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Dicyclomine Anticholinergic Alternative

Dicyclomine, or dicyclomine hydrochloride, is a drug belonging to a group of medications called anticholinergics. These medications are classified as antispasmodics and are commonly used to treat cramps and spasms in the bladder, stomach or intestines. Dicyclomine is typically used to relieve symptoms of irritable bowel syndrome (IBS), including spasms and diarrhea. IBS sufferers who are unable to take dicyclomine may receive any one of a number of alternative medications.

  1. Other Anticholinergics

    • If you are unable to take dicyclomine (Bentyl), you may still be able to take other anticholinergics. Options include scopolamine, pirenzepine, methscopolamine, methantheline, mepenzolate, hyoscyamine, belladonna and atropine. Anticholinergics are powerful medications, and if you take any of them you must follow your doctor's dosing instructions accurately. Symptoms of an anticholinergic overdose include convulsions, breathing difficulties, blurred vision, rapid heartbeat, dizziness, hallucinations, severe drowsiness and slurred speech. Consult your doctor to learn more about the risks and benefits of these medications and to determine whether you are a candidate for alternative anticholinergic use.

    Tricyclic Antidepressants

    • If you cannot take other anticholinergics, your doctor may choose to treat your IBS abdominal pain with low doses of tricyclic antidepressants. In addition to their antidepressant effects, these medications can block pain signals to your brain and may also help ease the symptoms of diarrhea. According to the Mayo Clinic and the International Foundation for Functional Gastrointestinal Disorders, tricyclic antidepressants include amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), desipramine (Norpramin) and imipramine (Tofranil). Consult your doctor to learn more about these medications.

    Anti-Diarrhea Medications

    • Your doctor may also recommend relieving your diarrhea with over-the-counter medications such as loperamide (Imodium). He may also prescribe stronger anti-diarrhea medications such as diphenoxylate. Be aware that both prescription and non-prescription diarrhea products can trigger symptoms of constipation.

    Alosetron

    • If you are female and have IBS with severe diarrhea, your doctor may prescribe a dicyclomine alternative called alosetron (Lotronex). According to the Mayo Clinic, this medication is classified as a nerve receptor antagonist. It works by relaxing your colon and slowing the passage of waste through your bowels. Alosetron use carries risks of serious or severe side effects, and to prescribe this product your doctor must enroll in a program administered by the drug's manufacturer. Typically, alosetron use should be considered only if other treatment alternatives prove ineffective. Consult your doctor to learn more about this medication. If you are male, alosetron use is not an option.

    Additional Considerations

    • Not all individuals respond to medications in the same way, and your doctor will not know in advance whether a particular medication will prove effective. Proper resolution of your symptoms may require time and experimentation.

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