Hyoscine hydrobromide or Scopolamine hydrobromide appears as colorless crystals or white powder or solid. Has no odor. pH (of 5% solution): 4-5.5. Slightly efflorescent in dry air. Bitter, acrid taste.
Scopolamine Hydrobromide is the hydrobromide salt form of scopolamine, a tropane alkaloid derived from plants of the nightshade family (Solanaceae), specifically Hyoscyamus niger and Atropa belladonna, with anticholinergic, antiemetic, and antivertigo properties. Structurally similar to acetylcholine, scopolamine antagonizes acetylcholine activity mediated by muscarinic receptors located on structures innervated by postganglionic cholinergic nerves as well as on smooth muscles that respond to acetylcholine but lack cholinergic innervation. The agent is used to cause mydriasis, cycloplegia, to control the secretion of saliva and gastric acid, to slow gut motility, and prevent vomiting.
Scopolamine hydrobromide appears as colorless crystals or white powder or solid. Has no odor. pH (of 5% solution): 4-5.5. Slightly efflorescent in dry air. Bitter, acrid taste. (NTP, 1992). Scopolamine hydrobromide (anhydrous) is a hydrobromide that is obtained by the reaction of scopolamine with hydrogen bromide. It has a role as a muscarinic antagonist. It contains scopolamine(1+).
Mechanism Of Actions
Scopolamine Hydrobromide is the hydrobromide salt form of scopolamine, a tropane alkaloid derived from plants of the nightshade family (Solanaceae), specifically Hyoscyamus niger and Atropa belladonna, with anticholinergic, antiemetic and antivertigo properties. Structurally similar to acetylcholine, scopolamine antagonizes acetylcholine activity mediated by muscarinic receptors located on structures innervated by postganglionic cholinergic nerves as well as on smooth muscles that respond to acetylcholine but lack cholinergic innervation. The agent is used to cause mydriasis, cycloplegia, to control the secretion of saliva and gastric acid, to slow gut motility, and prevent vomiting.
Indications of Hyoscine Hydrobromide
- Motion sickness, Vertigo
- Nausea- vomiting,
- Travel sickness or motion sickness
- Vertigo, dizziness, Drowsiness
- Gastrointestinal tract spasm, Genitourinary spasm
- IBS (irritable bowel syndrome)
- Postoperative nausea and vomiting
- Adjuvants, Anesthesia – Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease the required dosage.
- Cholinergic Antagonists – Drugs that bind to but do not activate CHOLINERGIC RECEPTORS, thereby blocking the actions of ACETYLCHOLINE or cholinergic agonists.
- Muscarinic antagonists – Drugs that bind to but do not activate MUSCARINIC RECEPTORS, thereby blocking the actions of endogenous ACETYLCHOLINE or exogenous agonists. have widespread effects including actions on the iris and ciliary muscle of the eye, the heart and blood vessels, secretions of the respiratory tract, GI system, and salivary glands, GI motility, urinary bladder tone, and the central nervous system.
- Mydriatics agents – that dilate the pupil. They may be either sympathomimetics or parasympatholytics.
- Since little of the medication crosses the blood-brain barrier, this drug has less effect on the brain and therefore causes a reduced occurrence of the centrally-mediated effects (such as delusions, somnolence, and inhibition of motor functions) which reduce the usefulness of some other anticholinergic drugs.
- Hyoscine butyl bromide – is still capable of affecting the chemoreceptor trigger zone, due to the lack of a well-developed blood-brain-barrier in the medulla oblongata, which increases the antiemetic effect it produces via local action on the smooth muscle of the gastrointestinal tract.[rx]
Contraindications of
- Myasthenia gravis, narrow-angle glaucoma, tachycardia, megacolon; hypersensitivity
- Hypersensitivity to this drug
-
Porphyria
Dosage of Hyoscine Hydrobromide
Strength: 150mg, 300mg
Dosage by tablet strength
| Age | Which strength? | Dose |
|---|---|---|
| 4 to 9 years | 150 micrograms | half tablet to 1 tablet |
| 10 to 17 years | 150 micrograms | 1 tablet to 2 tablets |
| 10 to 17 years | 300 micrograms | half tablet to 1 tablet |
| 18 years and over | 300 micrograms | 1 tablet |
How to take tablets for excess saliva
- These tablets are available on prescription only. They can be taken by adults and children aged 12 years or older.
- The usual dose is 1 tablet (300 micrograms), 3 times a day.
How to use patches for excess saliva
Adults and children aged 10 years or older:
- Stick a patch to the skin behind the ear.
- Leave the patch on for 72 hours (3 days).
- After 72 hours, remove the patch.
- Stick a new patch behind the other ear.
- After 72 hours, remove the patch.
- Repeat the process.
Occasionally a doctor may prescribe patches for a child under the age of 9 years. In this case, they’ll use your child’s weight to work out what size patch to use. They may only need to use half a patch.
How to use patches for travel sickness
Patches are suitable for adults and children aged 10 years or older.
- Stick a patch to the skin behind the ear 5 to 6 hours before the start of your journey (or the evening before you travel).
- Remove the patch at the end of your journey.
- For long journeys, you can keep the patch on for up to 72 hours (3 days).
- If you’re still traveling after 72 hours, remove the first patch and stick a new patch behind the other ear. You can keep this on for another 72 hours if needed.
Oral
Gastrointestinal tract spasm, Genitourinary spasm
- Adult: As hyoscine butyl bromide: 20 mg 4 times daily.
- Child: As hyoscine butyl bromide: 6-11 years 10 mg tid; ≥12 years Same as adult dose.
Oral
Prophylaxis of motion sickness
- Adult: As hyoscine hydrobromide: Initially, 0.15-0.3 mg 20-30 minutes before a journey, repeat 6 hourly if needed, up to max 3 doses in 24 hours. Max: 0.9 mg daily.
- Child: As hyoscine hydrobromide: 3-4 years Initially, 0.075 mg, repeated once if needed. Max: 0.15 mg daily; >4-10 years 0.075-0.15 mg, repeat 6 hourly if needed. Max: 0.45 mg daily; >10 years 0.15-0.30 mg, repeat 6 hourly if needed. Max: 0.9 mg daily. All doses should be given 20-30 minutes before a journey.
Oral
IBS (irritable bowel syndrome)
- Adult: As hyoscine butyl bromide: Initially, 10 mg tid, may increase up to 20 mg 4 times daily if needed.
- Child: As hyoscine butyl bromide: 6-11 years 10 mg tid; ≥12 years Same as adult dose.
Parenteral
Motion sickness, Nausea, and vomiting, Vertigo
- Adult: As hyoscine hydrobromide: 0.2 mg as a single dose via IM or SC inj (may also be given via IV inj if required).
- Child: As hyoscine hydrobromide: 0.006 mg/kg as a single dose via IM or SC inj.
Parenteral
Gastrointestinal tract spasm, Genitourinary spasm
- Adult: As hyoscine butyl bromide: 20 mg via slow IV or IM inj, may be repeated after 30 minutes if needed. Max: 100 mg daily.
Parenteral
Preoperative medication
- Adult: As hyoscine hydrobromide: 0.2-0.6 mg given via IV, IM, or SC inj, 30-60 minutes prior to induction of anesthesia.
- Child: As hyoscine hydrobromide: 0.015 mg/kg given via IM or SC inj, 30-60 minutes prior to induction of anesthesia.
Transdermal
Prophylaxis of motion sickness
- Adult: As hyoscine hydrobromide patch containing 1.5 mg: Apply 1 patch behind the ear, 4-6 hours before a journey or in the evening before the journey.
- Child: >10 years Same as adult dose.
Transdermal
Postoperative nausea and vomiting
- Adult: As hyoscine hydrobromide patch containing 1.5 mg: Apply 1 patch behind the ear on the evening before the surgery or 1 hour before cesarean section. Discard 24 hours after the surgery.
- Child: >10 years Same as adult dose.
Side Effects Of Hyoscine Hydrobromide
- Symptoms of exposure to this chemical include drowsiness, sleepiness, excitement, hallucinations, delirium, psychotic behavior and central nervous system depression.
- Other symptoms include narcosis, mydriasis, dryness of the mouth and restlessness.
- Drowsiness
- Dry mouth
- Headache
- Indigestion
- Depression
- Skin rashes
- Restlessness
- Weight gain
- Mydriasis, cycloplegia, eye pruritus.
- Muscle weakness.
- Urinary retention, dysuria.
- Flushing, sweating, dry skin, rash, erythema, pruritus, skin burns, contact dermatitis (transdermal).
Common
- Tachyarrhythmias, hypotension, increased intraocular pressure, drowsiness, confusional states, visual hallucinations, blurred vision, eye pain, idiosyncratic reactions (e.g. agitation, delusion, acute toxic psychosis), epileptic seizures.
- Dizziness, headache, equilibrium disturbance, excitement, ataxia, hallucinations, behavioural abnormalities, acute toxic psychosis, agitation, confusion, paranoia, rambling speech, fatigue, migraine, irritability, amnesia, restlessness, sedation.
- Bradycardia, Hypersalivation, diarrhea, dry mouth, abdominal cramps, constipation, oesophageal ulceration.
Hyperpyrexia. - Cough producing mucus
- difficulty with breathing
- tightness in the chest
- Abdominal or stomach pain and tenderness
- blistering, peeling, or loosening of the skin
- Anxiety
- dry mouth
- irritability
- sleepiness or unusual drowsiness
- trouble sleeping
- Decreased appetite
Serious
- Swelling of the hands, arms, feet, ankles, or lower legs
- Chest pain
- Difficulty breathing
- Itching or rash
- Dizziness
- Lack of energy
- Black, tarry, or bloody stools
- Bloody vomit, or vomit that looks like coffee grounds
- Pale skin
- passing out or fainting
- seizures
Drug Interactions of Hyoscine Hydrobromide
Hyoscine Hydrobromide may interact with the following drugs
Pregnancy & Lactation Of Hyoscine Hydrobromide
FDA Pregnancy Category C
The safety of Hyoscine Hydrobromide in human pregnancy has not been established although studies in animals have not demonstrated teratogenic effects. As with other drugs, it is not advisable to administer Hyoscine Hydrobromide in pregnancy.
Lactation
There are no data on the excretion of Hyoscine Hydrobromide in human breast milk. Taking Hyoscine Hydrobromide whilst breastfeeding is not recommended.
What if I take too much?
Taking 1 extra dose of hyoscine hydrobromide by accident is unlikely to harm you. But you may get more side effects, such as a dry mouth or blurred vision. The amount of hyoscine hydrobromide that can lead to an overdose varies from person to person, and too much hyoscine can be dangerous.
References
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