What is the correct dosing of dicyclomine for a 14-year-old male weighing 89.9 kg?

Dicyclomine Dosing for a 14-Year-Old Male Weighing 89.9 kg

For a 14-year-old male weighing 89.9 kg, the appropriate dicyclomine dosage is the adult dose of 10-20 mg orally three to four times daily, as he exceeds the 40 kg weight threshold for adult dosing.

Dosing Rationale

• Pediatric medication dosing typically transitions to adult dosing when children exceed certain weight thresholds, commonly 40 kg (88 lb) 1
• For patients weighing more than 40 kg (88 lb), adult dosing is appropriate regardless of age 2
• This 14-year-old patient weighs 89.9 kg, which is well above the 40 kg threshold for adult dosing

Adult Dicyclomine Dosing

• Standard adult dosing for dicyclomine is 10-20 mg orally 3-4 times daily 3
• The maximum daily dose should not exceed 160 mg per day 3
• For irritable bowel syndrome, studies have shown effectiveness at 40 mg four times daily 3

Important Clinical Considerations

• Dicyclomine is an anticholinergic medication commonly used for irritable bowel syndrome and gastrointestinal spasms 3

• Monitor for anticholinergic side effects, which may include:

  • Dry mouth, blurred vision, urinary retention 3
  • Constipation, which may worsen certain gastrointestinal conditions 3
  • Central nervous system effects such as dizziness or confusion 4

• Start at the lower end of the dosing range (10 mg three times daily) and titrate based on clinical response and tolerability 3

Potential Drug Interactions

• Caution when combining with other anticholinergic medications as effects may be additive 4
• Potential interaction with hydrochlorothiazide has been reported, which may lead to metabolic abnormalities 4
• Avoid concomitant use with medications known to prolong QT interval 1

Monitoring

• Assess clinical response after 2 weeks of therapy 3
• Monitor for adverse effects at each follow-up visit
• If inadequate response at maximum tolerated dose, consider alternative therapies

Special Considerations for Adolescents

• Despite meeting weight criteria for adult dosing, adolescents may sometimes be more sensitive to anticholinergic side effects 4
• Consider starting at the lower end of the dosing range and titrating up as needed and tolerated
• Educate the patient and family about potential side effects and when to seek medical attention