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Dicycloverine hydrochloride, or dicyclomine, is a tertiary amine antimuscarinic agent with anticholinergic effects similar to, but weaker than, those of atropine. It is used to treat gastrointestinal spasms, particularly those associated with irritable bowel syndrome. It is taken orally three to four times a day.
Although it is excreted in breast milk in very small amounts, a case of severe apnea has been reported in a 12-day-old infant whose mother was taking dicycloverine, although a causal relationship could not be established with certainty. (Briggs 2015, based on a 1992 manufacturer’s note)
Because of high protein-binding capacity, clinically significant excretion into breast milk is unlikely. However, both the mother and the infant would benefit of the use of a better-known alternative drug that would be safer while breastfeeding (Mahadevan 2006), especially in the neonatal period and in case of prematurity.
Although it is believed that antimuscarinics may reduce prolactin production (Müller 1983, Masala 1982), once lactation is established, milk production depends more on repeated suckling stimulation than on prolactin levels.
It is licensed for use in children from 6 months of age as intestinal antispasmodic and treatment of Familial Mediterranean Fever, so there would be less risky when used by the breastfeeding mother.