What is bentyl 20 mg used for?

Dicyclomine

Before taking dicyclomine,

  • tell your doctor and pharmacist if you are allergic to dicyclomine or any other medications.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amantadine (Symmetrel); antacids; antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; diet pills; digoxin (Lanoxin); ipratropium (Atrovent); isosorbide (Imdur, Ismo, Isordil, others); medications for anxiety, asthma, glaucoma, irregular heartbeat, mental illness, motion sickness, Parkinson’s disease, seizures, ulcers, or urinary problems; metoclopramide (Reglan); monoamine oxidase (MAO) inhibitors, including phenelzine (Nardil) and tranylcypromine (Parnate); narcotic pain relievers such as meperidine (Demerol); nitroglycerin (Nitro-Bid, Nitrostat, others); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had glaucoma; ulcerative colitis (a condition which causes swelling and sores in the lining of the colon and rectum); an enlarged prostate (prostatic hyperplasia); difficulty urinating; esophageal reflux (heartburn); a blockage in the gastrointestinal tract; myasthenia gravis; high blood pressure; an overactive thyroid gland (hyperthyroidism); nerve disease (autonomic neuropathy); heart failure; rapid or pounding heartbeat; hiatal hernia; or liver, kidney, or heart disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dicyclomine, call your doctor. Do not breast-feed while taking this medication.
  • talk to your doctor about the risks and benefits of taking dicyclomine if you are 65 years of age or older. Older adults should not usually take dicyclomine because it is not as safe or effective as other medications that can be used to treat the same condition.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking dicyclomine.
  • you should know that dicyclomine may make you drowsy or cause blurred vision. Do not drive a car or operate machinery until you know how this medication affects you.
  • remember that alcohol can add to the drowsiness caused by this medication.
  • you should know that dicyclomine reduces the body’s ability to cool off by sweating. In very high temperatures, dicyclomine can cause fever and heat stroke.

PRECAUTIONS: Before taking dicyclomine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: glaucoma, enlarged prostate, problems with urination due to a blocked urinary tract, other stomach/intestinal problems (such as slow gut, blockage, ulcerative colitis, infection, little/no stomach acid, ileostomy/colostomy patients with diarrhea), overactive thyroid, heart problems (such as coronary artery disease, angina, congestive heart failure, fast/irregular heartbeat, heart problems due to severe bleeding), high blood pressure, heartburn problems (such as acid reflux, hiatal hernia, esophagus problems), certain nervous system problem (autonomic neuropathy), myasthenia gravis, liver problems, kidney problems.This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.This medication may make you sweat less which can increase your risk for heat stroke, a very serious condition. Avoid activities that might cause you to overheat (such as doing strenuous work/exercise in hot weather, using hot tubs). Drink plenty of fluids, and dress lightly while in hot weather or when exercising. If you become overheated, stop exercising and promptly seek cooler shelter. Seek immediate medical attention if you develop a fever, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, unusual excitement, constipation, fast heartbeat, and urination problems. Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. The manufacturer recommends that you do not breast-feed while using this drug. Consult your doctor for more details.

DRUG INTERACTIONS: See also the How to Use section.The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor’s approval.Some products that may interact with this drug include: potassium tablets/capsules, drugs that are affected by slowed gut movement (such as metoclopramide, pramlintide).Dicyclomine may affect the absorption of other products such as levodopa, certain azole anti-fungal drugs (ketoconazole, itraconazole), slowly-dissolving forms of digoxin, among others. If you are taking either ketoconazole or itraconazole, take it at least 2 hours before dicyclomine.Many other drugs that also cause dry mouth and constipation may interact with anticholinergics/antispasmodics such as dicyclomine. Tell your doctor or pharmacist about all the products you take, including: amantadine, other anticholinergic drugs (such as atropine, glycopyrrolate, scopolamine), other antispasmodic drugs (such as clidinium, propantheline), belladonna alkaloids, certain drugs used to treat Parkinson’s disease (such as benztropine, trihexyphenidyl), certain drugs used to treat irregular heart rhythms (such as disopyramide, quinidine), MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine), phenothiazines (such as chlorpromazine), tricyclic antidepressants (such as amitriptyline).Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products, diet aids) because they may contain ingredients that cause drowsiness or a fast heartbeat. Ask your pharmacist about using those products safely.This medication may interfere with certain laboratory tests (including gastric secretion tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

SLIDESHOW

Digestive Disorders: Common Misconceptions See Slideshow

Pharmacologic, or drug, therapy is best used in irritable bowel syndrome (IBS) patients with moderate to severe symptoms which do not respond to physician counseling and dietary manipulations.

What’s a medication?

Anything you take for a therapeutic effect counts as a medicine. It can be readily available over-the-counter, in a pharmacy or grocery store, or limited by prescription only. It might be a drug or a supplement; manufactured or “natural.” It might come in a pill, a liquid, or a food product. When you take something for a long-term therapeutic effect, tell your doctor about it. He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may be taking, or possible side effects.

Remember, all medicines have potential side effects. Before taking any medication, whether over the counter or prescription, talk to your healthcare provider or pharmacist about dosage, other medicines you are taking, or any other questions you might have about the treatment. Otherwise, carefully follow the directions on the drug package or on your prescription label.

Medications for IBS

First line treatment has traditionally been aimed at treating the most bothersome symptom because of the lack of effective treatment for the overall improvement of multiple symptoms in IBS patients. However, new therapies for IBS have been recently introduced and have been shown to effectively treat multiple symptoms of IBS.

Laxatives – can help treat symptoms of constipation. Laxatives should be used under the supervision of a physician.

Read more about laxatives.

Bulking agents­ – provided they relieve and don’t worsen symptoms, can ease stool passage. Examples include bran or psyllium.

Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin).

Read more about anticholinergics/antispasmodics.

Anti-diarrheal agents – can be effective in preventing and relieving symptoms of diarrhea. Examples include Loperamide (Imodium), and diphenoxylate and atropine (Lomotil)

Read more about antidiarrheal agents.

Anti-anxiety medications – can be helpful for some people with IBS, mainly those with emotional distress.

There are also effective medications available that relieve the pain and improve the changes in bowel habit. They may need to be taken on a more long-term basis. These include low dose antidepressant agents or the relatively newer medications.

Antidepressants – The use of the antidepressant drug class in low doses for treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain and the gut. Antidepressant medications can reduce the intensity of pain signals going from gut to brain.

Read more about antidepressant medications.

Newer IBS-Targeted Medications Available – There are other medications that are either under study, or have been shown to be effective in treating IBS in multi-center, high quality clinical trials. These are prescription medications intended for specific use under a doctor’s supervision.

Read more about newer IBS medications.

Summary

The effectiveness of various agents differs between individuals. A medication regimen must be carefully chosen by the patient and his or her physician.

Individuals who have not responded to lifestyle changes and careful use of medications should consider being evaluated by a physician who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and specialized motility and/or psychological screening can reveal specific conditions which may respond to treatment.

Did This Article Help You?

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

If you found this article helpful, please consider supporting IFFGD with a small tax- deductible donation.

Adapted from IFFGD Publication #168 by Anthony J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA.

Last modified on February 23, 2015 at 12:18:55 PM

Generic Name: dicyclomine (dye SYE kloe meen)
Brand Name: Bentyl, Dibent, Dicyclocot

Medically reviewed by Drugs.com on Oct 29, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
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What is dicyclomine?

Dicyclomine relieves spasms of the muscles in the stomach and intestines.

Dicyclomine is used to treat functional bowel or irritable bowel syndrome.

Dicyclomine may also be used for purposes not listed in this medication guide.

Important Information

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of dicyclomine.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Dicyclomine can decrease your sweating, which can lead to heat stroke in a hot environment.

Stop using dicyclomine and call your doctor right away if you have serious side effects such as confusion, hallucinations, unusual thoughts or behavior, fast or uneven heart rate, or if you urinate less than usual or not at all.

There are many other medicines that can interact with dicyclomine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Before taking this medicine

You should not take this medication if you are allergic to dicyclomine, or if you have:

  • problems with urination;

  • a bowel obstruction or severe constipation;

  • severe ulcerative colitis or toxic megacolon;

  • gastroesophageal reflux disease (GERD);

  • a serious heart condition or active bleeding;

  • glaucoma;

  • myasthenia gravis; or

  • if you are breast-feeding a baby.

To make sure you can safely take dicyclomine, tell your doctor if you have any of these other conditions:

  • ulcerative colitis;

  • an ileostomy or colostomy;

  • a nerve problem (such as numbness or tingling);

  • liver or kidney disease;

  • heart disease, congestive heart failure, high blood pressure, or a heart rhythm disorder;

  • hiatal hernia; or

  • an enlarged prostate.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Dicyclomine can pass into breast milk and can cause breathing problems or other life-threatening side effects in infants younger than 6 months of age. Do not breast feed a baby while taking this medication.

Older adults may be more likely to have side effects from dicyclomine.

Dicyclomine should not be given to a child younger than 6 months old.

How should I take dicyclomine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Dicyclomine is usually taken 4 times each day. Your doctor may occasionally change your dose to make sure you get the best results.

Take this medicine with a full glass of water.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Talk with your doctor if your symptoms do not improve after 2 weeks of treatment.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, dilated pupils, weakness or loss of movement in any part of your body, trouble swallowing, fainting, or seizure (convulsions).

What should I avoid while taking dicyclomine?

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Dicyclomine can cause decreased sweating, which can lead to heat stroke in a hot environment.

Drinking alcohol can increase certain side effects of dicyclomine.

Avoid using antacids without your doctor’s advice. Use only the type of antacid your doctor recommends. Some antacids can make it harder for your body to absorb dicyclomine.

Dicyclomine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using dicyclomine and call your doctor at once if you have a serious side effect such as:

  • severe constipation, bloating, or stomach pain;

  • worsening of diarrhea or other irritable bowel symptoms;

  • feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin

  • confusion, hallucinations, unusual thoughts or behavior; or

  • pounding heartbeats or fluttering in your chest.

Less serious side effects may include:

  • drowsiness, dizziness, weakness, nervousness;

  • blurred vision;

  • dry mouth, stuffy nose; or

  • mild constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Dicyclomine dosing information

Usual Adult Dose for Irritable Bowel Syndrome:

Oral:
Initial dose: 20 mg orally four times a day
Maintenance dose: Up to 40 mg orally four times a day, after one week with initial dose

-Discontinue this drug if efficacy is not achieved within 2 weeks or side effects require doses below 80 mg per day.
-Documented safety data are not available for doses above 80 mg daily for periods longer than 2 weeks.
Intramuscular:
10 to 20 mg four times a day
Duration of therapy: 1 or 2 weeks, when patient cannot take oral form
Comments: Administer injection via IM only
Uses: Treatment of patients with functional bowel/irritable bowel syndrome

What other drugs will affect dicyclomine?

Before using dicyclomine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by dicyclomine.

Tell your doctor about all other medicines you use, especially:

This list is not complete and other drugs may interact with dicyclomine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 5.01.

Medical Disclaimer

More about dicyclomine

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  • Drug class: anticholinergics/antispasmodics

Consumer resources

  • Dicyclomine Capsules and Tablets
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  • Dicyclomine Syrup and Oral Solution

Other brands: Bentyl

Professional resources

  • Dicyclomine Hydrochloride (AHFS Monograph)
  • … +5 more

Related treatment guides

  • Irritable Bowel Syndrome
  • Noninfectious Colitis

Dicyclomine by Sandoz

How does this medication work? What will it do for me?

Dicyclomine belongs to the class of medications called antispasmodics. It is used to relieve the spasms in the digestive system that are associated with irritable bowel syndrome and other digestive tract conditions such as inflammation of the intestines. It can also be used to relieve constipation caused by muscle spasms of the digestive tract. It works by relaxing the muscles of the digestive tract, to relieve the pain associated with muscle cramps.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Capsule
This medication is available as a 10 mg capsule.

Injection
This medication is available as a 10 mg/mL injectable solution.

How should I use this medication?

The usual adult dose of dicyclomine is 10 to 20 mg taken three to four times a day depending on your response.

The dose is usually increased after the first week of therapy up to a maximum of 40 mg four times a day. If you do not get any relief of your signs and symptoms with this medication after 2 weeks or cannot tolerate more than 80 mg per day, your doctor may choose to stop this medication.

The usual dose for children between 2 and 12 years of age is 10 mg three to four times daily.

Infants between 6 months and 2 years of age should receive 5 to 10 mg taken 3 to 4 times daily to be given 15 minutes before feeding. The syrup form of dicyclomine should be mixed with an equal volume of water before taking it.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take dicyclomine if you:

  • are allergic to dicyclomine or any ingredients of the medication
  • have a blockage of the urinary tract
  • have a blockage of the gastrointestinal tract
  • have paralytic ileus (decreased movement of material through the digestive system) or intestinal atony (paralysis of the intestines)
  • have severe ulcerative colitis
  • have myasthenia gravis
  • have esophagus irritation caused by acid reflux from the stomach
  • have glaucoma (increased pressure in the eye)
  • have constantly changing blood pressure and heart function due to bleeding
  • are currently breast feeding

Do not give this medication to infants under 6 months of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blurred vision
  • dizziness
  • drowsiness
  • dry mouth
  • headache
  • nasal congestion
  • nausea
  • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • agitation
  • confusion
  • diarrhea
  • difficulty sleeping
  • disorientation
  • euphoria
  • fainting
  • fast, pounding heartbeat
  • forgetting periods of time
  • hallucinations (seeing or hearing things that aren’t there)
  • lack of coordination
  • mood changes
  • severe constipation (e.g., stomach pain, bloating)
  • skin redness, rash
  • symptoms of delirium

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs and symptoms of too much medication (overdose)
    • blurred vision
    • difficulty swallowing
    • dilated pupils
    • headache
    • hot, dry skin
    • nausea
    • vomiting

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood pressure: Dicyclomine may cause low blood pressure resulting in sudden dizziness when you stand up rapidly. Take care when first using this medication.

Drowsiness/reduced alertness: Dicyclomine may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Glaucoma: This medication may make the symptoms of glaucoma, such as blurred vision, to become more noticeable. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart disease: Some medications used to treat irregular heartbeat, congestive heart failure, and high blood pressure can cause an increase in the effects of dicyclomine. If you are taking medications for any of these conditions, or are at risk for developing any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney and liver condition: The removal of this medication from your body may be affected by liver and kidney disorders. If you have existing liver or kidney conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Prostate enlargement: Dicyclomine may cause difficulty staring to urinate, making symptoms of prostate hypertrophy (enlargement) worse. If you have prostatic hypertrophy, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Thyroid disease: If you have an overactive thyroid gland, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking dicyclomine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 months of age and should be avoided in this age group.

Seniors: Seniors may be more likely to experience severe side effects of dicyclomine. It may be necessary to use lower doses than those reported above.

What other drugs could interact with this medication?

There may be an interaction between dicyclomine and any of the following:

  • anti-arrhythmic medications (e.g., quinidine)
  • antihistamines (e.g., chlorpheniramine, diphenhydramine, hydroxyzine)
  • antipsychotics (e.g., chlorpromazine, haloperidol, olanzapine, quetiapine, risperidone)
  • atropine
  • benztropine
  • cyclobenzaprine
  • dimenhydrinate
  • donepezil
  • dronabinol
  • galantamine
  • ipratropium
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, tranylcypromine)
  • nabilone
  • narcotic opioids (e.g., codeine, fentanyl, meperidine, morphine)
  • orphenadrine
  • oxybutynin
  • phenothiazines (e.g., fluphenazine, perphenazine)
  • potassium chloride
  • procyclidine
  • rivastigmine
  • scopolamine
  • tricyclic antidepressants (e.g., amitriptyline, desipramine, trimipramine)
  • trihexyphenidyl
  • tiotropium
  • topiramate

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Dicyclomine-by-Sandoz

What happens if I miss a dose (Bentyl)?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Bentyl)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, dilated pupils, weakness or loss of movement in any part of your body, trouble swallowing, fainting, or seizure (convulsions).

What should I avoid while taking dicyclomine (Bentyl)?

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Dicyclomine can cause decreased sweating, which can lead to heat stroke in a hot environment.

Drinking alcohol can increase certain side effects of dicyclomine.

Avoid using antacids without your doctor’s advice. Use only the type of antacid your doctor recommends. Some antacids can make it harder for your body to absorb dicyclomine.

What other drugs will affect dicyclomine (Bentyl)?

Before using dicyclomine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by dicyclomine.

Tell your doctor about all other medicines you use, especially:

This list is not complete and other drugs may interact with dicyclomine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information (Bentyl)?

Your pharmacist can provide more information about dicyclomine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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2. Case summary

An 18-year old unmarried female patient (body weight 58 kg) from Kolkata, India, studying in 1st year in college, and belonging to a nuclear family with good socio-economic condition, was admitted in a confused state with fever for last 1.5 months associated with severe generalized weakness and palpitations for the same duration. The fever was continuous (100–101 °F), without any diurnal variation, not associated with chill and rigor, and temporarily relieved by oral paracetamol. There was associated progressive blurring of vision, dryness in eyes, chronic constipation and diminished urinary frequency but with maintained urine volume. There were also presence of diminished sweating and dry skin with difficulty in talking and swallowing for the last 6 months.

Repeated enquiry to the family members revealed that for the last 1-year, the patient used to experience occasional euphoria, hallucinations, fatigue, short-term memory loss with some short lasting episodes of altered behaviors including decreased anxiety, mannerisms and agitation. She had no sexual activities and menstrual habit was normal and regular.

A curious interrogation to the family members and later to the patient herself unveiled that the patient was absolutely normal 1.5 years back, just before she had an attack of an acute infective enterocolitis causing fever, diarrhea and severe spasmodic intestinal pain. She was then prescribed oral paracetamol, norfloxacin and intramuscular dicyclomine. Although the symptoms were completely relieved within a week, the patient started to take self injected intramuscular dicyclomine since then on a regular basis, without any medical indications or prescriptions. The reason could not be properly explained by the patients or by the family members, but some familial stress events could have played a role. She used to procure the drug regularly from a local familiar dispensary, by producing the original prescription again and again. The dose varied from 20 to 40 mg once to thrice daily 3–5 times per week throughout this entire period but of late, the frequency increased.

There were no evidences of any other significant medical or surgical history or any other hereditary, traumatic, infective, organic or pathologic diseases and events. 6 months back she took oral azithromycin 500 mg for 3 days for upper respiratory tract infection. There was no history of any other concomitant medications during the entire period.

Physical examination revealed a confused state with altered higher functions manifesting as disorientation, confusion, dysarthria and ataxia. Vitals showed a regular pulse rate of 120 per minute, blood pressure 100/84 mm of Hg, temperature 100.3 °F and respiratory rate of 22 per minute. Pupil was moderately dilated and sluggishly responsive to light. There was no urinary retention. Motor examination showed a diminished power of lower limb muscles with normal reflexes. There were multiple needle puncture marks with erythema and multiple small tender nodules on both arms, more on the left. Other systemic findings were within normal limits.

Routine blood investigation affirmed a normal picture. Septic markers, serum electrolytes, liver and renal function tests were essentially normal (Table 1). A 12 lead electrocardiography showed sinus tachycardia. Chest X ray, USG whole abdomen and CT scan of brain were also within normal limits.

Table 1

Relevant laboratory results on admission.

Serial nos. Parameters detected Detected values Normal range
1 Hemoglobin 13.7 g/dL 13.3–16.2 g/dL
2 Total WBC count 8500/μL 4000–11000/μL
3 ESR 15 mm after 1st h 0–15 mm/h
4 Fasting blood glucose 91 mg/dL 75–110 mg/dL
5 2 h postprandial blood glucose 116 mg/dL 70–120 mg/dL
6 Serum urea 15.1 mg/dL 7–20 mg/dL
7 Serum creatinine 0.8 ng/mL 0.6–1.2 ng/mL
8 Serum sodium 138 meq/L 136–146 meq/L
9 Serum potassium 4.1 meq/L 3.5–5.0 meq/L
10 Serum lipid profile Total cholesterol 160 mg/dL <200 mg/dL
LDL cholesterol 75.1 mg/dL <100 mg/dL
HDL cholesterol 54.4 mg/dL 40–60 mg/dL
VLDL cholesterol 30.5 mg/dL 6–40 mg/dL
Triglyceride 152.5 mg/dL 30–200 mg/dL
11 Liver function tests Total bilirubin 0.7 mg/dL 0.3–1.3 mg/dL
Direct bilirubin 0.2 mg/dL 0.1–0.4 mg/dL
Indirect bilirubin 0.5 mg/dL 0.2–0.9 mg/dL
Serum glutamic oxaloacetic transaminase (SGOT) 21 U/L 12–38 U/L
Serum glutamic pyruvic transaminase (SGPT) 24 U/L 7–41 U/L
Alkaline phosphatase 66 IU/L 20–140 IU/L
Albumin 4.8 g/dL 4.0–5.0 g/dL
Globulin 3.2 g/dL 2.3–3.5 g/dL

She was suffering from anticholinergic toxicities. Immediate treatment was started with slow injections of 2 mg intravenous physostigmine. After repetitive doses higher functions and muscle power gradually reverted to normal. Fever was treated with oral paracetamol and cold sponging. No respiratory resuscitation or urinary catheterization was required. Subsequent symptomatic treatment was continued for the next 5 days, when the general condition got much improved. However there were some episodes of drug craving, and withdrawal reactions were often present in the forms of nervousness, anxiety, sweating, weakness, depression, anorexia and hypertension.

The patient was then referred to a drug rehabilitation center where a strict abstinence from dicyclomine was followed. Symptomatic therapy was continued. During the initial phases, she showed other withdrawal reactions like insomnia, agitation, occasional tremors, abdominal cramps and blurred vision. At the end of subsequent 6 months of follow up, the patient is quite normal now, with absolutely no drug seeking behavior. Physical and psychological examinations are also well within normal limits.

Summit Medical Group Web Site

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What are other names for this medicine?

Type of medicine: antispasmodic; anticholinergic

Generic and brand names: dicyclomine, oral; Bentyl; Dicyclomine Hydrochloride

What is this medicine used for?

This medicine is taken by mouth to relieve cramps in your intestines in disorders such as irritable bowel syndrome.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

  • A blockage in your intestines or urinary tract
  • An allergic reaction to any medicine
  • An enlarged prostate or trouble urinating
  • Asthma or COPD
  • Dementia
  • Gastroesophageal reflux disease (GERD), hiatal hernia, or esophagitis (trouble swallowing)
  • Glaucoma
  • Heart problem such as heart failure, an irregular heartbeat, or a fast heartbeat
  • High blood pressure
  • Kidney or liver disease
  • Mental problems such as hallucinations or delusions
  • Muscle diseases such as myasthenia gravis
  • Nerve problems from diabetes, alcohol abuse, or injury
  • Severe ulcerative colitis
  • Thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider’s approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as prescribed. Do not take more than directed because increasing the dosage increases the risk of side effects.

Do not use this medicine in children under 6 months of age.

This medicine may come in different forms. Do not break, crush, or chew the tablets or capsules. Swallow them whole.

If you have the liquid form of this medicine, use a specially marked measuring device to measure each dose. The average household teaspoon may not hold the right amount of liquid.

This medicine works best when taken 30 to 60 minutes before meals.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: confusion, rapid heartbeat, dizziness, headache, nausea, vomiting, blurred vision, dilated pupils, hot dry skin, dry mouth, trouble swallowing, restlessness, nervousness, lightheadedness, fainting, slow breathing, numbness or tingling, muscle weakness, seizures.

What should I watch out for?

Contact your healthcare provider if your condition does not improve or if it gets worse. Keep appointments for follow up visits.

Dry mouth and constipation are common side effects of this medicine. If these become bothersome, contact your healthcare provider.

This medicine may cause blurred vision, dizziness, or drowsiness. Do not drive or operate machinery unless you are fully alert and able to see clearly. You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

This medicine increases the risk of heat stroke because it reduces sweating. Avoid extreme heat, saunas, hot tubs, and exercising too much (especially in hot weather).

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make your eyes more sensitive to light. Wear sunglasses to help protect your eyes.

This medicine increases the effects of alcohol and other medicines that slow down the nervous system. Do not drink alcohol or take other medicines that make you drowsy unless your healthcare provider approves.

Adults over the age of 65 may be at greater risk for side effects such as nervousness or drowsiness. Talk with your healthcare provider about this.

Do not give this medicine to infants less than 6 months of age. It may cause seizures, trouble breathing, coma, and death when given to infants.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat) or seizures.

Serious (report these to your healthcare provider right away): Severe vision problems, eye redness, or eye pain; confusion, clumsiness, trouble walking or keeping your balance; memory loss; unusual thoughts or behavior; fast or irregular heartbeat; slurred speech; hallucinations; muscle weakness; severe diarrhea; trouble urinating; trouble swallowing; severe or continued nausea, vomiting, or stomach pain; constipation that continues or gets worse.

Other: Constipation, dry mouth, dry skin, decreased sweating, flushing, mild nausea, vomiting, change in sense of taste, stuffy nose, restlessness, nervousness, dizziness, drowsiness, trouble sleeping, headache, dilated pupils, blurred vision, change in sexual ability or desire.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

  • Alcohol
  • Amantadine (Symmetrel)
  • Antacids such as Maalox or Mylanta (Take at least 2 hours apart from this medicine or as instructed by your healthcare provider.)
  • Antiarrhythmics (medicines to treat irregular heartbeat) such as disopyramide (Norpace, Norpace CR), procainamide, and quinidine
  • Antihistamines in many cold and allergy medicines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton); and in motion sickness medicines such as meclizine (Antivert, Dramamine Less Drowsy)
  • Antinausea medicines such as dronabinol (Marinol), nabilone (Cesamet), prochlorperazine, and promethazine (Phenergan)
  • Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril), fluphenazine, haloperidol (Haldol), olanzapine (Zyprexa), perphenazine, trifluoperazine, and thioridazine
  • Antianxiety medicines such as alprazolam (Xanax), clorazepate (Tranxene), chlordiazepoxide (Librium), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), and oxazepam
  • Corticosteroids such as dexamethasone, hydrocortisone (Cortef), methylprednisolone (Medrol), and prednisone
  • Decongestants and appetite suppressants such as phenylephrine (Neo-Synephrine) and pseudoephedrine (Sudafed)
  • Heart medicine such as digoxin, isosorbide (Imdur, ISMO, Monoket, Isordil), and nitroglycerin (Nitro-Bid, Nitro-Dur, Nitrol, Nitrostat, Minitran)
  • Hydroxyzine
  • Ipratropium (Atrovent, Combivent)
  • Ketoconazole (Nizoral)
  • MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
  • Medicines to treat Alzheimer’s disease such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
  • Medicines to treat Parkinson’s disease such as levodopa/carbidopa (Sinemet)
  • Metoclopramide (Reglan)
  • Muscle relaxants such as baclofen (Lioresal), carisoprodol (Soma), and cyclobenzaprine (Flexeril)
  • Narcotic painkillers such as codeine, hydromorphone (Dilaudid), meperidine (Demerol), morphine (MS Contin, Oramorph SR), and oxycodone (Percocet)
  • Natural remedies such as gotu kola, kava, St. John’s wort, and valerian
  • Other anticholinergic medicines such as atropine, benztropine (Cogentin), dicyclomine (Bentyl), hyoscyamine (Levsin), methscopolamine (Pamine), propantheline, and trihexyphenidyl
  • Potassium supplements
  • Pramlintide (Symlin)
  • Sleeping pills such as butabarbital (Butisol), flurazepam, phenobarbital, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien)
  • Topiramate (Topamax)
  • Tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), and nortriptyline (Pamelor)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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