5 Dicyclomine (Bentyl) Interactions You Should Know About
Key takeaways:
Dicyclomine (Bentyl) can interact with several medications. Examples include anticholinergics, medications that affect gut motility, glaucoma treatments, and antacids.
Some dicyclomine interactions can increase the risk of side effects, such as dry mouth and constipation. Others may cause other medications you’re taking to be less effective.
Talk to your healthcare team before taking other medications with dicyclomine. They can help check for potential interactions and suggest ways to manage them.
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Table of contents
Dicyclomine (Bentyl) is an anticholinergic medication used to relieve stomach cramps caused by irritable bowel syndrome (IBS). It’s not commonly used, but healthcare professionals may still prescribe it in some cases.
If you’re taking dicyclomine, it’s good to understand how it may interact with other medications. Some interactions can increase the risk of side effects or make other treatments less effective. Your healthcare team can help flag these interactions by reviewing your current medication list.
Some dicyclomine interactions can be managed with close monitoring, but others should be avoided altogether. Here’s what you should know.
Dicyclomine interactions summary
While it’s not a comprehensive list, below are examples of medications and substances that can interact with dicyclomine:
Anticholinergic medications, such as hyoscyamine (Levsin), glycopyrrolate (Robinul, Cuvposa), and benztropine (Cogentin)
Over-the-counter (OTC) medications, such as diphenhydramine (Benadryl)
Amantadine (Gocovri)
Chronic obstructive pulmonary disease (COPD) medications, such as tiotropium (Spiriva) and ipratropium (Atrovent)
Overactive bladder medications, such as oxybutynin (Ditropan XL) and solifenacin (Vesicare)
Antipsychotic medications, such as clozapine (Clozaril) and chlorpromazine
Tricyclic antidepressants (TCAs), such as nortriptyline (Pamelor), doxepin, and amitriptyline
Opioid pain medications, such as meperidine
Medications that affect gastrointestinal (GI) motility, such as tegaserod (Zelnorm), metoclopramide (Reglan), and erythromycin (E.E.S., Ery-Tab)
Glaucoma medications, such as latanoprost (Xalatan), timolol (Timoptic), and dorzolamide (Trusopt)
Antacids, such as Tums (calcium carbonate)
Digoxin
Let’s take a closer look at five key dicyclomine interactions and how to manage them.
1. Anticholinergic medications
Dicyclomine works by blocking the effects of acetylcholine. Acetylcholine is a chemical involved in many functions in the body, including muscle movement in the gut. But other medications, such as hyoscyamine, diphenhydramine, and oxybutynin, also have anticholinergic effects.
Taking dicyclomine with other anticholinergic medications increases the risk of side effects, such as:
Blurry vision
Difficulty urinating
Fast heart rate
Dicyclomine FAQs: Is dicyclomine used for anxiety? Get an answer to this and other frequently asked questions about dicyclomine.
What to expect: Review common and rare side effects that can happen while taking dicyclomine and what to do if they occur.
IBS flare-ups: Learn the common causes of increased IBS symptoms and how to prevent flare-ups.
While rare, anticholinergic toxicity is possible, especially if you take high doses or multiple anticholinergic medications. Symptoms include confusion, skin flushing, and fever. In severe cases, seizures or heart problems can occur.
Many medications have anticholinergic effects. Your healthcare team can help identify any others you may be taking. If needed, they may change your medications or recommend monitoring for side effects.
2. Medications that affect GI motility
Dicyclomine slows down movement in your gut (called gut motility). This may counteract the effects of medications that speed up gut motility, making them less effective. Examples include:
Metoclopramide (Reglan), which is used to treat gastroesophageal reflux disease (GERD) and gastroparesis (slowed stomach emptying)
Erythromycin, which is sometimes used off-label for gastroparesis
Tegaserod (Zelnorm), which is used to treat IBS with constipation
It’s unlikely that you’ll be prescribed one of these medications with dicyclomine. Still, it’s a good idea to be aware of this interaction.
Dicyclomine slows down movement in your gut (called gut motility). This may counteract the effects of medications that speed up gut motility, making them less effective. Examples include:
Metoclopramide (Reglan), which is used to treat gastroesophageal reflux disease (GERD) and gastroparesis (slowed stomach emptying)
Erythromycin, which is sometimes used off-label for gastroparesis
Tegaserod (Zelnorm), which is used to treat IBS with constipation
It’s unlikely that you’ll be prescribed one of these medications with dicyclomine. Still, it’s a good idea to be aware of this interaction.
3. Glaucoma medications
Anticholinergic medications like dicyclomine can counteract the effects of glaucoma medications, such as latanoprost (Xalatan). They may also increase the risk of angle-closure glaucoma, which is considered a medical emergency.
For this reason, people with glaucoma shouldn’t take dicyclomine. Your healthcare team can recommend a safer alternative.
4. Antacids
Antacids like Tums work by neutralizing stomach acid to relieve occasional heartburn. But this effect may interfere with how you absorb dicyclomine, potentially making it less effective. There’s not much research on this interaction, so it’s not clear if it makes a significant difference.
But in general, it’s best to avoid taking dicyclomine and an antacid at the same time. Your healthcare team can give you instructions for managing this interaction, which may include separating when you take each medication.
5. Digoxin
Digoxin (Lanoxin) is used to treat heart failure and heart rhythm problems. It has a narrow therapeutic index, meaning small changes in blood levels can significantly impact side effects and how well it works. Dicyclomine may increase digoxin levels, raising the risk of toxicity.
It’s best to avoid combining dicyclomine and digoxin. But if your prescriber wants you to take both medications, they may check your digoxin levels more often. Tell them right away if you notice symptoms such as nausea and vomiting, persistent diarrhea, and vision changes.
Frequently asked questions
Dicyclomine relaxes muscles in the digestive tract, which can help relieve stomach spasms and cramping. But it often slows bowel movements and can cause constipation. In some cases, this can lead to serious complications, especially if you have certain conditions, such as a bowel obstruction (blockage).
On the other hand, dicyclomine’s constipating effects can be helpful if you have IBS with diarrhea. That said, it’s a good idea to report any major changes in your bowel movements to your healthcare team.
There are no known food interactions with dicyclomine itself. But if you’re taking dicyclomine for IBS, it’s best to avoid certain foods and drinks that can worsen IBS symptoms, such as:
Spicy foods
Fatty foods
Caffeinated drinks
Alcohol
Dairy products, such as milk, cheese, and ice cream
Carbonated drinks
Yes, you can typically take melatonin with dicyclomine. There aren’t any known drug interactions between them. But talk to your healthcare team before starting melatonin. It may not be suitable if you have certain health conditions, such as bleeding disorders, low blood pressure, or seizures.
Possibly. Some research suggests dicyclomine may reduce acid reflux episodes, but evidence is limited. If you have acid reflux, medications specifically designed to reduce stomach acid, such as proton pump inhibitors or histamine-2 antagonists, will likely work better. Your healthcare team can recommend the best option for you.
The bottom line
Dicyclomine (Bentyl) is an anticholinergic medication that relieves stomach cramps in people with irritable bowel syndrome (IBS). It can interact with other anticholinergic medications, metoclopramide (Reglan), and antacids.
Before taking dicyclomine, ask your prescriber and pharmacist to check for potential interactions. In some cases, they might suggest an alternative to dicyclomine or the interacting medication. Or they may just recommend watching closely for side effects.
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References
Korselman, J., et al. (1999). Different effects of an oral anticholinergic drug on gastroesophageal reflux in upright and supine position in normal, ambulant subjects: A pilot study. American Journal of Gastroenterology.
Lacy, B. E., et al. (2021). ACG Clinical Guideline: Management of irritable bowel syndrome. American Journal of Gastroenterology.
Cardinal Health 107. (2022). Dicyclomine hydrochlolride [package insert].
Wu, A., et al. (2020). A review of systemic medications that may modulate the risk of glaucoma. Eye.
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