Brand name(s): Bentyl, Barmine

Generic name: Dicyclomine hydrochloride

Preparation(s): tablet, capsule, liquid, IM

Uses for IBS
Bentyl (dicyclomine) is an oral antispasmodic used as a second or third line agent to treat people suffering from IBS with motility problems. It is usually offered after unsuccessful trials of diet restriction and counseling. Although it is not a drug of choice for IBS, it is a widely used medication in the United States and helpful in decreasing abdominal pain and tenderness, and improving bowel habits. Sometimes, it is combined with phenobarbital, but there has not been ample evidence showing that this combination is especially effective. Bentyl has also been used within the pediatric population to alleviate infant colic (a benign and self-limiting intestinal disorder).

Bentyl is available in many different forms: tablet, capsules, solution, and IM (intramuscular) injection. It is usually taken orally. If there are limitations to the oral form, it can be administered IM and may cause local irritation. When taking Bentyl in the solution form, it should be mixed with an equal amount of water.

Bentyl should not be taken with potassium chloride (often purchased OTC as a supplement to increase potassium levels). Bentyl should also be avoided in people taking drugs that affect GI motility (e.g. pramlintide). Both of these medications, when mixed with Bentyl, can cause a drug-drug interaction with adverse effects and must be avoided. The anticholinergic phenothiazine, may also cause an adverse reaction but the risk is relative to the person and should be evaluated. Bentyl should not be given to infants less than 6 months old, lactating mothers, or the elderly, who are also on anticholinergics.

Certain disease conditions prohibit the use of Bentyl. The most significant of these are disorders of the esophagus (eg. Achlasia), bladder outflow obstruction (80% of the medicine is eliminated through urine) and GI obstruction.

Adverse Effects:
The most frequently reported adverse effects are constipation, reduced sweat, and dry mouth. Others include reduction of breast milk, blurry vision, drowsiness, and enlarged pupils. Rare adverse effects include allergic reactions (including skin rash), weakness, headache, and dizziness. Sedation, amnesia, and glaucoma are especially prevalent in the elderly population on anticholinergics.