From the Guidelines
Bentyl (dicyclomine) should generally be avoided in patients with open-angle glaucoma. This medication belongs to the anticholinergic class, which can potentially worsen glaucoma by causing pupillary dilation and increasing intraocular pressure 1. The anticholinergic properties of Bentyl block the action of acetylcholine, affecting the muscles that control pupil size and potentially interfering with the drainage of aqueous humor from the eye.
If you have open-angle glaucoma and need treatment for intestinal spasms or irritable bowel syndrome, you should discuss alternative medications with your healthcare provider. Non-anticholinergic antispasmodics like peppermint oil capsules or certain calcium channel blockers might be safer options. Always inform all your healthcare providers about your glaucoma diagnosis when discussing any new medications.
Key considerations for managing open-angle glaucoma include:
- Established risk factors for primary open-angle glaucoma (POAG) include older age, African race or Latino/Hispanic ethnicity, elevated intraocular pressure (IOP), family history of glaucoma, low ocular perfusion pressure, type 2 diabetes mellitus, myopia, and thin central cornea 1
- Characteristic clinical features of POAG include an open angle on gonioscopy, and glaucomatous optic nerve head (ONH) and retinal nerve fiber layer (RNFL)/macula imaging changes that usually are associated with typical glaucomatous visual field defects 1
- Clinical trials have shown that lowering IOP reduces the risk of developing POAG and slows the progression of POAG 1
If Bentyl is deemed absolutely necessary for your condition, your ophthalmologist should be consulted to monitor your intraocular pressure closely during treatment.
From the FDA Drug Label
7 DRUG INTERACTIONS
7.1 Antiglaucoma Agents Anticholinergics antagonize the effects of antiglaucoma agents. Anticholinergic drugs in the presence of increased intraocular pressure may be hazardous when taken concurrently with agents such as corticosteroids. Use of dicyclomine hydrochloride in patients with glaucoma is not recommended [see Contraindications (4)].
The use of bentyl (dicyclomine) in patients with open angle glaucoma is not recommended due to the potential for increased intraocular pressure and antagonism of antiglaucoma agents 2.
From the Research
Bentyl and Open Angle Glaucoma
- There is no direct evidence in the provided studies regarding the use of Bentyl with open angle glaucoma 3, 4, 5, 6, 7.
- The studies focus on the management and diagnosis of open angle glaucoma, discussing treatment options such as lowering intraocular pressure through topical drugs, laser trabeculoplasty, filtration surgery, or cyclodestructive techniques 3, 4, 5, 6.
- One study examines the effects of pilocarpine on outflow structures in primary open angle glaucoma patients compared to healthy individuals, but does not mention Bentyl 7.
- Another study discusses the pathophysiology of primary open-angle glaucoma and its diagnosis, but does not provide information on the use of Bentyl 6.
- The provided evidence does not support or refute the use of Bentyl with open angle glaucoma, as it is not addressed in the studies 3, 4, 5, 6, 7.