Adult: As hyoscine butylbromide: 20 mg 4 times daily. Child: As hyoscine butylbromide: 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 butylbromide: Initially, 10 mg tid, may increase up to 20 mg 4 times daily if needed. Child: As hyoscine butylbromide: 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.
Adult: As hyoscine butylbromide: 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 anaesthesia. Child: As hyoscine hydrobromide: 0.015 mg/kg given via IM or SC inj, 30-60 minutes prior to induction of anaesthesia.
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 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 caesarean section. Discard 24 hours after the surgery. Child: >10 years Same as adult dose.
Patient with angina, cardiac failure, (including those who are undergoing cardiac surgery), coronary artery disease, hypertension, open angle glaucoma, pyrexia, thyrotoxicosis; pyloric, intestinal or urinary bladder neck obstruction, paralytic ileus, gastrointestinal tract stenoic lesions, prostatic hypertrophy, urinary retention; history of seizure or psychosis. Renal or hepatic impairment. Children. Pregnancy and lactation.
This drug may cause drowsiness, disorientation, confusion, or blurred vision, if affected, do not drive or operate machinery. Remove transdermal hyoscine before medical scan.
Monitor heart rate, urinary output, body temperature, and intraocular pressure.
Symptoms: CNS stimulation, tachycardia, arrhythmia, urinary retention, coma, respiratory depression. Management: Symptomatic and supportive treatment. Empty stomach immediately via gastric lavage or induced emesis. Short acting benzodiazepines or barbiturate may be given to control CNS stimulation.
May decrease the absorption of oral medicines due to decreased gastric motility and delayed gastric emptying. The sedative effect of hyoscine may be enhanced by other CNS depressants. Other drugs with anticholinergic properties (e.g. amantadine, antihistamines) may enhance the effects of hyoscine.
The sedative effect of hyoscine may be enhanced by alcohol.
Interferes with gastric secretion test.
Description: Mechanism of Action: Hyoscine is a tertiary amine antimuscarinic agent. It blocks the action of acetylcholine in the smooth muscles of the gastrointestinal, biliary and urinary tracts, in secretory glands and in the CNS, thus exhibiting spasmolytic actions on smooth muscles and inhibit secretions. It also blocks transmission of cholinergic impulses from the vestibular nuclei to the CNS, thus preventing motion-induced nausea and vomiting. Onset: Inhibition of saliva: Within 30-60 minutes (IM, oral); Amnesia: Within 10 minutes (IV); Antiemesis: Within 15-30 minutes (IM), approx 4 hours (transdermal). Duration: Antiemesis: Up to 72 hours. (transdermal), approx 4 hours (IM); Inhibition of saliva: Up to 4-6 hours (IM, oral); Amnesia: ≥2 hours (IV); Mydriasis: Up to 8 hours (IM). Pharmacokinetics: Absorption: Tertiary salts: Readily absorbed from the gastrointestinal tract. Quaternary salts: Poorly absorbed. Bioavailability: 8% (oral). Time to peak plasma concentration: Within 24 hours (transdermal); As hydrobromide: Approx 20 minutes (IM), 15 minutes (SC); As butylbromide: Approx 2 hours (oral). Distribution: Tertiary salts: Crosses blood-brain barrier and the placenta, enters breast milk. Volume of distribution: As butylbromide: 128 L. Plasma protein binding: As butybromide: Approx 4%, to albumin. Metabolism: Metabolised in the liver mainly via conjugation. Excretion: As hydrobromide: Mainly via urine (<10% as unchanged drug and some metabolites). As butylbromide: IV: Via urine (42-61% as unchanged drug) and faeces (28-37%). Elimination half-life: Hyoscine base 9.5 hours; As butylbromide: Approx 5-11 hours; As hydrobromide: Approx 1-4 hours.
A04AD01 - scopolamine ; Belongs to the class of other antiemetics.
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