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ALIMENTARY TRACT AND METABOLISM › DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS › DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS › Synthetic anticholinergics, quaternary ammonium compounds
(2-benzhydryloxyethyl)diethyl-methylammonium iodide
A03AB16
Forms & Strengths
- Oral tablets: 2 mg
- Oral drops: 2 mg/mL
- Suppositories: 5 mg
Adult Dosing
- Gastrointestinal spasm and hyperhidrosis: 2 to 5 mg orally 3 times daily
- Maximum daily dose: 15 mg orally
Pediatric Dosing
- Children > 6 years: 1 to 2 mg orally 2 to 3 times daily
- Not recommended for infants and toddlers due to risk of severe anticholinergic toxicity
Indications
- Symptomatic relief of gastrointestinal spasms
- Irritable bowel syndrome
- Hyperhidrosis
Mechanism of Action
- Competitive antagonism of peripheral muscarinic acetylcholine receptors
- Reduces tone and motility of the gastrointestinal smooth muscle
- Decreases secretions from salivary, sweat, and bronchial glands
Contraindications
- Hypersensitivity to the active substance or quaternary ammonium compounds
- Glaucoma (angle-closure)
- Gastrointestinal obstruction or paralytic ileus
- Toxic megacolon
- Myasthenia gravis
- Severe urinary retention due to prostatic hyperplasia
Adverse Reactions
- Xerostomia (dry mouth)
- Blurred vision and mydriasis
- Constipation
- Urinary retention
- Tachycardia and palpitations
- Drowsiness and dizziness
- Reduced sweating leading to hyperthermia in hot environments
Drug Interactions
- Enhanced anticholinergic effects when co-administered with tricyclic antidepressants, antihistamines, or antiparkinsonian drugs
- Decreased gastrointestinal absorption of other oral medications due to delayed gastric emptying
- Antagonism of prokinetic agents such as metoclopramide and cisapride
Curated Content: Needs Vetting Before Put to Clinical Use