What to expect when taking dicyclomine 10 mg

In this article:

• What is dicyclomine 10 mg used for?
• How does it work?
• Primary uses
• Dosing
• Side effects
• Who should (and shouldn’t) take dicyclomine 10 mg?
• Tips for safe and effective use
• Is it right for you?
• Expert takeaway

In this article

• What is dicyclomine 10 mg used for?
• How does it work?
• Primary uses
• Dosing
• Side effects
• Who should (and shouldn’t) take dicyclomine 10 mg?
• Tips for safe and effective use
• Is it right for you?
• Expert takeaway

If you have irritable bowel syndrome (IBS) or other bowel problems, you’re intimately familiar with the pain of abdominal cramping and intestinal spasms. Dicyclomine hydrochloride is a generic prescription drug used to relieve these symptoms. If you’ve been prescribed dicyclomine 10 mg — the drug’s starting dose — here’s what to know about how it works, which IBS symptoms it helps, and what possible side effects or other adverse effects to be aware of during treatment.

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What is dicyclomine 10 mg used for?

Dicyclomine, the generic name for the brand-name drug Bentyl, is used to treat painful cramping from IBS or functional bowel problems. It helps prevent intestinal muscles from spasming. “Think of dicyclomine as a brake pedal that slows down the bowel and helps reduce pain,” says Oluwatosin Ajao, MD, a board-certified internal medicine physician and lifestyle and obesity medicine specialist in Houston.

How does dicyclomine 10 mg work?

Dicyclomine belongs to a class of drugs called anticholinergics, which block the action of acetylcholine (ACh), a neurotransmitter. ACh is responsible for sudden contractions in the smooth muscles of the intestine. 

That said, ACh also has other roles. Blocking its activity can affect multiple body systems and cause several unpleasant side effects, which is why dicyclomine 10 mg is not considered a first-line IBS treatment. 

Dicyclomine works quickly, but its effects also end quickly. This IBS medication has a half-life of 1.8 hours, meaning that half the dose is eliminated from the body within 2 hours of administration and almost all of it is gone 10 hours after a dose. That’s why people on dicyclomine may need to take it 3 to 4 times per day.

Primary uses of dicyclomine 10 mg

Dicyclomine 10 mg is approved by the Food and Drug Administration (FDA) to treat people with functional bowel disorder and irritable bowel syndrome. It has no other approved uses. 

Dosing dicyclomine 10 mg

Dicyclomine is available in four dosage forms: 

• 10 mg oral capsules
• 20 mg and 40 mg oral tablets
• Oral liquid solution
• Injection administered in a clinical setting

According to the drug label, patients can start dicyclomine tablets or capsules at 20 mg four times per day, though some healthcare providers may recommend starting at 10 mg four times per day. Rather than taking it on a scheduled basis, patients are often instructed to take it as needed for symptoms. Dose escalation is recommended at the discretion of a healthcare provider who is familiar with the patient’s medical history, current conditions, and other medications. 

Here is an example of a standard dicyclomine dosing escalation schedule:

• Starting dose. An individual might be told to take 10 to 20 mg up to four times per day.
• After one week of treatment, if side effects are not severe, the dose can be increased to 20 to 40 mg four times per day, but oftentimes, healthcare professionals are reluctant to escalate the dose too high.
• After two weeks of treatment, the prescriber will determine whether the medication has successfully provided symptom relief. If not, or if the side effects are too severe to allow for dosing at 80 mg or more per day, dicyclomine should be discontinued, according to the drug’s label. In practice, doses below 80 mg per day or use as-needed may be advised. 

Regardless of the dose, dicyclomine can be taken with or without food. In some cases, the drug is taken four times per day. Anyone concerned about missed doses or their ability to stick to a consistent dosing schedule should seek personalized medical advice. In some cases, a different IBS treatment might be a better fit.

Potential side effects of dicyclomine 10 mg

Even dicyclomine 10 mg, the medication’s lowest possible dose, can cause side effects. 

Mild dicyclomine side effects include:

• Dry mouth
• Dry skin
• Dizziness
• Blurred vision
• Drowsiness 
• Nausea
• Nervousness

Seek medical advice for serious side effects such as:

• Racing heart
• Irregular heartbeat or weak pulse
• Severe dizziness, fatigue, or lightheadedness
• Agitation, confusion, or disorientation
• Hallucinations
• Trouble breathing

Like any other medication, dicyclomine can cause an allergic reaction. Signs of a severe, potentially life-threatening allergic reaction include:

• Swelling of the face, throat, or tongue
• Trouble breathing
• Trouble swallowing
• Abnormally fast or slow pulse
• Hives or a sudden skin rash

Who should (and shouldn’t) take dicyclomine 10 mg?

“First-line IBS treatment starts with lifestyle and behavior modifications,” says Chandhana Paka, MD, a board-certified and fellowship-trained gynecologic surgeon, urogynecologist, and lifestyle medicine physician at Mount Sinai West. In other words, drugs like dicyclomine 10 mg are recommended only after lifestyle changes have not been able to control symptoms.

Individuals with IBS or other bowel conditions should only take dicyclomine when prescribed by a healthcare professional familiar with their full medical history. For instance, Dr. Paka says dicyclomine is “less suitable” for IBS-C, or IBS with constipation, since the effect of the medication on your intestines can worsen constipation. It may also be unsafe for people on certain medications or with certain health conditions to take dicyclomine. Seniors may be at higher risk of side effects of anticholinergics, which is why dicyclomine’s label points out the need for caution in the geriatric population. 

Medications to avoid mixing with dicyclomine

The following medications may interact with dicyclomine:

• Inhaled muscarinic antagonists such as Atrovent HFA (ipratropium), Spiriva Respimat (tiotropium bromide), Anoro Ellipta (umeclidinium-vilanterol), and Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)
• Oral muscarinic antagonists such as Ditropan XL (oxybutynin), Detrol LA (tolterodine), Vesicare (solifenacin), and Toviaz (fesoterodine)
• Antipsychotics such as Seroquel (quetiapine), Risperdal (risperidone), Abilify (aripiprazole), and Zyprexa (olanzapine)
• Thiazide diuretics such as Hydrochlorothiazide (HCTZ), metolazone, and chlorthalidone
• Opioid agonists such as Percocet (oxycodone-acetaminophen), hydrocodone-acetaminophen, and MS Contin (morphine sulfate)

This is not a complete list of drug-drug interactions with dicyclomine. Other potential dicyclomine interactions to avoid may include Benadryl (diphenhydramine), Topamax (topiramate), potassium supplements, antacids, and cannabinoids, among others. 

Dicyclomine contraindications

Dicyclomine may exacerbate or be unsafe to take with certain health conditions. “This medicine should not be used by mothers who are breastfeeding, babies under 6 months old, people with glaucoma, muscle weakness disease (myasthenia gravis), blocked urine flow, blocked intestines, or severe acid reflux,” Dr. Ajao says.

Your provider also needs to know if you have or have had any of the following apply to you:

• Ulcerative colitis
• Enlarged prostate
• Intestinal blockage
• Colostomy or ileostomy
• Pregnant or trying to get pregnant

Antispasmodics like dicyclomine are often not recommended for older adults (ages 65 and older), but some research shows they may be safe for certain individuals. 

Bottom line: It is crucial to share your full medical history and a complete list of prescription, over-the-counter, and herbal or supplement medications you take with your provider before starting dicyclomine 10 mg.

Tips for safe and effective use of dicyclomine 10 mg 

If you are prescribed dicyclomine 10 mg, it’s important to know the precautions to take. Follow these tips for safe and effective use of dicyclomine 10 mg:

• Tell your healthcare provider about any changes in your health while on the medication. Report concerning side effects, new diagnoses, or medications so that your dose can be adjusted (if necessary) or an alternative medication can be tried.

• Store at room temperature. Per the drug label, dicyclomine tablets or liquid should be kept in a sealed container at room temperature.

• Stick to the schedule. Missed doses are common with medications taken multiple times per day. Consider setting an alarm or writing yourself reminder notes to take all recommended doses on time. “If you miss a dose, skip the missed dose. Take your next dose at the regular time,” Dr. Ajao says.

• Avoid alcohol. Because dicyclomine can cause drowsiness, dizziness, and blurry vision, Dr. Ajao recommends avoiding alcohol and driving until you know how the medication affects you.

• Do not take antacids with dicyclomine. Dr. Ajao says antacids can usually be taken 1-2 hours after your dicyclomine dose. Ask your provider for personalized medical advice.

• Stay hydrated. “Avoid very hot weather or overheating, because this medicine reduces sweating,” Dr. Ajao says. Dehydration can lead to heat stroke or heat exhaustion.

• Keep out of reach of children. Dicyclomine is a potent medication. Seek urgent medical attention and call the Poison Control Center if accidentally swallowed.

• Watch for signs of adverse events. You and the people closest to you should be aware of serious dicyclomine side effects, such as a racing heart, breathing difficulties, disorientation, and hallucination. Report these to your healthcare provider right away. 

Is dicyclomine 10 mg the right choice for you?

Dicyclomine is not right for everyone. It is essential to work closely with your healthcare provider to determine the best IBS treatment for you. 

Here are some questions to consider before starting dicyclomine 10 mg:

• Have you shared your complete health history and medication list with your healthcare provider?
• Are you confident that you will remember to take dicyclomine up to four times per day?
• Are you prepared to deal with potential side effects such as dry mouth and constipation?
• Are you prepared to monitor for serious side effects such as dizziness, irregular heartbeat, and agitation or disorientation?

Again, only a healthcare provider familiar with your complete medical history and medications can determine whether dicyclomine is the right choice for you.

Expert takeaway

“When primary care providers and gastroenterologists prescribe dicyclomine for IBS-related abdominal cramps, mostly in the setting of IBS with diarrhea, patients can get great relief,” says Chad Shaffer, MD, a member of the SingleCare Medical Board, “but because it can worsen IBS-related constipation and induce serious side effects, cautious use or avoidance in certain patients is advisable.”