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Pronunciation: die-SIGH-kloe-meen HIGH-droe-KLOR-ide
- Capsules 10 mg
- Tablets 20 mg
- Syrup 10 mg/5 mL
- Injection 10 mg/mL
- Injection 10 mg/mL
- Injection 10 mg/mL
Relieves smooth muscle spasm of GI tract through anticholinergic effects and direct action on GI smooth muscle.
Rapidly absorbed. T max is 60 to 90 min (oral).
Vd approximately 3.65 L/kg.
79.5% excreted in the urine and 8.4% in feces. Half-life is approximately 1.8 h.
Indications and Usage
Treatment of functional bowel/irritable bowel syndrome (eg, irritable colon, spastic colon, mucous colitis).
Intestinal colic in children older than 6 mo.
Narrow angle glaucoma; adhesions between iris and lens; obstructive uropathy; obstructive disease of GI tract; paralytic ileus; intestinal atony of elderly or debilitated patient; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; hepatic or renal disease; tachycardia; myocardial ischemia; unstable cardiovascular status in acute hemorrhage; myasthenia gravis; infants younger than 6 mo.
Dosage and AdministrationAdults
PO 80 mg/day in 4 equally divided doses. Increase to 160 mg/day in 4 equally divided doses. Administer 30 min before meals.
IM 80 mg/day in 4 divided doses. Administer 30 min before meals.
Store in tightly closed container at room temperature and protect from light. Injection fluid should be clear.
Drug InteractionsAmantadine, tricyclic antidepressants
May cause increased anticholinergic adverse reactions.Atenolol, digoxin
May increase pharmacologic effects of these drugs.Phenothiazines
May reduce antipsychotic effectiveness.
Laboratory Test Interactions
None well documented.
CNS stimulation (restlessness, tremor), confusion, dizziness, drowsiness, fever (especially in children), flushing, headache, insomnia, light-headedness, mental confusion or excitement (especially in elderly, even with small doses), nervousness, weakness.
Local irritation following injection; severe allergic reactions including anaphylaxis, dermal manifestations, and urticaria.
Blurred vision, cycloplegia, dilated pupils, increased IOP, mydriasis, nasal congestion, photophobia.
Altered taste perception, bloated feeling, constipation, dry mouth, dysphagia, heartburn, nausea, paralytic ileus, vomiting.
Impotence, urinary hesitancy and retention.
Decreased sweating, suppression of lactation.
Category B .
Excreted in breast milk.
Safety and efficacy have not been established. Contraindicated in infants younger than 6 mo. In infants, serious respiratory symptoms, seizures, syncope, pulse rate fluctuation, muscular hypotonia, coma, and death have been reported.
Elderly patients may react with excitement, agitation, drowsiness, and other untoward manifestations to even small doses.
Special Risk Patients
Use with caution in patients with autonomic neuropathy, hyperthyroidism, hypertension, coronary heart disease, CHF, hiatal hernia, prostatic hypertrophy.
Reported in sensitive individuals and may include confusion, disorientation, short-term memory loss, hallucinations, dysarthria, ataxia, coma, euphoria, decreased anxiety, fatigue, insomnia, agitation and mannerisms, and inappropriate affect.
Diarrhea may be symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment of diarrhea with drug is inappropriate and possibly harmful.
May delay gastric emptying rate and complicate therapy.
Can occur in presence of high environmental temperature.
Circulatory failure, vomiting, abdominal distention, muscle weakness, anxiety, stupor, blurred vision, photophobia, dilated pupils, urinary retention.
- Advise contact lens wearers to use lubricating solutions.
- Warn patients to avoid direct sunlight and any heat extremes (eg, exercise in hot weather, saunas, prolonged activity in hot weather).
- Instruct patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
- Alert patients to pay special attention to fever, decreased ability to sweat and changes in bowel or bladder habits.
- Advise elderly patients to report eye pain to health care provider or ophthalmologist and to undergo testing for glaucoma.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
- Tell patient to report any difficulty in swallowing to health care provider.
Copyright © 2009 Wolters Kluwer Health.