American Society of Health-System Pharmacists. ^ a b c d e f g "Dicyclomine Hydrochloride Monograph for Professionals".^ a b British national formulary : BNF 76 (76 ed.).It is also a relatively non-polar tertiary amine, able to cross the blood-brain barrier, leading to delirium at high concentrations. Dicycloverine is an agonist at SIGMAR1 and HTR2A receptor sites, though its affinities for these targets are roughly one-fifth to one-tenth as strong as its affinities for CHRM1 and CHRM4 (its clinical targets). Society and culture Īlthough rarely, there have been reports of dicycloverine abuse. The case was part of the reshaping of the US pharmaceutical market that occurred in the 1990s, to favor generic entry. By 2000 several other generic competitors had started selling the drug.
The next year, Hoechst Marion Roussel, which by that time had acquired the business, granted a license to Endo Pharmaceuticals. The US market for the drug at that time was around $8 million Dow had 60% of it and Rugby had 40%. In 1994 the US Federal Trade Commission ordered Marion Merrell Dow, which had recently acquired Rugby Darby, the only generic manufacturer of dicycloverine in the US, to promise to grant licenses to its intellectual property on the drug to any company that wanted it, based on antitrust concerns. In the mid 1980s several governments restricted its use in infants due to reports of convulsions, difficult breathing, irritability, and restlessness in infants given the drug. Bendectin became the subject of many lawsuits due to allegations that it had caused birth defects similar to thalidomide, which Merrell had also marketed in the US and Canada. It was included in the combination drug for morning sickness called Bendectin, along with doxylamine and vitamin B6 which was launched in the US 1956 dicyclomine was removed from the formulation in 1976 after Merrell determined that it added no value. The INN name "dicycloverine" was recommended in 1959. It was first marketed in 1952 for gastrointestinal disorders, including colic in infants. History Ī 10-mg oral capsule of dicyclomine hydrochlorideĭicycloverine was first synthesized chemically in the United States circa 1945 by scientists at William S. Pharmacology ĭicycloverine blocks the action of acetylcholine on cholinergic receptors on smooth muscles in the GI tract, relaxing the smooth muscle. Adverse effects ĭicycloverine can cause a range of anticholinergic side effects such as dry mouth, nausea, blurred vision, dizziness, confusion, severe constipation, stomach pain, heart palpitations, difficulty urinating, and seizures. The effect on the baby during pregnancy or breastfeeding is not well understood. īecause dicycloverine is known to impair thinking and coordination, people taking the drug should avoid driving or operating machinery. It should not be given to children or infants with colic due to the risks of convulsions, difficult breathing, irritability, and restlessness, and there is little evidence to support the efficacy in such use in any case. This medicine should not be used for people who have an obstructive GI or urinary condition, severe ulcerative colitis, reflux, any unstable cardiac condition, glaucoma, myasthenia gravis, and anyone who is acutely bleeding. As of 2016, clinical guidelines recommended dicycloverine and other antispasmodics for IBS with diarrhea as a first line treatment, although the evidence for their effectiveness was very weak. Dicyclomine is used to treat the symptoms of irritable bowel syndrome, specifically hypermotility, in adults.