Clidinium bromide
Encyclopedia
Clidinium bromide is an anticholinergic
Anticholinergic
An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. An example of an anticholinergic is dicycloverine, and the classic example is atropine....

 drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...

. It may help symptoms of cramping and abdominal/stomach pain by decreasing stomach acid
Gastric acid
Gastric acid is a digestive fluid, formed in the stomach. It has a pH of 1 to 2 and is composed of hydrochloric acid , and large quantities of potassium chloride and sodium chloride...

, and slowing the intestines. It is commonly prescribed in combination with chlordiazepoxide
Chlordiazepoxide
Chlordiazepoxide, is a sedative/hypnotic drug and benzodiazepine. It is marketed under the trade names Angirex, Klopoxid, Librax , Libritabs, Librium, Mesural, Multum, Novapam, Risolid, Silibrin, Sonimen and Tropium.Chlordiazepoxide was the first benzodiazepine to be synthesised and...

 (a benzodiazepine derivative) using the brand name Librax
Librax
Librax is a drug consisting of chlordiazepoxide and clidinium bromide and used to treat peptic ulcers, irritable bowel syndrome , and gastritis. It helps relieve stomach spasms, abdominal cramps, and anxiety related to gastric disorders...

.

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.

Preclinical studies

Clidinium is an effective anticholinergic agent with activity approximating that of atropine
Atropine
Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...

 sulfate against spasms induced by acetylcholine
Acetylcholine
The chemical compound acetylcholine is a neurotransmitter in both the peripheral nervous system and central nervous system in many organisms including humans...

 in isolated intestinal strips. On oral administration in mice it proved an effective antisialagogue
Antisialagogue
Antisialagogues are substances that decrease the production of saliva and their effect is opposite to that of sialagogues. Their origin may be both natural and synthetic. Classic antisialagogues:* atropine,* opium,* alkalies,* belladonna,* hyoscyamus,...

 in preventing salivation induced by pilocarpine
Pilocarpine
Pilocarpine is a parasympathomimetic alkaloid obtained from the leaves of tropical American shrubs from the genus Pilocarpus. It is a non-selective muscarinic receptor agonist in the parasympathetic nervous system, which acts therapeutically at the muscarinic acetylcholine receptor M3 due to its...

. Spontaneous intestinal motility in both rats and dogs is reduced following oral dosing with 0.1 to 0.25 mg/kg. Potent cholinergic ganglionic blocking effects (vagal
Vagus nerve
The vagus nerve , also called pneumogastric nerve or cranial nerve X, is the tenth of twelve paired cranial nerves...

) are produced with intravenous usage in anesthetized dogs.

Oral doses of 23 mg/kg administered to dogs produced nasal dryness and slight pupillary dilation. In two other species, monkeys and rabbits, doses of 5 mg/kg by mouth, three times a day, for 5 days produced no apparent changes.

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