Clidinium bromide

Clidinium bromide (INN) is an anticholinergic (specifically a muscarinic antagonist) drug.[1][2] It may help symptoms of cramping and abdominal/stomach pain by decreasing stomach acid, and slowing the intestines. It is commonly prescribed in combination with chlordiazepoxide (a benzodiazepine derivative) using the brand name Normaxin.

Not to be confused with Acridinium bromide or Aclidinium bromide.
Clidinium bromide
Clinical data
AHFS/Drugs.comMonograph
MedlinePlusa601036
Routes of
administration		Oral
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityLow
ExcretionRenal and biliary
Identifiers
IUPAC name
  • 3-[(2-hydroxy-2,2-diphenylacetyl)oxy]-1-methyl-1-azabicyclo[2.2.2]octan-1-ium bromide
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC22H26NO3+
Molar mass352.454 g·mol−1
3D model (JSmol)
SMILES
  • O=C(OC2C1CC[N+](CC1)(C)C2)C(O)(c3ccccc3)c4ccccc4
InChI
  • InChI=1S/C22H26NO3/c1-23-14-12-17(13-15-23)20(16-23)26-21(24)22(25,18-8-4-2-5-9-18)19-10-6-3-7-11-19/h2-11,17,20,25H,12-16H2,1H3/q+1 Y
  • Key:HOOSGZJRQIVJSZ-UHFFFAOYSA-N Y
 NY (what is this?)  (verify)

Uses

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.[3]

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.

Mechanism of action

Clidinium inhibits muscarinic acetylcholine receptors on smooth muscles, secretory glands, and in the central nervous system to relax smooth muscle and decrease biliary tract secretions.[4]

References
  1. "Clidinium bromide". Drugs.com. Retrieved August 24, 2013.
  2. Aronson JK (2016). "Clidinium bromide". Meyler's side effects of drugs: the international encyclopedia of adverse drug reactions and interactions (Sixteenth ed.). Amsterdam: Elsevier. p. 404. ISBN 978-0-444-53716-4.
  3. "Clidinium Bromide Monograph". Drugs.com. Retrieved August 24, 2013.
  4. "Clidinium bromide". 2014 Nurse's Drug Handbook (13th ed.). Burlington, MA: Jones & Bartlett Learning. 2013. pp. 245–246. ISBN 978-1-284-03115-7.
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