Irritable Bowel Syndrome Treatments
| IRRITABLE BOWEL SYNDROME TREATMENTS | ||||||
|---|---|---|---|---|---|---|
| Generic & Class | Strength | Brand & Company | Formulations* | Usual Dose | ||
| 5-HT3 RECEPTOR ANTAGONIST | ||||||
| alosetron HCl | 0.5mg, 1mg | LOTRONEX
Prometheus Labs |
Rx | tabs | Adults: Initially 0.5mg twice daily. May increase to 1mg twice
daily after 4wks if starting dose is tolerated but inadequate. Discontinue if inadequate
control of symptoms after 4wks of treatment at 1mg twice daily. If constipation occurs,
discontinue until constipation resolves, then restart at 0.5mg once daily. If constipation
recurs, discontinue immediately.
Children: Not recommended |
|
| ANTICHOLINERGIC | ||||||
| 1-hyoscyamine sulfate | 0.125mg | ANASPAZ
Ascher, B.F. & Co. |
Rx | ODT | Adults and children: <2yrs: not recommended. 2–12yrs: ½–1 tab every 4hrs or as needed; max 6 tabs/24hrs. ≥12yrs: 1–2 tabs every 4hrs or as needed; max 12 tabs/24hrs. Tabs may be swallowed, chewed, or dissolved sublingually. | |
| dicyclomine HCl | 10mg | BENTYL
Aptalis Pharmaceutical Technologies |
Rx | caps | Adults: Initially 20mg 4 times daily; increase to 40mg
4 times daily if tolerated. Discontinue if not effective within 2wks or daily doses
≥80mg are not tolerated.
Children: <6months: not recommended. ≥6months: consult manufacturer. |
|
| 20mg | tabs | |||||
| 10mg/5mL | BENTYL SYRUP
Aptalis Pharmaceutical Technologies |
syrup | ||||
| hyoscyamine sulfate | 0.125mg/mL | Hyoscyamine sulfate drops¹
various |
Rx | liq | Adults: 1–2mL every 4hrs or as needed; max
12mL/day.
Children: 3.4kg: 4 drops. 5kg: 5 drops. 7kg: 6 drops. 10kg: 8 drops. Older children (2yrs–12yrs): 0.25–1mL; max 6mL/day. All: every 4hrs or as needed. |
|
| 0.125mg | LEVSIN
Meda |
tabs+ | Adults: 1–2 tabs or 5–10mL every 4hrs or
as needed; max 12 tabs or 60mL daily.
Children: Use drops. |
|||
| 0.125mg | LEVSIN/SL²
Meda |
SL tabs+ | Adults: 1–2 tabs sublingually, swallowed, or chewed every
4hrs or as needed; max 12 tabs/day.
Children: <2yrs: not recommended. ≥2yrs: ½–1 tab every 4hrs or as needed; max 6 tabs/day. |
|||
| 0.125mg | NULEV
Alaven |
Rx | chewable melt tabs | Adults and children: <2yrs: not recommended. 2–12yrs: ½–1 tab every 4hrs or as needed; max 6 tabs/day. ≥12yrs: 1–2 tabs every 4hrs or as needed; max 12 tabs/day. Tabs may be chewed or dissolved on tongue and swallowed. | ||
| BARBITURATE + ANTICHOLINERGICS | ||||||
| phenobarbital | 16.2mg/5mL | DONNATAL ELIXIR¹
PBM Pharmaceuticals |
Rx | liq | Adults: 5–10mL 3–4 times daily.
Children: <10lb (4.5kg): not recommended. 10lb (4.5kg): Initially 0.5mL every 4hrs or 0.75mL every 6hrs. 20lb (9.1kg): 1mL every 4hrs or 1.5mL every 6hrs. 30lb (13.6kg): 1.5mL every 4hrs or 2mL every 6hrs. 50lb (22.7kg): 2.5mL every 4hrs or 3.75mL every 6hrs. 75lb (34kg): 3.75mL every 4hrs or 5mL every 6hrs. 100lb (45.4kg): 5mL every 4hrs or 7.5mL every 6hrs. |
|
| hyoscyamine sulfate | 0.1037mg/5mL | |||||
| atropine sulfate | 0.0194mg/5mL | |||||
| scopolamine HBr | 0.0065mg/5mL | |||||
| phenobarbital | 48.6mg | DONNATAL EXTENTABS
PBM Pharmaceuticals |
Rx | ext-rel tabs | Adults: 1 tab every 8–12hrs.
Children: Not recommended |
|
| hyoscyamine sulfate | 0.3111mg | |||||
| atropine sulfate | 0.0582mg | |||||
| scopolamine HBr | 0.0195mg | |||||
| phenobarbital | 16.2mg | DONNATAL TABLETS
PBM Pharmaceuticals |
Rx | tabs | Adults: 1–2 tabs 3–4 times daily.
Children: Not recommended |
|
| hyoscyamine sulfate | 0.1037mg | |||||
| atropine sulfate | 0.0194mg | |||||
| scopolamine HBr | 0.0065mg | |||||
| BENZODIAZEPINE + ANTICHOLINERGIC | ||||||
| chlordiazepoxide HCl | 5mg | LIBRAX
Valeant |
CIV | caps | Adults: 1–2 caps 3–4 times daily before
meals and at bedtime. Elderly or debilitated: max 2 caps daily initially, then may increase
gradually.
Children: Not recommended |
|
| clidinium bromide | 2.5mg | |||||
| GI MOTILITY ENHANCER (CHLORIDE CHANNEL ACTIVATOR) | ||||||
| lubiprostone | 8micrograms, 24micrograms | AMITIZA
Sucampo and Takeda |
Rx | caps | ≥18yrs: Take with food and water. 8micrograms twice daily. Severe hepatic
impairment: 8micrograms once daily.
<18yrs: Not recommended |
|
| GUANLYATE CYCLASE-C AGONIST | ||||||
| linaclotide | 145micrograms, 290micrograms | LINZESS
Forest and Ironwood |
Rx | caps | ≥18yrs: Swallow whole. Take on empty stomach, at least 30 minutes before first
meal of the day. IBS-C: 290mcg once daily. CIC: 145mcg once daily.
<18yrs: Not recommended |
|
| NOTES | ||||||
|
*caps = capsules; ext-rel = extended release; liq = liquid; ODT = orally disintegrating tablets; tabs = tablets; SL = sublingual; +scored ¹Contains alcohol ²Dye-free (Rev. 3/2013) |
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