatment with opioid receptor activity. Imodium’s abuse potential should be considered when prescribing it, especially since most cases of mild diarrhea do not need any treatment. Here is a news article about loperamide abuse.
Venlafaxine (Effexor). Abuse potential (+). Effexor is an antidepressant with many substitutes such as Cymbalta and the SSRIs. Venlafaxine is not abused in all facilities.
Topiramate (Topamax). Abuse potential (++). Topamax has legitimate use as as a seizure drug. When sought illegitimately, it is usually requested as a psychiatric drug or headache medication.
Carbamazepine (Tegretol). Abuse potential (+). Carbamazepine has legitimate use as a seizure drug and a Bipolar drug but is a second or third tier drug for both indications. Better substitutes are available for both uses.

Psychedelics. The drugs abused for their psychedelic, sensorium altering effects are mainly drugs with anticholinergic effects. You know how goofy you feel after you take Benadryl? That’s what we are talking about.
First generation antihistamines. This includes all of the following medications: Benadryl (diphenhydramine), Vistaril (hydroxyzine), Chlorpheniramine (CTM), benztropine (Cogentin), and trihexyphenidyl (Artane). Abuse potential (++). Cogentin and Artane have legitimate use as treatments for dystonia caused by antipsychotics. The other first generation antihistamines are commonly used for allergic symptoms. However, second generation antihistamines such as loratidine (Claritin) and cetirizine (Zyrtec) have less abuse potential and often can be substituted.
Oxybutynin (Ditropan). Abuse potential (++). This is a drug commonly prescribed for overactive bladder symptoms, but is desired for its anticholinergic effects. Don’t underestimate this drug! One can get quite intoxicated on oxybutynin. The potential for drug seeking should be considered for atypical patients seeking this drug.
Diciclomine (Bentyl). Abuse potential (++). Bentyl is prescribed for Irritable Bowel Syndrome and abdominal cramps, but achieves its antispasmodic effects as an anticholinergic. The risk for abuse often outweighs the potential benefit of this drug. If Bentyl is used, it should be short term.
Dextromethorphan (DM). Abuse potential HIGH (+++). Unlike the other medications in this list, Dextromethorphan has dissociative, hallucinogenic properties that are not due to anticholinergic effects. DM is commonly abused in the community. It is available OTC as a cough suppressant, but its actual effect on cough is minimal. DM should not be prescribed nor should DM be available on commissary due to its high abuse potential and minimal legitimate effect.

Non-mood altering agents. These medications are abused for reasons other than their psychiatric effects.
Psyllium powder. Abuse potential HIGH (+++). Packaged psyllium powder can be molded into a hardened shank. Since many benign fiber products available, psyllium should not be used in jails or prisons.
Lactulose. Abuse potential (+). Lactulose is used as a sweetener for illicit prison liquor. It is an essential drug for those few who have hepatic encephalopathy. It should not be prescribed to anyone else–there are too many other, better treatments for constipation. Most cases of constipation need no therapy at all.
Stimulant laxatives. Abuse potential (++). Stimulant laxatives can be abused as a weight loss tool and can be quickly habituating. Non-stimulant laxatives are preferable in most cases.

Controlled substances: Three medications deserve special mention because it is sometimes not known that these drugs are DEA controlled substances.
Tramadol. Abuse potential HIGH (+++). Tramadol is DEA schedule IV. It is still commonly believed that Tramadol is not a narcotic (it is) and that it is not addictive (it is). In fact, in my experience, acute tramadol withdrawal tends to be more severe than withdrawal from many other narcotics.
Pregabalin (Lyrica). Abuse potential HIGH (+++). Lyrica is DEA schedule V. There is little difference (in my opinion) between Lyrica and gabapentin in both use for neuropathic pain or for abuse potential.
Carisoprodol (Soma). Abuse potential HIGH (+++). Soma is DEA schedule IV. All skeletal muscle relaxers have abuse potential, but Soma is the worst and should not normally be prescribed in correctional settings.

As always, the opinions presented here are mine and mine alone. Remember that I could be wrong! If you disagree, please comment and say why!

Have you had problems with any drugs in your facility that I have not listed here? Please comment!

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SIDE EFFECTS

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The pattern of adverse effects seen with dicyclomine is mostly related to its pharmacological actions at muscarinic receptors . They are a consequence of the inhibitory effect on muscarinic receptors within the autonomic nervous system. These effects are dose-related and are usually reversible when treatment is discontinued.

The most serious adverse reactions reported with dicyclomine hydrochloride include cardiovascular and central nervous system symptoms .

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The data described below reflect exposure in controlled clinical trials involving over 100 patients treated for functional bowel/irritable bowel syndrome with dicyclomine hydrochloride at initial doses of 160 mg daily (40 mg four times a day)

In these trials most of the side effects were typically anticholinergic in nature and were reported by 61% of the patients. Table 1 presents adverse reactions (MedDRA 13.0 preferred terms) by decreasing order of frequency in a side-by-side comparison with placebo.

Table 1: Adverse reactions experienced in controlled clinical trials with decreasing order of frequency

MedDRA Preferred Term Dicyclomine Hydrochloride (40 mg four times a day) % Placebo %
Dry Mouth 33 5
Dizziness 40 5
Vision blurred 27 2
Nausea 14 6
Somnolence 9 1
Asthenia 7 1
Nervousness 6 2

Nine percent (9%) of patients were discontinued from BENTYL because of one or more of these side effects (compared with 2% in the placebo group). In 41% of the patients with side effects, side effects disappeared or were tolerated at the 160 mg daily dose without reduction. A dose reduction from 160 mg daily to an average daily dose of 90 mg was required in 46% of the patients with side effects who then continued to experience a favorable clinical response; their side effects either disappeared or were tolerated.

Postmarketing Experience

The following adverse reactions, presented by system organ class in alphabetical order, have been identified during post approval use of BENTYL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Cardiac disorders: palpitations, tachyarrhythmias
  • Eye disorders: cycloplegia, mydriasis, vision blurred
  • Gastrointestinal disorders: abdominal distension, abdominal pain, constipation, dry mouth, dyspepsia, nausea, vomiting
  • General disorders and administration site conditions: fatigue, malaise
  • Immune System Disorders: drug hypersensitivity including face edema, angioedema, anaphylactic shock
  • Nervous system disorders: dizziness, headache, somnolence, syncope
  • Psychiatric disorders: As with the other anti-cholinergic drugs, cases of delirium or symptoms of delirium such as amnesia (or transient global amnesia), agitation, confusional state, delusion, disorientation, hallucination (including visual hallucination) as well as mania, mood altered and pseudodementia, have been reported with the use of Dicyclomine. Nervousness and insomnia have also been reported.
  • Reproductive system and breast disorders: suppressed lactation
  • Respiratory, thoracic and mediastinal disorders: dyspnoea, nasal congestion
  • Skin and subcutaneous tissue disorder: dermatitis allergic, erythema, rash

Cases of thrombosis, thrombophlebitis and injection site reactions such as local pain, edema, skin color change and even reflex sympathetic dystrophy syndrome have been reported following inadverent IV injection of BENTYL.

Adverse Reactions Reported With Similar Drugs With Anticholinergic/Antispasmodic Action

Gastrointestinal: anorexia,

Central Nervous System: tingling, numbness, dyskinesia, speech disturbance, insomnia

Peripheral Nervous System: With overdosage, a curare-like action may occur (i.e., neuromuscular blockade leading to muscular weakness and possible paralysis).

Ophthalmologic: diplopia, increased ocular tension

Dermatologic/Allergic: urticaria, itching, and other dermal manifestations;

Genitourinary: urinary hesitancy, urinary retention in patients with prostatic hypertrophy

Cardiovascular: hypertension

Respiratory: apnea

Other: decreased sweating, sneezing, throat congestion, impotence. With the injectable form, there may be temporary sensation of light-headedness. Some local irritation and focal coagulation necrosis may occur following the intramuscular injection of BENTYL.

Read the entire FDA prescribing information for Bentyl (Dicyclomine)

IBS Tales Home > Treatment Reviews > IBS Medications > Bentyl

Overall rating 4/5 based on 23 reviews

Bentyl (dicyclomine) is an anti-spasmodic drug which relaxes the muscle in the wall of the gut. It can reduce the intestinal contractions of an irritable bowel and therefore reduce pain and diarrhea. It is usually taken in table form, but a syrup form is also available.

Bentyl side effects

The most common side effects of Bentyl are dizziness, drowsiness, lightheadedness, weakness, blurred vision, dry eyes, dry mouth, nausea, constipation and abdominal bloating.

REVIEWS OF BENTYL

Review by Patricia

I have had IBS since 2009. No other medication works for me except the Bentyl brand name drug. It was such a good medication for me but unfortunately it was discontinued in Canada in 2017 and I’m so upset because I don’t know why. It’s available in America but I can’t order online.

Review by Lydia

I am seeking others with side effects from Bentyl. I had so much hope for dicyclomine/Bentyl. I’ve had IBS-D since my teens and I have been in an IBS/ulcerative colitis flare for four years straight now. Usually I can ‘healthy’ myself out of them but this one is bad. I haven’t found a med that works for me, including ‘biologics’.

I’m trying to avoid a colectemy so I started going backwards, trying older drugs or medicines I haven’t taken in a while. Dicyclomine took the pain away, which surprised me. Outside of Lortab, which is impossible for people who legitimately need it to get, nothing relieved my pain until dicyclomine. Then the side effects started.

Has anyone else had extreme weakness? I mean, it was impossible to raise my arms. The doctor thought I was dehydrated and gave me two bags of saline IV and IV iron treatment. I was still weak but it was not acute. I started dicyclomine again and the same thing happened, only this time it was hard to breathe. The doctor sent me to hospital. I got a blood transfusion, more saline and iron and this time potassium too.

I didn’t take dicyclomine in hospital. They let me take hydrocodone in quarter stregth doses until it worked – I’ve always done that so I don’t get spacey. It’s such a shame that the one thing that offered me relief was taken from me because other people misused it.

Anyhow, back home I started dicyclomine again and the weakness is through my entire body, even my legs. I only took it three times and started on the fourth day out of hospital, not taking any other pain meds or meds with known interactions except maybe Wellbutrin 200mg. I saw one report where they interacted but everything I’ve ever seen since says different.

Anyhow, the weakness won’t go away now, even though I’ve stopped dicyclomine. I have heart arrhythmia now too. Has anyone had this happen? The doctor at the hospital thought that the symptoms would fade if I took it for longer but that sounds insane to me. Has anyone had weakness that went away the longer you took it? I’m desperate to not be in pain and have some semblance of a normal life. Bentyl is as close as I’ve come to it. I would appreciate your help.

Review by Tracey

I was prescribed Bentyl and Miralax in the ER for IBS-C. Because Bentyl is an anti-cholinergic/anti-spasmodic I expected it to worsen my constipation. For this reason I put off taking it for several weeks. When I finally started using it my bowel movements became more regular than they’ve been in my life! I’d only had marginal success with Miralax before but with Bentyl added to the mix it works great.

I take 10-20mg of Bentyl before bed and have a BM every morning like clockwork. As with most meds, Bentyl comes with some side effects. For me these included dry mouth and a feeling of stimulation/euphoria. Nothing to complain about, really. My doctor says Bentyl is only for cramping but it definitely helps my constipation for whatever reason.

Review by Marc

I used Bentyl as needed for a while when I was first diagnosed with IBS 15 years ago. The side effects were much worse for me than the symptoms I had when not taking it, so I stopped taking it. I was able to manage my IBS with diet and exercise (more or less) for the next decade or so, until it came back with a vengeance. Again I tried Bentyl and again the side effects were too much to handle. I read that it’s a street drug in some parts of Asia due to the psychedelic side effects!

Review by Lorann

I was prescribed Bentyl by my gastroenterologist after a horrible bout of what we thought was food poisoning/stomach flu/God only knows what I have had IBS for most of my life but passed it off as complications from adhesions in my intestines due to reproductive issues. After beginning the Bentyl I have been able to eat ‘real food’ and actually go out to dinner. I was unable to do this for a long time, especially during the past two years. I would get violently ill, sometimes before my meal was over, and it became embarrassing on top of making me so sick. I still get sick if I don’t take my pills before I eat, or if I take them too close to eating, but it’s nothing like it used to be.

My only real complaint about the medication is the weight gain. I’ve gained 12lbs since starting it, but it looks more like 20 and it feels like even more. The doctor told me to choose my battles, and I do agree that buying new pants because they’re too small is much preferable to making the person I’m with run into a store to buy me pants because I went out to eat. But I would like to know if there is any way to combat this weight gain and bloating. I’ve battled my weight since I was a teenager, and it breaks my heart to gain and look like I’m pregnant all the time.

Review by Teri

I had suffered from IBS for months. My doctor ordered Bentyl, 10mg before meals. I am no longer a hostage to the bathroom. I am pain free. I now have my life back because of this wonderful drug.

Review by Scheryl

A year ago I was prescribed Bentyl, also known as dicyclomine hydrochloride 10mg. I take one or two capsules by mouth four times daily as needed for pain and cramping. My IBS was so severe that I honestly thought I was in labor all over again due to the pain and of course the millions of trips to the bathroom. I could not eat as the smell of food made me so sick to my stomach that I just threw up everywhere.

So I got this miracle pill and I was also taking some probiotics. This medication has helped me much with the pain issues and the trips to the bathroom. However the side effects are unwanted as this pill makes me drink so much from the dry mouth issues that I have gained a ton of weight. I am a soda drinker, I have been all my life, and for me to just cut this out is not something that I am so willing to do. I do not like water; honestly this sounds crazy but water makes my throat hurt, I’m not sure why this happens but it does, and juice is not for me either so it’s either I am in pain or I gain a ton of weight.

I do not take this four times a day but I do end up taking it at least twice a day because the pain is still there and it has not gone away. It has greatly decreased my pain level but the pain is still there. I also noticed one other side effect that I have not read about and that is that if I take two pills at once like the directions say I end up getting a lumpy feeling in my throat. If I swallow it just feels as if my throat is closed off. Anyone else having any issues regarding this?

Another thing that I have been reading about is that this medication makes people sleepy. It makes me sleepy too but I had thought this was all in my head as the bottle does not state this as a side effect. Now I know. I do hope this review has helped in some way.

Review by Kelly

I just recently started using this medicine and I must say it seems to be working very well. I’ve been dealing with these symptoms for about six years. I went to the ER once again and they confirmed it was IBS and gave me pain meds. To help deal with the pain from it I have to go see a gastroenterologist. I never really realized that this is a disease. Many people I read about have had this for 10-plus years!

I’m hopeful that this is really the answer for my pain and problems and I can get to feeling myself again. It has affected my life in so many different ways…but will I really have to take this pill four times a day for the rest of my life? It does make me feel a little funny, I just feel like my muscles are very relaxed. But I will use it for the rest of my life if I don’t have to deal with the pain! So anyways, so far thumbs up on Bentyl.

Review by Leigh

I’m a male of 21 years of age and I have suffered from IBS for about a year. I’ve had attacks that would last months at a time, I had severe pain every day and I was unable to eat anything except crackers, bread and bananas. I suffered from explosive diarrhea four times a day, and with severe attacks I would have perhaps 20 bowel movements within an hour. Life was ruined for me.

I had tried Buscopan, mebeverine and peppermint tablets, all of which did barely anything. But then I was given a liquid form of Bentyl (dicyclomine) called Kolanticon Gel, which may only be available in the UK. It is a mixture of an anti-spasmodic agent dicycloverine hydrochloride (also known as dicyclomine), two antacids (aluminium hydroxide and magnesium oxide) and an anti-flatulent agent (simethicone).

I have to say that after taking it three times a day I’m nearly cured, and 80 to 90% of my symptoms have calmed down with few side effects apart from mildly dry eyes and the vile taste of the liquid. I have to say I have my life back. The IBS is still there but it’s controlled thanks to the Bentyl/dicycloverine. If you’re in the US you may still be able to get a similar liquid form of Bentyl. I rate it five stars!

Review by Sandra

The doctor finally tried giving me Bentyl. I take two at bedtime and it works on the stomach pain/urgency of my IBS-D and my insomnia. So far so good…it has really helped. I have even taken it when I had ongoing symptoms during the day and it has not failed me yet, which was a huge switch from not being able to leave the house until I knew my stomach would settle down (which wasn’t very often). I also started taking Align almost two months ago and I think that has helped me also.

Review by Rita

I have had what is now called IBS for over 40 years. In the beginning I took a pill called Combid. It worked great, but medicine being what it is they soon quit making it or the doctors quit prescribing it. Now I use Bentyl, and let me tell you it sure makes my life easier.

I can drink water and eat plain soda crackers and wind up with cramps. Thanks to Bentyl I can now eat more of a regular diet. True it tends to leave you with a dry mouth, but I drink some extra water, like my doc recommends, or eat sugar-free hard candy and that problem is solved.

As for the sleep effect, it works for me as I have insomnia so Bentyl is a win/win in my book. If you are a first time user of Bentyl, give yourself at least a month before you decide it isn’t for you. You may just find you actually have a full active life waiting thanks to Bentyl.

Review by Diane

Until this past February our lives were a mess. My husband had been in and out of hospitals and ERs for the last year years with pains in his stomach that he never was able to handle. We had no life. No-one could figure it out and after many bad experiences with doctors and nurses, one great doctor had the intelligence to suggest and write a script for Bentyl after a painful visit to the ER. He said David had IBS. After all the years of diagnosis of pancreatitis, gastritis and diverticulitis (I never believed any of them) finally someone cared enough to go the extra step. His life has now changed. It’s been two solid months of no pain! Nothing! Bentyl was the amazing drug we had prayed for.

Review by Teresa

Bentyl is an amazing drug! I have suffered for years with IBS and my problem is almost always constipation. I used to get such terrible stomach pains and nothing would ease them except going to bed, and then as soon as I’d get up the stomach pains would return. My doctor gave me Bentyl about 15 years ago. I only take it when the pain comes on now and it always takes the pain away before I have to go to bed. What a Godsend! Amazing drug!

Review by Amira

I’ve had bouts of IBS for years. I feel I can’t eat anything most days and had a horrible fear of traveling anywhere. This past summer I started taking a probiotic with two Bentyls daily and it really has changed my life! The Bentyl calms my stomach and the probiotic seems to help the diarrhea part.

Review by Jafafa

I was prescribed Bentyl a few years ago by my PCP, who said it was for diarrhea, though a subsequent PCP said it’s really just for cramps. I have taken it for cramps and diarrhea, and I have to say I have never noticed any effect whatsoever, nor any side effects. Seems totally useless…I still take it when I remember to thinking that perhaps it made those particular attacks less severe than they would have been otherwise, but overall I have seen no noticeable effect.

Review by Joe

This medicine does not work for me. In fact my IBS symptoms have not gone away at all, and I’m still running to the bathroom all the time. All I’m feeling is the side effects, and not the relief I should be feeling.

Review by Jennifer

Bentyl seems to help my stomach but it has bad side effects. I have problems trying to sleep and eat and I’m always thirsty. My pupils get really big also. I still take it because it’s better than being sick to my stomach all the time. I used to take Levbid and it works great but the company stopped making the product.

Review by Erin

Amazing! I couldn’t thank my doctor enough for putting me on Bentyl. It has given me immense relief from the stomach cramping that was leaving me unable to do so many things. Being a mom and military wife, I cannot be down and out due to my IBS…Bentyl has made it possible for me to go back to the family activities I had been forced to give up on. I can go to my kids’ baseball and soccer games again without fear and anguish!

Review by Brandy

I have on/off bouts of what is diagnosed as IBS (stomach cramping and aches and indigestion with either constipation or diarrhea). The urgent care doc gave me a script for Bentyl and said it would help move things along. The good thing is, it stops the aching that makes you want to roll up in a ball. I switch between this and Levsin for relief. It does dry you out and make you pretty tired, but sometimes it’s worth the side effects to feel better.

Update on Brandy…

My treatments stopped working and I had long bouts of IBS-C (after Maalox, milk of magnesia and magnesium/vitamin c stopped working). I tried my go-to for occasional cramping, Bentyl, which I had only taken on an as-needed basis previously, and moved to more of a daily regime. And it worked! Once again I had daily BMs, no more bloating, no more sensitivity and no more cramping.

I noticed after about a month or so that I was extremely dizzy, a brain zap type of feeling. I was light headed, my eyes had trouble focusing and my heart was skipping beats (palpitations). I was pretty scared and not sure what was happening. I stopped drinking caffeine (which was very hard for me) and tried to watch anything I ate or drank.

I finally narrowed it down to the Bentyl. I checked out some reviews on other sites and found this to be a pretty common side effect of the Bentyl or dicyclomine (generic) which was devastating because this put me back to square one with trying to find another cure. I still use this when the cramping gets horribly bad or when I haven’t had a BM in a few days but I cannot tolerate it every day.

Review by Amber

I think Bentyl is the best medicine ever made! My life was a mess before – I even ended up in the hospital. I would get such severe attacks of diarrhea that I couldn’t handle it. I couldn’t even go out to eat anymore. Now I just take Bentyl half an hour before I eat, usually twice a day, and I’m fine. Before I could never have eaten at a buffet, or at a restaurant more than five minutes from home. If I forget to take it, look out – there better be a bathroom close by. Bentyl has been a lifesaver for me. I can’t believe how much of a difference it has made. Thanks Bentyl.

Review by Barbara

I’ve been on Bentyl now for several years. It has really helped reduce the number of painful stomach attacks. I take two capsules twice a day, but when I feel the stomach pain coming on I increase the dosage and it usually seems to work. Before, I could look forward to full-blown stomach attacks several times a year, but now they are very rare. It also seems to lessen the severity of the attacks that I do still get.

Bentyl has really helped my IBS. I take it four times a day and it’s made the tummy pain much easier to handle. I do find that when I miss a dose I can tell within two hours as the pain is back full force. It does seem to make the bathroom trips a little less frequent….instead of going five times an hour, I’m down to three or so an hour. I’ve had IBS for 10 years and I’ll take any help I can get!

Review by Julie

Bentyl definitely helps with the terrible pain associated with attacks. It relaxes your tummy so you don’t have the stabbing, aching pain quite so bad. But it doesn’t prevent attacks or make the IBS symptoms go away, it just helps once they have gotten out of control. Also, if you take it before a meal, I have noticed that it helps keep me from getting a stomach ache from eating.

For me, the drawback of taking Bentyl is the side effects. It makes me really sleepy, dizzy, and feel really weird! I can’t take it when I go to work, when I drive, or when I go out. I only take it when I am going to be at home. I had tried Levsin but that did nothing for me.

Do you suffer from IBS? Have you tried Bentyl? Please contact Sophie to send in your review.

CME Corner says:

Thank you for your question.

Dr. Lacy: It’s a balancing act. Smooth muscle anti-spasmodics (dicyclomine is one of these agents) can help abdominal pain/cramps/spasms due to smooth muscle spasm. However, due to anti-cholinergic effects, it can cause or worsen constipation in some patients. Generally, these agents should be used on a prn basis, as tachyphylaxis may occur. If someone has chronic pain (rather than mild intermittent pain), it may be better to use a low dose TCA at night (5 or 10 mg of desipramine) or use low dose pregabalin or gabapentin; the latter two should not cause constipation. Alternatively, both lubiprostone and linaclotide have been shown to help IBS-C symptoms and CC symptoms of abdominal pain and constipation, and those would be worth using too.

Dr. Cash: There is scant data supporting dicyclomine with several negative studies using standard doses and one positive study that used higher than recommended doses of dicyclomine. In this study dicyclomine was associated with improvements in abdominal pain but at the expense of anti-cholinergic side effects such as constipation, dry eyes, and dry mouth. The other commonly prescribed anticholinergic “antispasmodic” in the US is hyoscyamine. This agent also suffers from a lack of a strong evidence base, but some patients do respond to its use on an as-needed basis. Enteric coated peppermint oil is another option for some patients and does have a relatively strong evidence base to support its use. (see Khanna R, et al. Peppermint oil for the treatment of irritable bowel syndrom: A systematic review and meta-analysis. J Clin Gastroenterol 2014;48:505-12). It is a natually occuring carminative that is thought to promote relaxation of the gastrointestinal smooth muscle through calcium channel blockade. Common adverse reactions to peppermint oil include heartburn symptoms, dry mouth, belching, peppermint taste or smell, rash, headache and a cold perianal sensation. Chlordiazepoxide/clindinium is a benzodiazipine/anticholinergic combination that has also been used for IBS associated abdominal pain, but should be used with great caution due to its potential adverse effects.

How to beat a stomach bug: advice from a doctor

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As stomach viruses continue to sweep through the region, there’s one medication you should have on your radar.

Zofran (ondansetron), a prescription tablet that disintegrates on the tongue, ends vomiting quickly in kids and adults, said Dr. Rodd Stein, a pediatrician with Westchester Health in Yorktown Heights.

Long used for chemotherapy patients battling nausea, the drug was approved in recent years for gastroenteritis, and is generally well tolerated, he said.

By stopping vomiting, Zofran can help prevent the dehydration that sometimes requires treatment with IV fluids.

“It’s been so helpful,” said Stein. “We’ve been able to keep so many kids out of the emergency rooms with it.”

Stomach bugs hit home: http://lohud.us/1JPBRCa

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Stomach viruses are not treated with antibiotics. Bacterial stomach bugs often produce blood or mucus in the stool, and warrant a call to the doctor, said Stein, who also offered these tips:

• During a bout of vomiting, try introducing small sips of water or Pedialyte every 10 minutes. Ice chips are also good. Stay away from sports drinks if you have diarrhea, as the higher sugar content can make diarrhea worse.

•Small sips of the liquid from canned fruit in heavy syrup can help stave off nausea and vomiting.

•If you have diarrhea, don’t take Imodium (Loperamide), said Stein. Your body is trying to rid itself of the infection, and Immodium keeps it in — and can sometimes prolong symptoms, he said.

•Never take Imodium for diarrhea caused by suspected food poisoning (like E. coli or salmonella), as it can make you sicker, he said.

•Probiotics work well to fight diarrhea and can often shorten its duration, said Stein.

Twitter: @LindaLombroso

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