Adult Dosing

Obstetric amnesia and preoperative sedation

• 0.32 mg-0.65 mg IM/IV/SC tid-qid PRN

Sedation or tranquilization

• 0.6 mg IM/IV/SC tid-qid PRN

Antiemetic

• 0.3-1 mg SC tid-qid PRN

Antisecretory

• 0.2 mg-0.6 mg IM/IV/SC tid-qid PRN

Pediatric Dosing

Antiemetic

• 6 mcg/kg IM/IV/SC; Alt: 0.2 mg/m² IM/IV/SC

Anticholinergic (Mydriatic and cycloplegic)

• 6 mcg/kg/dose IM/IV/SC; Alt: 0.2 mg/m² IM/IV/SC

Antisecretory

• 4-7 mo: 0.1 mg IM/IV/SC
• 7 mo-3 yrs: 0.15 mg IM/IV/SC
• 3-8 yrs: 0.2 mg IM/IV/SC
• 8-12 yrs: 0.3 mg IM/IV/SC

[Outline]

• Adult Dosing
• Pediatric Dosing

• Sedative and tranquilizing depressant to CNS
• Antiemetic
• Anesthesia adjunct for sedative, tranquilizing and antisecretory action
• Maniacal stage (in delirium tremors and in obstetrics)
• Mydriatric and cycloplegic

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to belladona or barbiturates
• Narrow angle glaucoma
• BPH
• Obstructive GI disease
• Obstructive uropathy
• Paralytic ileus
• Ulcerative colitis
• Severe toxic megacolon
• MI
• Acute unstable cardiovascular status
• Renal impairment
• Hepatic impairment
• Myasthenia gravis

• N/A

Renal Dose Adjustment

• Renal impairment: Contraindicated

Hepatic Dose Adjustment

• Hepatic impairment: Contraindicated

• Sudden withdrawal of scopolamine in patients with parkinsonism may develop malaise, vomiting, sweating and salivation
• Overdose may lead to toxicity, idiosyncrasy
• Use cautiously in infants, children, persons with mongolism, brain damage, spasticity or light irides
• Monitor urinary function in men with BPH
• Caution advised in patients with cardiovascular disorders as it may cause tachycardia, hypertension, orthostatic hypotension
• Closely monitor patients with autonomic neuropathy
• Hypersensitivity reactions may develop in patients with a history of allergies or bronchial asthma
• Do not engage in activities requiring mental alertness, such as driving or operating dangerous machinery

Cautions: Use cautiously in

• Cardiac disease
• Open angle glaucoma
• GERD
• Hyperthyroidism
• Alcohol abuse
• Psychosis
• Hx of seizure disorder
• Co-administration of CNS depressants
• Co-administration of other anticholinergics
• Elderly population

Pregnancy Category:C

Breastfeeding: Safety unknown; no information is available on the use of scopolamine during breastfeeding. Long term use might suppress lactation. A single systemic dose is unlikely to interfere with breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 23 November 2010). Manufacturer advises caution while administering to a nursing woman.

• CV: Tachycardia, arrhythmia
• CNS: Delirium, disorientation, dizziness, drowsiness, locomotor difficulties, restlessness, somnolence, tremors, visual hallucinations, toxic psychosis, seizures, heat stroke, cycloplegia, disorientation, confusion
• DERM: Dry skin, contact dermatitis, erythema, flushing
• EENT: Mydriasis, Angle closure glaucoma, photophobia, increased IOP, local irritation including follicular conjunctivitis, blurred vision, mydriasis vascular congestion, dysphagia, edema, exudates, and an eczematoid dermatitis
• GI: Dry mouth, paralytic ileus, constipation
• GU: Urinary retention, difficulty urinating
• RESP: Decreased respiratory rate
• MISC: Severe hypersensitivity reactions, anaphylactoid reactions, thirst, dental caries

• Anticholinergic (Belladonna alkaloid); inhibits the action of ACh on autonomic effectors innervated by postganglionic cholinergic nerves
• Metabolized by the liver; CYP450: Unknown
• Renally excreted (< 5% unchanged)
• Half-life: 8 hrs

US Trade Name(s)

• Only generic available

US Availability

scopolamine hydrobromide (generic)

• INJ: 0.4 mg/mL
• INJ: 1 mg/mL

Canadian Trade Name(s)

• Buscopan

Canadian Availability

scopolamine hydrobromide (generic)

• INJ: 0.4 mg/mL
• INJ: 0.6 mg/mL

Buscopan (hyoscine butylbromide)

• INJ: 20 mg/mL (1 mL amp)

UK Trade Name(s)

• Buscopan

UK Availability

hyoscine hydrobromide (generic)

• INJ: 0.4 mg/mL (1 mL amp)
• INJ: 0.6 mg/mL (1 mL amp)

Buscopan (hyoscine butylbromide)

• INJ: 20 mg/mL (1 mL amp)

Australian Trade Name(s)

• Buscopan

Australian Availability

hyoscine hydrobromide (generic)

• INJ: 0.4 mg/mL (1 mL amp)

Buscopan (hyoscine butylbromide)

• INJ: 20 mg/mL (1 mL amp)

[Outline]

Gastrointestinal

Anticholinergics/Antispasmodics (GI)

Gastrointestinal

Antiemetics

Anticholinergic Antiemetics