Adult Dosing
Anesthesia adjunct
Preanesthetic medication
- 0.004 mg/kg IM; give 30-60 mins prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered
Intraoperative medication
- 0.1 mg IV x 1; may repeat PRN at intervals of 2-3 mins
- It counteracts drug-induced or vagal reflexes and associated arrhythmias
Reversal of neuromuscular blockade
- 0.2 mg IV for each 1 mg neostigmine or 5 mg pyridostigmine; blocks peripheral muscarinic effects of cholinergic agents
Adjunctive therapy for the treatment of peptic ulcer
- 0.1 mg IM/IV at 4-hour intervals, 3 or 4 times daily
- Alt: 0.2 mg IM/IV may be given for profound effect
Pediatric Dosing
Anesthesia adjunct
Preanesthetic medication
- 0.004 mg/kg IM; give 30-60 mins prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered
- Infants 1 month-2 yrs: May require up to 0.009 mg/kg IM
Intraoperative medication
- 0.004 mg/kg IV x 1; may repeat PRN at intervals of 2-3 mins; Max: 0.1 mg
Reversal of neuromuscular blockade
- Administer 0.2 mg IV for each 1 mg of neostigmine or 5 mg of pyridostigmine
- The drugs may be administered simultaneously or as a mixture through same syringe, to minimize cardiac adverse effects
[Outline]
See Supplemental Patient Information
- Use with caution in patients with glaucoma
- Therapy may cause toxicity and increased incidence of kernicterus, particularly in small preterm infants due to exposure to excessive amounts of benzyl alcohol (preservative)
- Drowsiness or blurred vision may occur with the therapy. Therefore patient should be warned not to engage in activities requiring mental alertness such as operating a motor vehicle or other machinery, or performing hazardous work
- Therapy may cause heart prostration in the presence of a high environmental temperature
- Do not administer in patients with ileostomy or colostomy as it may cause diarrhea
- Overdosage may cause neuro-muscular blockade leading to muscular weakness and possible paralysis
- Investigate any tachycardia before giving Glycopyrrolate Injection since an increase in the heart rate may occur
- Therapy may produce a delay in gastric emptying due to antral statis
- Potential increased response in pediatric patients with spastic paralysis or brain damage
Cautions: Use cautiously in
- Concomitant drugs with anticholinergic activity
- Renal impairment
- Hepatic impairment
- Elderly patients
- Autonomic neuropathy
- Prostatic hypertrophy
- Esophagitis
- GERD
- Hiatal hernia
- CAD
- CHF
- HTN
- Hyperthyroidism
- Urinary retention
- Urinary tract obstruction
- Febrile patient
- High environmental temperature
- Diarrhea
- Brain damage
- Down's syndrome
Supplemental Patient Information
- Drowsiness or blurred vision may occur with the therapy. Therefore do not engage in activities requiring mental alertness such as operating a motor vehicle or other machinery, or performing hazardous work
Pregnancy Category:B
Breastfeeding: Safety unknown. Because glycopyrrolate is poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 23 March 2011). Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.
