indication

For the treatment of peptic ulcer disease and also to help relieve abdominal or stomach spasms or cramps due to colicky abdominal pain, diverticulitis, and irritable bowel syndrome.

pharmacology

Clidinium is a synthetic anticholinergic agent which has been shown in experimental and clinical studies to have a pronounced antispasmodic and antisecretory effect on the gastrointestinal tract.

mechanism of action

Inhibits muscarinic actions of acetylcholine at postganglionic parasympathetic neuroeffector sites primarily by inhibiting the M1 muscarinic receptors.

toxicity

Signs of toxicity include confusion, paralytic ileus, urinary hesitancy/retention, and blurred vision.

drug interactions

Donepezil: Possible antagonism of action

Galantamine: Possible antagonism of action

Haloperidol: The anticholinergic increases the risk of psychosis and tardive dyskinesia

Potassium Chloride: Anticholinergic agents such as clidinium may enhance the ulcerogenic effect of potassium chloride. Solid oral dosage forms of potassium chloride are contraindicated in patients with impaired gastric emptying (e.g., due to the effects of drugs such as many anticholinergics). Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride; liquid or effervescent potassium preparations are possible alternatives.

Pramlintide: Pramlintide may enhance the anticholinergic effect of anticholinergics such as clidinium. These effects are specific to the GI tract. Use caution during concomitant therapy with pramlintide and anticholinergics. Additive effects on reduced GI motility may occur.

Secretin: Anticholinergic agents such as secretin may diminish the stimulatory effect of secretin. Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor response to secretin closely.

Tacrine: The therapeutic effects of the central acetylcholinesterase inhibitor, Tacrine, and/or the anticholinergic, Clidinium, may be reduced due to antagonism. The interaction may be beneficial when the anticholinergic action is a side effect. Monitor for decreased efficacy of both agents.

Trimethobenzamide: Trimethobenzamide and Clidinium, two anticholinergics, may cause additive anticholinergic effects and enhance their adverse/toxic effects. Monitor for enhanced anticholinergic effects.

Triprolidine: Triprolidine and Clidinium, two anticholinergics, may cause additive anticholinergic effects and enhance their adverse/toxic effects. Monitor for enhanced anticholinergic effects.

Trospium: Trospium and Clidinium, two anticholinergics, may cause additive anticholinergic effects and enhanced adverse/toxic effects. Monitor for enhanced anticholinergic effects.