BMA Concise Guide to Medicine & Drugs

Hyoscine

Brand names Buscopan, Joy-Rides, Kwells, Scopoderm TTS

Used in the following combined preparation Papaveretum and Hyoscine Injection

QUICK REFERENCE

Drug group Drug for irritable bowel syndrome, drug affecting the pupil, and anti-emetic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed No (for most preparations)

Available as generic Yes

GENERAL INFORMATION

Originally derived from the henbane plant, hyoscine is an anticholinergic drug that has both an antispasmodic effect on the intestine and a calming action on the nerve pathways that control nausea and vomiting. By its anticholinergic action, hyoscine also dilates the pupil.

The drug is produced in two forms. Hyoscine butylbromide is prescribed to reduce spasm of the gastrointestinal tract in irritable bowel syndrome, and sometimes with other drugs, to treat dysmenorrhoea (painful menstruation). The other form, hyoscine hydrobromide, is used to control motion sickness and the giddiness and nausea caused by disturbances of the inner ear (see Vertigo and Meniérè’s disease) and can be administered as skin patches as well as in tablets. This form is also used as a premedication to dry secretions before operations. Eye drops containing the hydrobromide form are used to dilate the pupil during eye examinations and eye surgery.

INFORMATION FOR USERS

Follow instructions on the label. Call your doctor if symptoms worsen.

How taken/used Tablets, injection, skin patches.

Frequency and timing of doses Irritable bowel syndrome Up to 4 x daily, as required, by mouth (tablets). Motion sickness Up to 3 x daily (tablets); every 3 days as required (patches).

Adult dosage range Irritable bowel syndrome 30–80mg daily (hyoscine butylbromide). Motion sickness 0.3mg per dose (tablets); 1 mg over 72 hours (hyoscine hydrobromide patches).

Onset of effect Within 1 hour.

Duration of action Up to 6 hours (by mouth); up to 72 hours (patches).

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose Take when you remember. Adjust the timing of your next dose accordingly.

Stopping the drug Can be safely stopped as soon as you no longer need it.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause drowsiness or agitation. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Administered by mouth or injection, hyoscine has a strong anticholinergic effect, causing various minor symptoms, such as dry mouth, drowsiness, and constipation. These can sometimes be minimized by a reduction in dosage. The butylbromide form of hyoscine is less likely to cause these side effects. Other possible adverse effects of hyoscine include blurred vision, difficulty in passing urine, and an increased heart rate. Consult your doctor if you experience any of these symptoms.

INTERACTIONS

Anticholinergic drugs Many drugs have anticholinergic, or antimuscarinic, effects, such as dry mouth, difficulty in passing urine, and constipation. The risk of such side effects is increased with hyoscine.

Sedatives All drugs that have a sedative effect on the central nervous system are likely to increase the sedative properties of hyoscine. Such drugs include anti-anxiety and sleeping drugs, antidepressants, opioid analgesics, and antipsychotics.

Sublingual tablets Hyoscine can cause a dry mouth and may reduce the effectiveness of sublingual tablets.

SPECIAL PRECAUTIONS

Be sure to consult your doctor or pharmacist before taking this drug if:

· You have long-term liver or kidney problems.

· You have heart problems.

· You have epilepsy.

· You have megacolon or intestinal obstruction problems.

· You have had glaucoma.

· You have prostate trouble or urinary retention.

· You have porphyria.

· You are taking other medicines.

Pregnancy Safety not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not recommended under 4 years for motion sickness. Patches not recommended under 10 years. Other uses not recommended under 6 years. Reduced dose necessary in older children.

Over 60 Reduced dose may be necessary.

Driving and hazardous work Avoid such activities until you have learned how hyoscine affects you because the drug can cause drowsiness and blurred vision.

Alcohol Avoid. Alcohol may increase the sedative effect of this drug.

PROLONGED USE

Use of this drug for longer than a few days is unlikely to be necessary.