Dicyclomine Shortage: What Providers and Prescribers Need to Know in 2026

Dicyclomine remains a first-line antispasmodic option for irritable bowel syndrome (IBS), with over 2 million prescriptions dispensed annually in the United States. While dicyclomine is not on the FDA's drug shortage list as of 2026, some of your patients may present having had difficulty filling their prescription — particularly if they are on the 40 mg tablet or the oral syrup. This guide helps you counsel patients effectively and know when to consider a clinical switch.

Current Supply Status: What the Data Tells Us

Dicyclomine is not included in the FDA Drug Shortage Database as of 2026. The medication has been manufactured by multiple generic pharmaceutical companies since its patent expiration, which generally provides supply redundancy. The discontinuation of brand-name Bentyl oral forms (tablets, capsules, and solution) is a potential point of confusion for patients and newer prescribers — the brand-name oral forms are no longer available, but generic dicyclomine is widely available and therapeutically equivalent.

The Bentyl brand continues only as an intramuscular injection. The oral generic is the only option for outpatient dispensing. Ensure your patients understand this when their prescription says "Bentyl" — their pharmacist should automatically substitute generic dicyclomine.

Dosage Forms and Their Availability

Availability varies significantly by dosage form. Understanding this can guide your prescribing to minimize fill delays:

20 mg oral tablet: Most widely stocked. Standard starting dose is 20 mg QID; this form aligns with standard dosing and is the most reliably available at chain and grocery pharmacies.

10 mg oral capsule: Reasonably common. Useful for patients requiring dose titration below 20 mg.

40 mg oral tablet: Less commonly stocked. If prescribing at the 40 mg QID maintenance dose, consider prescribing two 20 mg tablets QID and noting this in the instructions.

10 mg/5 mL oral syrup: May require special ordering at many pharmacies. Consider whether the tablet or capsule form is feasible for the patient before prescribing the syrup.

10 mg/mL IM injection (Bentyl brand + generic): For inpatient/short-term use only. Not for IV use. Typically stocked in institutional settings.

Prescribing Considerations to Minimize Fill Delays

To reduce the chance that your patients encounter a stockout:

Prefer the 20 mg tablet as your default when initiating therapy and titrating.

If prescribing 40 mg doses, write for "dicyclomine 20 mg tabs, take 2 tablets four times daily" to increase fill likelihood.

If the patient requires the syrup (e.g., swallowing difficulty), give them advance notice to call the pharmacy ahead of time to ensure stock or allow for ordering time.

Note on e-prescriptions: Ensure your EHR maps "Bentyl" correctly to generic dicyclomine to avoid patient confusion at the pharmacy counter.

When to Consider a Clinical Switch: Alternatives

If a patient is experiencing persistent difficulty obtaining dicyclomine locally, the following alternatives merit consideration:

Hyoscyamine (Levsin, Levbid): The most direct pharmacological alternative. Same drug class (anticholinergic antispasmodic). Faster onset (30–60 min), shorter duration. Available in immediate-release, extended-release, and sublingual forms. Not a controlled substance.

Low-dose TCA (amitriptyline 10–25 mg nightly): Appropriate for chronic pain-predominant IBS, especially IBS-D. Does not provide acute antispasmodic relief but addresses visceral hypersensitivity over time.

Linaclotide (Linzess) or lubiprostone (Amitiza): Appropriate only for IBS-C. Different mechanism; not antispasmodic.

Rifaximin (Xifaxan): FDA-approved for IBS-D. Antibiotic targeting gut microbiome imbalance. Not a direct antispasmodic replacement but addresses a different pathway.

The Beers Criteria and Elderly Patients

Dicyclomine is listed in the AGS Beers Criteria as a potentially inappropriate medication for older adults due to its high anticholinergic burden. The criteria note that the drug is not as safe or effective as other options for treating the same conditions in this population. For elderly patients (≥65 years) with IBS, consider whether the anticholinergic risk profile is acceptable and whether lower-anticholinergic alternatives are more appropriate.

How medfinder Supports Your Patients

When patients call your office because they can't find their medication, consider directing them to medfinder. medfinder is a paid service that calls pharmacies near the patient to check availability of their exact medication and dosage, then texts the results. This offloads the stock-check burden from your staff and helps your patients get their prescriptions filled faster.

Summary for Providers

No FDA-declared shortage of dicyclomine as of 2026

Bentyl oral brands are discontinued; generic dicyclomine is the only oral option

Prefer the 20 mg tablet form to maximize fill success; 40 mg and syrup may require special orders

Hyoscyamine is the most direct therapeutic alternative if a switch is needed

Beers Criteria: use with caution in patients ≥65 years; review anticholinergic burden

Direct patients unable to locate their fill to medfinder for pharmacy availability checking