A fixed-dose combination oral suspension containing an antispasmodic agent (Dicyclomine) and an antiflatulent agent (Dimethicone). Dicyclomine is an anticholinergic that relieves smooth muscle spasm in the gastrointestinal tract, while Dimethicone is a silicone polymer that reduces surface tension of gas bubbles, aiding in their coalescence and expulsion. This combination is widely used in India for symptomatic relief of abdominal pain, bloating, and discomfort associated with functional gastrointestinal disorders like Irritable Bowel Syndrome (IBS) and functional dyspepsia.
Adult: 10 ml (containing Dicyclomine 20mg + Dimethicone 80mg) three to four times daily, preferably 20-30 minutes before meals and at bedtime. The dose may be adjusted based on response, but total Dicyclomine should not exceed 160mg/day.
Note: Shake the bottle well before use. Use the measuring cup or spoon provided. Can be taken with or without food, but taking 20-30 minutes before meals may provide better prophylactic relief for postprandial symptoms. Do not dilute. Follow with a glass of water if desired.
Dicyclomine competitively inhibits muscarinic acetylcholine receptors (M1, M2, M3) on smooth muscle cells in the gastrointestinal tract, leading to direct smooth muscle relaxation. It also has a direct papaverine-like spasmolytic effect. Dimethicone is a physiologically inert silicone oil with defoaming properties. It reduces the surface tension of gas bubbles trapped in the GI mucus and chyme, causing them to coalesce. This allows the gas to be more easily expelled via belching or flatus, relieving bloating and discomfort.
Pregnancy: Category B (US FDA). Animal studies have shown no risk, but adequate and well-controlled studies in pregnant women are lacking. Use only if clearly needed. Dicyclomine may cause fetal tachycardia if used in the third trimester.
Driving: May cause drowsiness, dizziness, or blurred vision. Patients should not drive or operate machinery until they know how the medicine affects them.
| Other Anticholinergics (e.g., Atropine, Oxybutynin, TCAs, Antihistamines) | Additive anticholinergic side effects (dry mouth, constipation, urinary retention, confusion, tachycardia). | Major |
| Amantadine | Increased anticholinergic side effects. | Moderate |
| Potassium Chloride (wax-matrix tablets) | Dicyclomine may reduce GI motility, increasing risk of GI mucosal lesions from KCl. | Moderate |
| Metoclopramide, Domperidone | Pharmacological antagonism; Dicyclomine reduces GI motility, counteracting prokinetic effects. | Moderate |
| Opioid Analgesics (e.g., Codeine, Tramadol) | Additive constipation and CNS depression. | Moderate |
| Benzodiazepines, Alcohol, CNS Depressants | Additive sedative effects, increased drowsiness and dizziness. | Moderate |
| Digoxin | Reduced GI motility may increase digoxin absorption, potentially leading to toxicity. | Moderate |
| Antacids, Kaolin | May reduce absorption of Dicyclomine. Administer at least 1-2 hours apart. | Minor |
| Monoamine Oxidase Inhibitors (MAOIs) | May intensify anticholinergic effects. | Moderate |
Same composition (Dicyclomine (10mg/5ml) + Dimethicone (40mg/5ml)), different brands: