From the Research
Dicyclomine is more likely to cause urinary retention in pediatric patients compared to drotaverine due to its anticholinergic properties, which can affect bladder function. The mechanism of action of dicyclomine, an anticholinergic antispasmodic, involves blocking muscarinic receptors, which can lead to urinary retention 1. On the other hand, drotaverine, a phosphodiesterase-4 inhibitor with antispasmodic properties, has a lower incidence of urinary retention compared to dicyclomine because it works primarily by inhibiting phosphodiesterase enzymes rather than through anticholinergic effects.
Key Points to Consider
- Dicyclomine is generally not recommended for infants under 6 months due to serious adverse effects, including urinary retention.
- Children with a history of urological problems, bladder outlet obstruction, or those taking other medications with anticholinergic properties may be at higher risk for urinary retention.
- Healthcare providers should monitor children taking either medication for signs of urinary retention, including decreased urinary output, discomfort or pain in the lower abdomen, and restlessness.
- The most recent study 1 highlights the potential for anticholinergic toxicity, including urinary retention, in patients taking dicyclomine, which supports the need for caution when prescribing this medication to pediatric patients.
Recommendations for Clinical Practice
- Avoid using dicyclomine in pediatric patients, especially those under 6 months, due to the risk of urinary retention and other serious adverse effects.
- Consider alternative medications, such as drotaverine, which have a lower risk of urinary retention.
- Monitor pediatric patients taking either medication closely for signs of urinary retention and adjust treatment accordingly.