Adult Dosing

Adjunctive therapy in the treatment of peptic ulcer

Robinul, Robinul Forte

• Initial: 1 mg PO tid
• Maintenance Dose: 1 mg PO bid-tid
• Max: 8mg/day

Pediatric Dosing

Adjunctive therapy in the treatment of peptic ulcer

Robinul, Robinul Forte

• >12 yrs: Initial: 1 mg PO tid. Maintenance Dose: 1 mg PO bid-tid

Chronic severe drooling

Cuvposa

• 3-16 yrs: 0.02 mg/kg PO tid; titrate in increments of 0.02 mg/kg q5-7 days, based on therapeutic response and adverse reactions
• Max: 0.1 mg/kg PO tid not to exceed 1.5 to 3mg/dose based on weight
• Administer at least 1 hr before or 2 hrs after meals

• Adjunctive therapy in the treatment of peptic ulcer (Robinul, Robinul Forte)
• To reduce chronic severe drooling in patients aged 3-16 with neurologic conditions associated with problem drooling (Cuvposa)

• Hypersensitivity to any of the ingredients of the product
• Glaucoma
• Benign Prostate Hypertrophy
• GI obstruction
• Obstructive uropathy
• Myasthenia gravis
• Paralytic ileus
• Unstable cardiovascular status
• Acute hemorrhage
• Tachycardia
• Ulcerative colitis
• Toxic megacolon

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined, caution advised

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined, caution advised

• Therapy may cause heat prostration in the presence of a high environmental temperature
• Ileostomy or colostomy; diarrhea may indicate incomplete intestinal obstruction
• Drowsiness or blurred vision may occur with 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
• Overdosage may cause neuro-muscular blockade leading to muscular weakness and possible paralysis

Cautions: Use cautiously in

• Renal impairment
• Hepatic impairment
• Elderly patients
• Autonomic neuropathy
• Esophagitis
• GERD
• Hiatal hernia
• CAD
• CHF
• HTN
• Hyperthyroidism
• Urinary retention
• Urinary tract obstruction
• Febrile patient
• High environmental temperature
• Diarrhea
• Brain damage

Cuvposa, Robinul, Robinul Forte interacts with :

	Aricept
	Aricept ODT
	Donepezil
	Exelon
	Galantamine
	Razadyne
	Razadyne ER
	Rivastigmine

Pregnancy Category:B (Robinul, Robinul Forte) and C (Cuvposa)

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). According to manufacturer data, nursing should not be undertaken while a patient is on a drug.

• CNS: Drowsiness, dizziness, headache, heat stroke, delirium, seizures, coma, anosmia, insomnia, weakness, hyperthermia
• PSYCHIATRY: Psychosis, confusion
• EENT: Blurred vision, cycloplegia, dry eyes, mydriasis, ocular HTN, mydriasis
• CV: Tachycardia, orthostatic hypotension, palpitations, QT prolongation, arrhythmias heart block, HTN
• RESP: Respiratory arrest
• GI: Dry mouth, nausea, constipation, paralytic ileus, toxic megacolon, abdominal pain, vomiting, dysgeusia
• GU: Urinary hesitancy, retention
• REPRODUCTIVE: Impotence
• DERM: Urticaria, anhidrosis
• HYPERSENSITIVITY: Anaphylactic reactions
• MUSC: Hypotonia
• MISC: Fever

• Anticholinergic; blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS
• Incompletely absorbed (10%) after oral administration
• Metabolism: Unknown
• Excreted in urine and bile
• Half-life (Cuvposa): 3.0 hrs

US Trade Name(s)

• Cuvposa
• Robinul
• Robinul Forte

US Availability

glycopyrrolate (generic)

• TABS: 1, 1.5, 2 mg

Cuvposa

• SOLN: 1 mg/5 mL

Robinul

• TABS: 1 mg

Robinul Forte

• TABS: 2 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Gastrointestinal

Anticholinergics/Antispasmodics (GI)

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

• Robinul 1 MG TABS [Bottle] (SHIONOGI PHARMA)
  90 mg = $359.99
  270 mg = $1010.34
• Robinul-Forte 2 MG TABS [Bottle] (SHIONOGI PHARMA)
  60 mg = $628.79
  180 mg = $1798.76

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.

• GLYCOPYRROLATE 1 mg (UDL Laboratories, Inc.)
• Glycopyrrolate 1 MG Oral Tablet (Dr. Reddy's Laboratories Limited)
• Glycopyrrolate 1 MG Oral Tablet (NCS HealthCare of KY, Inc dba Vangard Labs)
• Glycopyrrolate 1 MG Oral Tablet (Par Pharmaceutical Inc.)
• Glycopyrrolate 1 MG Oral Tablet (Qualitest Pharmaceuticals)
• Glycopyrrolate 1 MG Oral Tablet (Ranbaxy Pharmaceuticals Inc.)
• Glycopyrrolate 1 MG Oral Tablet (Rising Pharmaceuticals Inc)
• Glycopyrrolate 1 MG Oral Tablet (West-ward Pharmaceutical Corp)
• Glycopyrrolate 2 MG Oral Tablet (Par Pharmaceutical Inc.)
• Glycopyrrolate 2 MG Oral Tablet (Qualitest Pharmaceuticals)
• Glycopyrrolate 2 MG Oral Tablet (Ranbaxy Pharmaceuticals Inc.)
• Glycopyrrolate 2 MG Oral Tablet (Rising Pharmaceuticals Inc)
• Glycopyrrolate 2 MG Oral Tablet (West-ward Pharmaceutical Corp)
• Robinul 1 MG Oral Tablet (Shionogi Pharma, Inc.)
• Robinul 2 MG Oral Tablet (Shionogi Pharma, Inc.)