Dicyclomine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Irritable Bowel Syndrome

Parenteral: 20 mg IM 4 times a day. Institute oral therapy as soon as possible.

Oral:
Initial: 20 mg orally 4 times a day.

Maintenance: 40 mg orally 4 times a day.

Usual Pediatric Dose for Irritable Bowel Syndrome

6 months to less than 1 year: 5 mg orally every 6 to 8 hours.

1 to 12 years: 10 mg orally every 6 to 8 hours.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Dicyclomine is contraindicated in patients with obstructive uropathy, obstructive disease of the gastrointestinal tract, severe ulcerative colitis, reflux esophagitis, unstable cardiovascular status in acute hemorrhage, glaucoma, and myasthenia gravis. Dicyclomine is contraindicated in infants less than 6 months of age and in nursing mothers.

In the presence of a high environmental temperature, heat prostration (fever and heat stroke due to decreased sweating) can occur with the administration of dicyclomine. The drug should be discontinued and supportive measures instituted if symptoms occur.

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

Dicyclomine may cause drowsiness or blurred vision. The elderly and the renally or hepatically impaired may be particularly sensitive to these effects. All patients should be cautioned against engaging in activities which require mental alertness, such as driving or operating a motor vehicle or other machinery or performing hazardous work while taking this drug.

Psychosis has been reported in sensitive individuals given anticholinergic drugs. CNS signs and symptoms include confusion, disorientation, short-term memory loss, hallucinations, dysarthria, ataxia, coma, euphoria, decreased anxiety, fatigue, insomnia, agitation and mannerisms, and inappropriate affect. These CNS signs and symptoms usually resolve within 12 to 24 hours after discontinuation of the drug.

Caution should be used when initiating treatment with dicyclomine in patients with autonomic neuropathy.

Dicyclomine should be used with caution in patients with hepatic disease.

Dicyclomine 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. Dicyclomine should be used with caution in patients with renal disease.

Dicyclomine should be used with caution in patients with ulcerative colitis. Large doses of dicyclomine may suppress intestinal motility to the point of producing a paralytic ileus and the use of dicyclomine may precipitate or aggravate the serious complication of toxic megacolon.

Caution should be used when initiating treatment with dicyclomine in patients with hyperthyroidism.

Dicyclomine should be used with caution in patients with hypertension, coronary heart disease, congestive heart failure, and cardiac tachyarrhythmia. Tachycardia of any kind should be investigated before the administration of dicyclomine, since it may increase the heart rate.

Dicyclomine should be used with caution in patients with hiatal hernia.

Dicyclomine should be used with caution in patients with known or suspected prostatic hypertrophy.

Clinical studies of dicyclomine have not included adequate 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 elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

There are reports that administration dicyclomine syrup to infants has been followed by serious respiratory symptoms (dyspnea, shortness of breath, breathlessness, collapse, respiratory, apnea, asphyxia), seizures, syncope, pulse rate fluctuations, muscular hypotonia, and coma. Death has been reported. No causal relationship between these effects observed in infants and dicyclomine use has been established. Efficacy and safety of dicyclomine in pediatric patients have not been established.

Dialysis

Data not available

Other Comments

Administer the oral form 30 minutes before a meal.

The injectable form is for IM use only.

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