Dicycloverine


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intramuscular
Gastrointestinal tract spasm
Adult: 10-20 mg 4 times daily for 1-2 days if oral therapy is temporarily impractical.

Oral
Gastrointestinal tract spasm
Adult: 10-20 mg tid.
Child: 6 months to 2 years 5-10 mg 3-4 times daily. Max: 40 mg. >2-12 years 10 mg tid. >12 years Same as adult dose.
Cách dùng
May be taken with or without food.
Chống chỉ định
Obstructive diseases of the gastrointestinal tract, severe ulcerative colitis, reflux oesophagitis, unstable cardiovascular status in acute haemorrhage, glaucoma, obstructive uropathy, myasthenia gravis, salmonella dysentery. Infants (<6 months). Lactation.
Thận trọng
Patient with prostatic hypertrophy, coronary artery disease, tachyarrhythmic conditions thyrotoxicosis, congestive heart failure, hypertension, autonomic neuropathy, mild-moderate ulcerative colitis, ileostomy or colostomy, mental illness. Renal and hepatic impairment. Children and elderly. Pregnancy.
Phản ứng phụ
Significant: Heat prostration, psychosis or delirium, diarrhoea.
Cardiac disorders: Tachyarrhythmia, palpitations, transient bradycardia.
Eye disorders: Mydriasis, cycloplegia, photophobia, rarely, blurred vision.
Gastrointestinal disorders: Dry mouth with difficulty swallowing and talking, dyspepsia, abdominal distension, abdominal pain, rarely rarely, constipation, nausea, vomiting.
General disorders and admin site conditions: Malaise, fatigue.
Investigations: Decreased lactation.
Metabolism and nutrition disorders: Thirst, rarely, anorexia.
Nervous system disorders: Dizziness, rarely, sedation, headache.
Psychiatric disorders: Nervousness, insomnia, confusion, hallucinations.
Renal and urinary disorders: Rarely, dysuria.
Respiratory, thoracic and mediastinal disorders: Reduced bronchial secretions.
Skin and subcutaneous tissue disorders: Dry skin, rarely, rash.
Thông tin tư vấn bệnh nhân
This drug may cause dizziness, drowsiness or blurred vision, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor anticholinergic effects (e.g. asthenia, nervousness), urinary output, gastrointestinal symptoms.
Quá liều
Symptoms: Headache, dizziness, blurred vision, nausea, dry mouth, difficulty swallowing, dilated pupils, hot dry skin, CNS stimulation (e.g. convulsion), curare-like action (e.g. neuromuscular weakness, paralysis). Management: Symptomatic treatment. Perform gastric lavage, administration of emetic and activated charcoal to reduce absorption. If necessary, administer sedatives (e.g. short-acting barbiturates, benzodiazepines) for management of overt signs of excitement, and parenteral cholinergic agent as an antidote.
Tương tác
May enhance the anticholinergic effect of tiotropium, ipratropium, glycopyrrolate, oxatomide, revefenacin. May enhance ulcerogenic effect of K citrate. Increased serum concentration of thiazide diuretics. May decrease the absorption of nitroglycerin.
Tác dụng
Description: Dicycloverine, a tertiary amine antimuscarinic, relieves gastrointestinal smooth muscle spasm by blocking the action of acetylcholine at parasympathetic sites in the smooth muscle, CNS and secretory glands.
Synonym: Dicyclomine.
Onset: 1-2 hours.
Duration: Up to 4 hours.
Pharmacokinetics:
Absorption: Rapidly and well absorbed from the gastrointestinal tract. Bioavailability: IM injection: Approx 2 times more bioavailable than oral administration. Time to peak plasma concentration: 60-90 minutes (oral).
Distribution: Enters breast milk. Volume of distribution: 3.65 L/kg.
Metabolism: Undergoes extensive metabolism.
Excretion: Via urine (80%; small amounts as unchanged drug), faeces (8%). Elimination half-life: Approx 1.8 hours (initial phase).
Đặc tính

Chemical Structure Image

Source: National Center for Biotechnology Information. PubChem Database. Dicyclomine, CID=3042, https://pubchem.ncbi.nlm.nih.gov/compound/Dicyclomine (accessed on Jan. 21, 2020)

Bảo quản
Store below 25°C. Protect from direct sunlight. Protect from excessive heat.
Phân loại MIMS
Phân loại ATC
A03AA07 - dicycloverine ; Belongs to the class of synthetic anticholinergics, esters with tertiary amino group. Used in the treatment of functional bowel disorders.
References
Anon. Dicyclomine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/10/2019.

Buckingham R (ed). Dicycloverine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/10/2019.

Dicyclomine Capsule/Tablet (A-S Medication Solutions). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/10/2019.

Dicyclomine Hydrochloride Injection (West-Ward Pharmaceuticals Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 14/11/2016.

Dicyclomine Hydrochloride Tablet and Capsule (Lannett Company, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 14/11/2016.

Dicyclomine Solution for Injection (Leucadia Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 04/10/2019.

Joint Formulary Committee. Dicycloverine Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/11/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Dicyclomine Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 14/11/2016.

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