Pediatric Dosing of Dicyclomine
For children over 2 years of age, dicyclomine should be dosed at 5-10 mg three to four times daily, with a maximum daily dose of 40 mg per day. 1
Dosing Recommendations by Age
- Under 6 months: Dicyclomine is contraindicated in infants under 6 months due to serious safety concerns 1
- 6 months to 2 years: No standardized dosing is recommended; use should be extremely limited and only under specialist supervision 1
- Over 2 years: Initial dose of 5-10 mg three to four times daily (maximum 40 mg/day) 1
Administration Considerations
- Oral administration is the preferred route for children 1
- Dosing should be adjusted based on clinical response and side effect profile 1
- Careful monitoring is essential during administration due to potential anticholinergic effects 1
Safety Concerns and Monitoring
- Monitor closely for anticholinergic side effects, including:
- Vital sign monitoring is important during administration 1
- Serious adverse events have been reported with dicyclomine, including drowsiness (13%), wide-eyed state (4%), and prolonged sleep (4%) 2
Important Precautions
- Avoid concomitant use with other anticholinergic medications 1
- Use with extreme caution in children with history of:
- Autonomic neuropathy
- Intestinal obstruction
- Myasthenia gravis 1
- Consider non-pharmacological interventions first for conditions like infantile colic 1, 2
- Pediatric patients require individualized dosing based on age, size, and organ maturity - not simply reduced adult doses 3
Clinical Applications
- While dicyclomine has been studied for irritable bowel syndrome in adults 4, pediatric use requires special consideration
- Evidence for use in infantile colic is sparse and prone to bias; current evidence does not support its routine use for this indication 2
- Careful benefit-risk assessment should be performed before prescribing to pediatric patients 1, 3