Hyoscine

Antispasmodic & Anticholinergic · Anticholinergic

Indications

Symptomatic relief of gastro-intestinal or genito-urinary disorders characterized by smooth muscle spasm, excessive respiratory secretions and bowel colic in palliative care. Transdermal Patch: Motion sickness.

Dosage

INJECTION: Acute spasm and spasm in diagnostic procedures: Adults: IM or IV or SC. 20 mg repeated after 30 min if necessary (may be repeated more frequently in endoscopy), max 100 mg daily. Children: Not recommended. Excessive respiratory secretions in palliative care: Adults: By SC inj: 20 mg every 4 hrs if needed, altered according to response to up to 20 mg every 1 hr. By SC inf: 20-120 mg/24 hrs. Children: Not recommended. Bowel colic in palliative care: Adults: By SC inj: 20 mg every 4 hrs if needed, altered according to response to up to 20 mg every 1 hr. By SC inf: 60-300 mg/24 hrs. Children: Not recommended. ORAL: Symptomatic relief of gastro-intestinal or genito-urinary disorders characterized by smooth muscle spasm: Adults: 20 mg 4 times daily. Irritable bowel syndrome: Adults: 10 mg three times daily. Children: Under 6 yr, not recommended. 6-12 yr, 5 mg three times…

Administration

For IM, IV or SC use. Stability: Store at 15°C-30°C (59°F-86°F). Protect from light.

Adverse Effects

Constipation, transient bradycardia (followed by tachycardia, palpitation and arrhythmias), reduced bronchial secretions, urinary urgency and retention, dilatation of the pupils with loss of accommodation, photophobia, dry mouth, flushing and dryness of the skin. Side-effects that occur occasionally include confusion (particularly in the elderly), nausea, vomiting and giddiness. Very rarely, angle-closure glaucoma may occur.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Caution advised or effect undetermined. Contraindications: Antimuscarinics are contra-indicated in Myasthaenia gravis (but may be used to decrease muscarinic side-effects of anticholinesterases), paralytic ileus, pyloric stenosis, toxic megacolon and prostatic enlargement. Narrow angle glaucoma, porphyria. Precautions: Antimuscarinics should be used with caution in Down's syndrome, in children and in the elderly; they should also be used with caution in gastro-esophageal reflux disease, diarrhoea, ulcerative colitis, autonomic neuropathy, acute myocardial infarction, hypertension, conditions characterised by tachycardia (including hyperthyroidism, cardiac insufficiency, cardiac surgery), epilepsy, pyrexia and in individuals susceptible to angle-closure glaucoma. Hepatic or renal impairment.

Interactions

Amantadine, atenolol, digoxin, phenothiazines, tricyclic antidepressants. Alcohol, MAOIs, TCADs, other anticholinergics, antihistamines, nefopam, domperidone, metoclopramide, parasympathomimetics, sublingual nitrates. Inj: Anticoagulants.

Advice to Patient

Take oral form with or without meals.

Pharmacokinetics

Onset of action: Oral, IM: 0.5-1 hr, IV: 10 min, Transdermal: 6-8 hrs. Duration: IM: 4-6 hrs, IV: 2 hrs, Transdermal: 72 hrs. Absorption: IM, Subcutaneous: Rapid, Oral: Quaternary salts are poorly absorbed. Metabolism: Hepatic. Bioavailability: Oral: 8%. Half-life elimination: Approx. 5-11 hrs. Time to peak: Oral: Approx. 2 hrs. Excretion: Urine, faeces.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.