Adult: 10-20 mg 4 times daily for 1-2 days if oral therapy is temporarily impractical.
Oral Gastrointestinal tract spasm
Adult: 10-20 mg tid. Dose is individualised according to patient needs. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines). Child: 6 months to <2 years 5-10 mg 3-4 times daily. 2-12 years 10 mg tid. >12 years Same as adult dose. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
Administration
May be taken with or without food.
Contraindications
Obstructive disease of the gastrointestinal tract, reflux oesophagitis, severe ulcerative colitis, unstable CV status in acute haemorrhage, glaucoma, obstructive uropathy, myasthenia gravis, salmonella dysentery. Infants <6 months. Lactation.
Special Precautions
Patient with coronary artery disease, heart failure, hypertension, tachyarrhythmia (e.g. thyrotoxicosis), hyperthyroidism, autonomic neuropathy, known or suspected prostatic hyperplasia, mild to moderate ulcerative colitis, altered physical or mental abilities, fever. Patients undergoing cardiac surgery. Presence of increased environmental temperature (e.g. hot weather, exercise). Renal and hepatic impairment. Children and elderly. Pregnancy.
Adverse Reactions
Significant: Drowsiness, blurred vision, diarrhoea, heat prostration (in increased environmental temperature), psychosis and delirium (especially elderly and mentally ill patients). Cardiac disorders: Palpitations, tachyarrhythmia. Eye disorders: Mydriasis, cycloplegia, photophobia. Gastrointestinal disorders: Dry mouth, thirst, constipation, nausea, vomiting, abdominal pain, abdominal distension, dyspepsia. General disorders and admin site conditions: Fatigue, asthenia. Metabolism and nutrition disorders: Anorexia. Nervous system disorders: Dizziness, sedation, headache, nervousness. Psychiatric disorders: Insomnia. Renal and urinary disorders: Dysuria. Reproductive system and breast disorders: Suppressed lactation. Respiratory, thoracic and mediastinal disorders: Dyspnoea, nasal congestion, reduced bronchial secretions. Skin and subcutaneous tissue disorders: Rash, allergic dermatitis, erythema. Vascular disorders: Flushing.
This drug may cause drowsiness or blurred vision, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor urinary output, anticholinergic effects, and gastrointestinal symptoms.
Overdosage
Symptoms: Headache, dizziness, nausea, vomiting, dry mouth, difficulty swallowing, dilated pupils, blurred vision; hot, dry skin; CNS stimulation, convulsion. Management: Symptomatic treatment. May perform gastric lavage or administer emetics and activated charcoal. May administer sedatives (e.g. benzodiazepines, short-acting barbiturates) to manage overt signs of excitement. May use appropriate parenteral cholinergic agent as antidote.
Drug Interactions
Enhanced adverse effect with other anticholinergic agents (e.g. amantadine, quinidine, antihistamines, phenothiazine, benzodiazepines, MAOIs, meperidine, nitrates and nitrites, TCAs, sympathomimetic agents). May antagonize the effects of antiglaucoma agents. May diminish the therapeutic effect of gastrokinetic drugs (e.g. metoclopramide). Altered absorption with antacids.
Action
Description: Mechanism of Action: Dicycloverine, a tertiary amine antimuscarinic, relieves gastrointestinal smooth muscle spasm by blocking the action of acetylcholine at parasympathetic sites in the smooth muscle, CNS and secretory glands.
Synonym: dicyclomine. Onset: 1-2 hours. Duration: Up to 4 hours. Pharmacokinetics: Absorption: Rapid and well absorbed. Bioavailability: IM: Approx 2 times more bioavailable than oral administration. Time to peak plasma concentration: 60-90 minutes (oral). Distribution: Enters breast milk. Volume of distribution: 3.65 L/kg. Metabolism: Extensively metabolised. Excretion: Mainly via urine (80%, small amounts as unchanged drug); faeces (8%). Elimination half-life: Approx 1.8 hours (initial phase).
Chemical Structure
Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 3042, Dicyclomine. https://pubchem.ncbi.nlm.nih.gov/compound/Dicyclomine. Accessed May 26, 2022.
Storage
Store between 20-30°C. Cap/tab/oral solution: Protect from direct sunlight and excessive heat. Inj: Protect from freezing. Storage recommendations may vary among individual products (refer to specific product guidelines).
A03AA07 - dicycloverine ; Belongs to the class of synthetic anticholinergics, esters with tertiary amino group. Used in the treatment of functional bowel disorders.
References
Anon. Dicyclomine. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 16/05/2022.Anon. Dicycloverine (Dicyclomine). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/03/2022.Buckingham R (ed). Dicycloverine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2022.Dicyclomine Hydrochloride Injection (Akorn). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/03/2022.Dicyclomine Hydrochloride Solution (Remedyrepack Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/03/2022.Dicyclomine Hydrochloride Tablet (RedPharm Drug, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/03/2022.Dicycloverine Hydrochloride 10 mg/5 mL Oral Solution (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 01/03/2022.Dicycloverine Hydrochloride Capsule (Bryant Ranch Prepack). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 01/03/2022.Dicycloverine Hydrocholoride 20 mg Tablets (Zentiva Pharma UK Limited). MHRA. https://products.mhra.gov.uk. Accessed 01/03/2022.Dicymed 10 mg/5 mL Syrup, 10 mg Tablet (Lloyd Laboratories, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 01/03/2022.Joint Formulary Committee. Dicycloverine Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2022.Ritemed Dicycloverine Hydrochloride (Ritemed Phils., Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 01/03/2022.Spasdon 5 mg/mL Syrup (Oral Drops) (AD-Drugstel Pharmaceutical Laboratories, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 01/03/2022.Spasmin Tablet (Prime Pharmaceutical Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/03/2022.
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