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# Hyoscine butylbromide (Buscopan)
## Overview
Hyoscine butylbromide is an anticholinergic medication. It acts as a peripheral antimuscarinic agent, primarily producing antispasmodic effects on the smooth muscle of the gastrointestinal and genitourinary tracts. It has limited absorption from the gastrointestinal tract and does not readily cross the blood-brain barrier, resulting in fewer central nervous system side effects compared to centrally acting anticholinergics.
## Primary Indications
* Symptomatic relief of painful spasms of the stomach and intestines.
* Symptomatic relief of painful spasms of the biliary system.
* Symptomatic relief of painful spasms of the urinary tract.
## Adult Dosing
* **Oral:** 10 mg to 20 mg three to five times daily.
* **Parenteral (IM/IV):** 20 mg every 6 to 8 hours as needed. Doses up to 100 mg have been used in specific situations (e.g., renal colic) but should be administered cautiously and under strict medical supervision.
## Pediatric Dosing
* **Oral:** For children aged 6 to 12 years: 10 mg two to three times daily.
* **Parenteral (IM/IV):** Dosing in children is not well-established and should be used with caution. Limited data suggests doses of 0.3 mg/kg to 0.4 mg/kg may be used, not to exceed adult doses. Conservative dosing is recommended, and it is often best to consult specialist pediatric literature or local protocols.
## Dose Adjustments
No specific dose adjustments are typically required for hepatic or renal impairment due to minimal systemic absorption and metabolism. However, caution is advised in patients with severe liver or kidney disease.
## Contraindications
* Hypersensitivity to hyoscine butylbromide or any excipients.
* Myasthenia gravis.
* Untreated narrow-angle glaucoma.
* Tachyarrhythmias.
* Ileus or intestinal obstruction.
* Atony of the intestines.
* Prostatic hypertrophy with urinary retention.
* Megacolon.
* In severe, undiagnosed abdominal pain where the cause is not yet established.
## Adverse Effects
Common adverse effects are generally mild and related to anticholinergic activity:
* Dry mouth
* Tachycardia
* Constipation
* Urinary retention
* Blurred vision
* Sweating may be reduced.
Less common but serious:
* Anaphylactic reactions, including anaphylactic shock.
* Angioedema.
* Drowsiness.
* Dizziness.
## Key Drug Interactions
* **Other Anticholinergics:** Additive effects, increasing risk of anticholinergic side effects (e.g., tricyclic antidepressants, antihistamines, some antipsychotics, amant
