A fixed-dose combination (FDC) of an antispasmodic (Dicyclomine) and an H2-receptor antagonist (Ranitidine). Dicyclomine relieves smooth muscle spasm in the gastrointestinal tract, while Ranitidine reduces gastric acid secretion. This combination is primarily used for the symptomatic relief of acid-related disorders accompanied by visceral colic and spasms. Note: The FDC of Dicyclomine and Ranitidine was banned by the Indian government in 2018 under Gazette Notification G.S.R. 72(E) due to an unfavorable risk-benefit ratio. However, individual components are still available separately and the combination may be found in some contexts, though its prescription is strongly discouraged.
Adult: One tablet (Dicyclomine 10mg + Ranitidine 150mg) twice daily, preferably before meals or at bedtime. Maximum: Two tablets per day. Note: This is historical data; the combination is banned.
Note: Take orally with a glass of water. Can be taken before food or at bedtime. Do not crush or chew unless advised. Avoid concomitant antacids within 1-2 hours of Ranitidine dose as they may impair absorption.
Dicyclomine exerts a direct relaxant effect on visceral smooth muscle and possesses antimuscarinic (anticholinergic) activity, relieving colic and spasms. Ranitidine competitively inhibits histamine at H2 receptors of gastric parietal cells, leading to a marked reduction in basal and stimulated gastric acid secretion, volume, and hydrogen ion concentration.
Pregnancy: Category B (US FDA) for both. Use only if clearly needed. Dicyclomine may cause neonatal intestinal atony. Ranitidine crosses the placenta. Safer alternatives exist.
Driving: May impair mental and/or physical abilities. Drowsiness, dizziness, and blurred vision are common. Do not drive or operate machinery until effect is known.
| Antacids (Aluminum/Magnesium hydroxide) | Decreased absorption of Ranitidine | Moderate |
| Ketoconazole, Itraconazole | Decreased absorption of azole antifungals due to increased gastric pH | Major |
| Digoxin | Increased bioavailability of Digoxin (theoretical) | Moderate |
| Warfarin | Potential increased anticoagulant effect (rare, disputed) | Moderate |
| Metoprolol, Propranolol | Increased plasma levels of beta-blockers due to reduced hepatic blood flow (Ranitidine) | Moderate |
| Midazolam, Triazolam | Increased sedation and prolonged effect (CYP3A4 inhibition by Ranitidine is weak) | Moderate |
| Other Anticholinergics (e.g., Amitriptyline, Atropine) | Additive anticholinergic side effects | Major |
| Alcohol | Enhanced sedative effect with Dicyclomine | Moderate |
| Metformin | Increased Metformin exposure (reduced renal clearance by Ranitidine) | Moderate |
| Phenytoin | Increased Phenytoin levels (Ranitidine inhibits metabolism) | Major |
Same composition (Dicyclomine (10mg) + Ranitidine (150mg)), different brands: