Clidinium
Class: Antimuscarinics/Antispasmodics
VA Class: AU350
Chemical Name: 3-hydroxy-1-methylquinuclidinium bromide benzilate
CAS Number: 3485-62-9
Introduction
Antimuscarinic; synthetic quaternary ammonium.
Uses for Clidinium
Peptic Ulcer Disease
Used in fixed combination with chlordiazepoxide as adjunctive therapy in the treatment of peptic ulcer disease; however, no conclusive data that antimuscarinics aid in the healing, decrease the rate of recurrence, or prevent complications of peptic ulcers.
With the advent of more effective therapies for the treatment of peptic ulcer disease, antimuscarinics have only limited usefulness in this condition.
GI Motility Disturbances
Used in fixed combination with chlordiazepoxide in the treatment of functional GI motility disturbances (e.g., irritable bowel syndrome).
Has limited efficacy in treatment of GI motility disturbance and should only be used if other measures (e.g., diet, sedation, counseling, amelioration of environmental factors) have been of little or no benefit.
Acute Enterocolitis
Used in fixed combination with chlordiazepoxide in the treatment of acute enterocolitis. However, antimuscarinics should be used with extreme caution in patients with diarrhea or ulcerative colitis. (See Cautions.)
Clidinium Dosage and Administration
Administration
Oral Administration
Administer orally 3 or 4 times daily before meals and at bedtime.
Dosage
Available as clidinium bromide; dosage expressed in terms of the salt.
As with other antimuscarinics, higher than recommended dosage may be required for therapeutic effect.
Clidinium bromide is commercially available in the US only in fixed combination with chlordiazepoxide hydrochloride. Fixed-ratio combination preparations do not permit individual titration of dosages.
Adults
GI Disorders
Oral
Usual maintenance clidinium bromide dosage is 2.5 or 5 mg (1 or 2 capsules of clidinium bromide in fixed combination with chlordiazepoxide hydrochloride) 3 or 4 times daily administered before meals and at bedtime.
Special Populations
Hepatic Impairment
No specific dosage recommendations. Use with caution.
Renal Impairment
No specific dosage recommendations. Use with caution.
Geriatric Patients
Initially, no more than 5 mg of clidinium bromide daily (2 capsules of clidinium bromide in fixed combination with chlordiazepoxide hydrochloride). Gradually increase dosage if needed and tolerated. Administer the smallest effective dosage. (See Geriatric Use under Cautions.)
Debilitated Patients
Initially, administer up to 5 mg of clidinium bromide daily (2 capsules of clidinium bromide in fixed combination with chlordiazepoxide hydrochloride); then adjust subsequent dosages based on patient tolerance and response. Administer the smallest effective dosage.
Cautions for Clidinium
Contraindications
Glaucoma (to avoid mydriasis).
