Dicyclomine (Bentyl) is a prescription anticholinergic antispasmodic medication used to manage the symptoms of Irritable Bowel Syndrome (IBS). The drug works by blocking acetylcholine, a neurotransmitter, on the smooth muscles of the gastrointestinal tract. This action causes the muscles to relax, effectively reducing the frequency and intensity of muscle spasms and cramping characteristic of IBS. The primary goal of treatment is to relieve the abdominal pain and discomfort caused by these involuntary contractions.
Standard Dosage and Frequency
Determining how often to take Dicyclomine is individualized and must be guided by a healthcare professional. Treatment typically begins with a standard adult starting dose of 20 milligrams (mg) taken four times per day. This schedule, usually every six hours, aims to minimize the risk of initial side effects and is often taken before meals and at bedtime.
The dosage may be gradually increased after the first week if the initial dose is well-tolerated but insufficient for symptom relief. A physician may titrate the dose up to 40 mg four times a day, resulting in a maximum total daily dose of 160 mg. If a patient cannot tolerate a dose of at least 80 mg per day due to side effects, the medication should generally be discontinued, as lower doses may not be effective.
If a dose is missed, take it as soon as it is remembered. If it is almost time for the next scheduled dose, skip the missed dose entirely to avoid doubling up. Taking two doses too close together increases the risk of adverse reactions. Safety data for doses exceeding 80 mg daily for periods longer than two weeks are not established, emphasizing the need for close medical supervision.
Recognizing Common Side Effects
Because Dicyclomine blocks acetylcholine, its common side effects relate directly to this anticholinergic action. The most frequently reported adverse reactions include dry mouth, blurred vision, dizziness, and somnolence (drowsiness). Patients must avoid driving or operating heavy machinery until they know how the drug affects them.
Less severe side effects involve the digestive system, such as nausea and constipation, or general feelings of weakness and nervousness. These reactions are usually manageable and often dose-dependent, meaning they may lessen if the dosage is reduced. Patients should communicate any persistent or bothersome side effects to the prescribing doctor.
Less common, but more serious, reactions require immediate medical evaluation. These include central nervous system symptoms like confusion, agitation, or hallucinations, often seen with higher doses. Difficulty urinating (urinary retention) can also occur, as the drug interferes with bladder function. Any signs of an allergic reaction, such as hives or swelling of the face, lips, or tongue, require immediate medical attention.
Important Warnings and Who Should Avoid Dicyclomine
Dicyclomine is not safe for everyone, and its anticholinergic properties create several specific contraindications. The medication is strictly prohibited in infants younger than six months old due to reports of severe respiratory problems. People diagnosed with glaucoma, particularly angle-closure glaucoma, should not take Dicyclomine because it can increase intraocular pressure.
Patients with certain obstructive conditions must also avoid this drug. These include obstructive uropathy (urinary tract blockage) or obstructive disease of the gastrointestinal tract, such as paralytic ileus or toxic megacolon. Because Dicyclomine slows down muscle movement, it can worsen these blockages. Other serious gastrointestinal contraindications include severe ulcerative colitis and reflux esophagitis.
A warning for all users concerns the risk of heat prostration, as Dicyclomine decreases the body’s ability to sweat and regulate temperature. Individuals in hot environments or those engaging in strenuous exercise should be cautious to avoid overheating. Antacids can reduce the absorption of Dicyclomine, so they should be taken at a separate time.