Scopolamine (Hyoscine)
- Atc Codes:A04AD01#N05CM05#S01FA02
- CAS Codes:6533-68-2#114-49-8#51-34-3
- PHARMGKB ID:6533-68-2#114-49-8#51-34-3
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Buscopan; Belgium: Buscopan; Czech Republic: Buscopan; Denmark: Scopoderm; Finland: Buscopan, Scopoderm; France: Bromhydrate de scopolamine, Scoburen, Scopoderm, Scopolamine; Germany: Boro-Scopol, BS, Buscopan, Butylscopolamin, Scopoderm, Spasman; Greece: Avotrin, Buscopan; Hungary: Buscopan Forte; Ireland: Buscopan, Hyoscine Hydrobromide, Kwells; Italy: Addofix, Buscopan, Joscina B, Scopol B; Latvia: Buscopan; Luxembourg: Buscopan; Malta: Buscopan; Netherlands: Buscopan, Scopoderm; Poland: Buscolysin, Buscopan, Scopolan; Portugal: Buscopan; Romania: Buscopan, Buscorem, Buscotil, Fracorelaxin, Scobunord, Scobutil, Scopantil, Uscosin; Slovakia: Buscopan; Slovenia: Buscopan; Spain: Buscapina, Escopolamina; Sweden: Buscopan, Scopoderm; UK: Hyoscine, Hyoscine Hydrobromide, Joy-Rides, Kwells, Scopoderm, Travel Calm.
North America
Canada: Scopolamine Hydrobromide, Transderm-V; USA: Transderm Scop.
Latin America
Argentina: Buscapina, Butil Bromuro de Hioscina Larjan, Cifespasmo, Colobolina, Excelentia Antiespasmódico, Hioscina, Luar-G, Rupe-N; Brazil: Buscopan, Butilbrometo de Escopolamina, Escopolamina, Hioariston, Hiospan, Uni Hioscin; Mexico: Alpin, Biomesina, Bipasmin, Brolamina, Buscapina, Busprina-S, Butilhioscina, Butiral, Cryopina, Espacil, Excosine S, Grafin, Hiosultrina, Lemophar, Selpiran-S, Serralpina.
Asia
Japan: Buscom, Buscopan, Busfoliron, Buspon, Butiburon, Butylmin, Butylpan, Butysco, Reladan, Scorpan, Sporamin, Viviv.
Drug combinations
Scopolamine and Acetaminophen
Scopolamine and Dipyrone
Scopolamine and Homatropine
Scopolamine and Ibuprofen
Scopolamine, Acetaminophen, Caffeine, and Codeine
Scopolamine, Chlorpromazine, Procaine, and Pyridoxine (Vitamin B~6~)
Chemistry
Scopolamine Hydrobromide: C~17~H~21~NO~4~ HBr 3H~2~O. Mw: 438.31. (1) Benzeneacetic acid, α-(hydroxymethyl)-, 9-methyl-3-oxa-9-azatricyclo[3.3.1.0^2,4^]non-7-yl ester, hydrobromide, trihydrate, [7(S)-(1α,2β,4β,5α,7β)]-; (2) 6β,7β-Epoxy-1αH,5αH-tropan-3α-ol (-)-tropate (ester) hydrobromide trihydrate. CAS-6533-68-2; CAS-114-49-8 (anhydrous); CAS-51-34-3 (scopolamine).
Pharmacologic Category
Anticholinergic Agents; Antimuscarinics/Antispasmodics. EENT Preparations; Mydriatics. Antiemetics, Miscellaneous. (ATC-Code: A04AD01; N05CM05; S01FA02).
Mechanism of action
Competitively inhibits acetylcholine or other cholinergic stimuli at autonomic effectors innervated by postganglionic cholinergic nerves and, to a lesser extent, on smooth muscles that lack cholinergic innervation. At usual doses, principally antagonizes cholinergic stimuli at muscarinic receptors and has little or no effect on cholinergic stimuli at nicotinic receptors. Apparently corrects some central imbalance of acetylcholine and norepinephrine which may occur in motion sickness. Antimuscarinics may block transmission of cholinergic impulses from vestibular nuclei to higher centers in CNS and from reticular formation to vomiting center; these effects result in prevention of motion-induced nausea and vomiting. Referred to as parasympatholytics since antagonized functions are principally under parasympathetic division of nervous system. Doses used to decrease gastric secretions likely to cause dryness of mouth (xerostomia) and interfere with visual accommodation, and possibly cause difficulty in urinating. Antagonizes histamine and serotonin.
Therapeutic use
Prevention of nausea/vomiting associated with motion sickness and recovery from anesthesia and surgery. Preoperative medication to produce amnesia, sedation, tranquilization, antiemetic effects, and decrease salivary and respiratory secretions. Iridocyclitis. Symptomatic treatment of postencephalitic parkinsonism and paralysis agitans. Spastic states. Irritable colon syndrome, mild dysentery, diverticulitis, pylorospasm, and cardiospasm. Smooth muscle spasm of GU or GI tract. Prior to radiological/diagnostic procedures to prevent spasm.
Pregnancy and lactiation implications
Teratogenic effects not observed in animals. Scopolamine crosses placenta; may cause respiratory depression and/or neonatal hemorrhage when used during pregnancy. Transdermal scopolamine used as adjunct to epidural anesthesia for cesarean delivery without adverse CNS effects on newborn. Except when used prior to cesarean section, use during pregnancy only if benefit to mother outweighs potential risk to fetus. Enters breast milk (use caution).
Unlabeled use
Contraindications
Hypersensitivity to scopolamine, other belladonna alkaloids, or any component of the formulation. Narrow-angle glaucoma. Acute hemorrhage. Paralytic ileus. Tachycardia secondary to cardiac insufficiency. Myasthenia gravis. Tablet formulations contraindicated in prostatic hyperplasia, pyloric obstruction, or idiosyncrasy to anticholinergic drugs. Injectable formulations contraindicated in chronic lung disease (repeated administration).
Warnings and precautions
May cause drowsiness and/or blurred vision. Patients with idiosyncratic reaction to anticholinergics may experience disorientation, delirium and/or marked somnolence. Use with caution in coronary artery disease, tachyarrhythmias, heart failure, or hypertension. Use with caution in gastrointestinal obstruction, in hepatic impairment (higher risk of adverse CNS effects), and in hiatal hernia with reflux esophagitis. Use injectable, ophthalmic, and transdermal products with caution in prostatic hyperplasia (nonobstructive) or urinary retention (oral products contraindicated). Use with caution in history of psychosis (may exacerbate condition), in renal impairment (higher risk of adverse CNS effects), in history of seizure disorder (may exacerbate condition), in ulcerative colitis (may precipitate/aggravate toxic megacolon), and in infants and children (higher susceptibility to adverse effects). May contain benzalkonium chloride, which may be absorbed by contact lenses. Scopolamine (hyoscine) hydrobromide should not be interchanged with scopolamine butylbromide formulations (dosages not equivalent). Transdermal patch may contain conducting metal (e.g. aluminum).