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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.

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.

What form(s) does this medication come in?

Riva-Dicyclomine is no longer being manufactured for sale in Canada. For brands that may still be available, search under dicyclomine. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

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 breast-feeding 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:

  • aclidinium
  • amantadine
  • anti-arrhythmic medications (e.g., quinidine)
  • antihistamines (e.g., bilastine, chlorpheniramine, diphenhydramine, hydroxyzine, rupatadine)
  • antipsychotics (e.g., chlorpromazine, haloperidol, olanzapine, quetiapine, risperidone)
  • atropine
  • belladonna
  • benztropine
  • botulinum toxin
  • cannabis
  • clozapine
  • cyclobenzaprine
  • darifenacin
  • dimenhydrinate
  • disopyramide
  • domperidone
  • donepezil
  • eluxadoline
  • fesoterodine
  • galantamine
  • glycopyrronium
  • ipratropium
  • ketotifen
  • methadone
  • metoclopramide
  • mirabegron
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, tranylcypromine)
  • nabilone
  • narcotic opioids (e.g., codeine, fentanyl, meperidine, morphine)
  • nitroglycerin
  • orphenadrine
  • oxybutynin
  • phenothiazines (e.g., fluphenazine, perphenazine)
  • potassium chloride
  • quinidine
  • rivastigmine
  • scopolamine
  • thiazide diuretics (e.g.,  hydrochlorothiazide, indapamide)
  • tricyclic antidepressants (e.g., amitriptyline, desipramine, trimipramine)
  • trihexyphenidyl
  • tiotropium
  • tolterodine
  • topiramate
  • umeclidinium

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.

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