hyoscyamine

Adult Dosing

Control gastric secretion, visceral spasm, and hypermotility

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Functional intestinal disorders

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Adjuvant therapy in peptic ulcer

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Adjuvant therapy irritable bowel syndrome and functional gastrointestinal disorders

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Adjuvant therapy neurogenic bladder and neurogenic bowel disturbances

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Symptomatic relief of biliary and renal colic

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Acute rhinitis

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Parkinsonism

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Poisoning by anticholinesterase agents

0.125-0.25 mg PO, SL q4 hrs or PRN
Alt: 0.375-0.75 mg ETABS/ECAPS q12 hrs
Max: 1.5 mg/day

Note:

Dosage may be adjusted according to the conditions and severity of symptoms
Do not chew or crush the tablet

Pediatric Dosing

Infantile colic

Child under 2 yrs

3.4 kg: 4 drops of oral soln PO q4 hrs or PRN; [Max: 24 drops/day]
5 kg: 5 drops of oral soln PO q4 hrs or PRN; [Max: 30 drops/day]
7 kg: 6 drops of oral soln PO q4 hrs or PRN; [Max: 36 drops/day]
10 kg: 8 drops of oral soln or 1.25 mL of Elixir PO q4 hrs or PRN; [Max: 48 drops/day]
20 kg: 2.5 mL of Elixir PO q4 hrs or PRN
40 kg: 3.75 mL of Elixir PO q4 hrs or PRN
50 kg: 5 mL of Elixir PO q4 hrs or PRN

GI spasm and Bladder spasm

Child >12 yrs: 0.125-0.25 mg PO, SL q4 hrs or PRN; Alt: 0.375 - 0.75 mg ETABS/ECAPS q12 hrs; [Max: 1.5 mg/day]
Child 2-12 yrs: 0.0625-0.125 mg PO q4 hrs or PRN, [Max: 1.75 mg/day]
Child under 2 yrs

3.4 kg: 4 drops of oral soln PO q4 hrs or PRN; [Max: 24 drops/day]
5 kg: 5 drops of oral soln PO q4 hrs or PRN; [Max: 30 drops/day]
7 kg: 6 drops of oral soln PO q4 hrs or PRN; [Max: 36 drops/day]
10 kg: 8 drops of oral soln or 1.25 mL of Elixir PO q4 hrs or PRN; [Max: 48 drops/day]
20 kg: 2.5 mL of Elixir PO q4 hrs or PRN
40 kg: 3.75 mL of Elixir PO q4 hrs or PRN
50 kg: 5 mL of Elixir PO q4 hrs or PRN

Note:

Dosage may be adjusted according to the conditions and severity of symptoms
Do not chew or crush the tablet

[Outline]

Adult Dosing
Pediatric Dosing

Indications ⬆ ⬇

Adjunctive therapy in the treatment of peptic ulcer
Control gastric secretion, visceral spasm, and hypermotility in spastic colitis, spastic bladder, cystitis, pylorospasm and associated abdominal cramps
To reduce symptoms in functional intestinal disorders like mild dysenteries, diverticulitis, and acute enterocolitis
Adjunctive therapy in the treatment of irritable bowel syndrome and functional gastrointestinal disorders
Adjunctive therapy in the treatment of neurogenic bladder and neurogenic bowel disturbances
SL tablet is indicated along with morphine or other narcotics in symptomatic relief of biliary and renal colic
Infantile colic
Acute rhinitis
Treatment of parkinsonism to reduce rigidity and tremors and to control associated sialorrhea and hyperhidrosis
Poisoning by anticholinesterase agents

Contraindications ⬆ ⬇

Hypersensitivity to any of the ingredients of the products
Glaucoma
Obstructive uropathy
Gastrointestinal tract obstruction
Paralytic ileus
Intestinal atony of elderly or debilitated patients
Unstable cardiovascular status
Severe ulcerative colitis
Toxic megacolon complicating ulcerative colitis
Myasthenia gravis

Black Box Warnings ⬆ ⬇

Dosing Adjustment ⬆ ⬇

Renal Dose Adjustment

Renal impairment: Use with caution. Dose adjustments not defined

Hepatic Dose Adjustment

Hepatic impairment: Use with caution. Dose adjustments not defined

Warnings/Precautions ⬆ ⬇

See Supplemental Patient Information

Hyoscyamine can cause heat prostration (fever and heat stroke due to decreased sweating) in the presence of high environmental temperature
Consider diarrhea as an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy; therapy with this drug is inappropriate and possibly harmful under such circumstances
Hyoscyamine can cause drowsiness, dizziness or blurred vision, warned patients not to engage in activities requiring mental alertness such as operating a motor vehicle or other machinery
Before using any anticholinergic drug investigate tachycardia as they can increase the heart rate
Hyoscyamine causes physchosis in sensitive patients

Cautions: Use cautiously in

Renal impairment
Hepatic impairment
Autonomic neuropathy
Hyperthyroidism
Coronary artery disease
Congestive heart failure
Cardiac arrhythmias
Hypertension
Hiatal hernia associated with reflux esophagitis
Fibrile patients
High environmental temperatures

Supplemental Patient Information

Advise patients to avoid engaging in activities requiring mental alertness such as operating a hazardous machinery or driving an automobile
Advise patient to avoid exposure to exposed to elevated environmental temperatures as hyoscyamine sulfate may decrease sweating resulting in heat prostration, fever or heat stroke

Interactions ⬆ ⬇

Anaspaz, Hyomax-DT, Hyomax-FT, Hyomax-SL, Hyomax-SR, Hyosyne, Levbid, Levsin, Nulev interacts with :

	Aricept
	Aricept ODT
	Donepezil
	Exelon
	Galantamine
	Razadyne
	Razadyne ER
	Rivastigmine

Pregnancy/Breast Feeding ⬆ ⬇

Pregnancy Category:C

Breastfeeding: As hyoscyamine is secreted in breast milk and due to the potential for adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Adverse Reactions ⬆ ⬇

CNS: Headache, nervousness, drowsiness, fatigue, dizziness, insomnia, ataxia, confusion, excitement, short-term memory loss, hallucinations, disorientation , euphoria, dysarthria
CV: Tachycardia; palpitations
GI: Dry mouth, nausea, vomiting, constipation, bloated feeling, abdominal pain, diarrhea
GU: Urinary hesitancy, urine retention, impotence
EENT: Blurred vision, mydriasis, increased ocular tension, loss of taste
MISC: Allergic reactions, heat stroke
DERM: Urticaria, decreased sweating

Clinical Pharmacology ⬆ ⬇

Anticholinergic/ antispasmodic, Belladonna alkaloid; competes favorably with acetylcholine for binding at muscarinic receptors in the salivary, bronchial, and sweat glands as well as in the eye, heart, and gastrointestinal tract; results in a reduction in salivary, bronchial, gastric and sweat gland secretions, mydriasis, cycloplegia, change in heart rate, contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle, and decreases gastrointestinal motility
Well absorbed
Partially metabolized in liver
Excreted mostly unchanged in urine
Half-life: 2-3.5 hrs

Brands and Availability ⬆ ⬇

US Trade Name(s)

Anaspaz
Hyomax-DT
Hyomax-FT
Hyomax-SL
Hyomax-SR
Hyosyne
Levbid
Levsin
Nulev

US Availability

hyoscyamine (generic)

ECAPS: 0.375 mg
ETABS: 0.375 mg
TABS: 0.125 mg
ODT: 0.125 mg
SL TABS: 0.125 mg
ORAL DROPS: 0.125 mg/mL
ELIXIR: 0.125 mg/5mL

Anaspaz

TABS: 0.125 mg

Hyomax-FT

ODT: 0.125 mg

Hyomax-SL

TABS: 0.125 mg

Hyomax-DT

TABS: 0.375 mg

Hyomax-SR

TABS: 0.375 mg

Hyosyne

ELIXIR: 0.125 mg/5mL

Levbid

ETABS: 0.375 mg

Levsin

TABS: 0.125 mg
SL TABS: 0.125 mg
Oral SOLN: 0.125 mg/mL
ELIXIR: 0.125 mg/5mL

Nulev

ODT: 0.125 mg

Canadian Trade Name(s)

Canadian Availability

UK Trade Name(s)

UK Availability

Australian Trade Name(s)

Australian Availability

[Outline]

Classification ⬆ ⬇

Gastrointestinal

Anticholinergics/Antispasmodics (GI)

Pricing ⬆ ⬇

Pricing data from www.DrugStore.com in U.S.A.

Hyoscyamine Sulfate 0.125 MG SUBL [Bottle] (PADDOCK)
30 mg = $26.99
90 mg = $58.97
HyoMax-SR 0.375 MG TB12 [Bottle] (ARISTOS PHARMACEUTICALS)
100 mg = $145.99
300 mg = $409.98
HyoMax-SL 0.125 MG SUBL [Bottle] (ARISTOS PHARMACEUTICALS)
100 mg = $79.99
200 mg = $149.98
Levbid 0.38 MG TB12 [Bottle] (MEDA PHARMACEUTICALS)
30 mg = $73.49
90 mg = $195.28
Anaspaz 0.125 MG TBDP [Bottle] (B.F. ASCHER)
100 mg = $35.92
300 mg = $79.06
Levsin 0.125 MG/ML SOLN [Bottle] (ALAVEN PHARMACEUTICAL)
LLC ml = $15
ml = $45
Levsin 0.13 MG TABS [Bottle] (MEDA PHARMACEUTICALS)
90 mg = $112.99
270 mg = $308.99
Hyoscyamine Sulfate 0.125 MG TABS [Bottle] (COUNTY LINE PHARMACEUTICALS)
30 mg = $31.99
90 mg = $79.99

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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Use and Dosing ⬇