Please check your internet connection and try again.
# Hyoscine butylbromide (Buscopan)
## Overview
Hyoscine butylbromide is an anticholinergic medication that acts as a smooth muscle relaxant, primarily affecting the gastrointestinal and genitourinary tracts. It competitively inhibits the action of acetylcholine at muscarinic receptors.
## Primary Indications
* Abdominal cramping and pain associated with gastrointestinal spasms, such as irritable bowel syndrome (IBS).
* Biliary colic.
* Renal colic.
## Adult Dosing
* **Oral:** 10 mg to 20 mg three times daily. Maximum dose not clearly established but typically not exceeding 100 mg per day.
* **Intramuscular/Intravenous:** 20 mg every 6 to 8 hours as needed. Maximum dose not clearly established but typically not exceeding 100 mg per day.
## Pediatric Dosing
Dosing in children is less established and should be guided by clinical judgment and local protocols. Some sources suggest:
* **Oral (age 6-12):** 10 mg three times daily. Higher doses may be used in severe cases under medical supervision.
* **Intramuscular/Intravenous:** 0.3 mg/kg to 0.4 mg/kg per dose, every 6 to 8 hours as needed. Maximum single dose typically 20 mg.
## Dose Adjustments
* **Renal Impairment:** No specific dose adjustment is typically required for mild to moderate renal impairment. Data for severe impairment is limited. Monitor for increased anticholinergic effects.
* **Hepatic Impairment:** No specific dose adjustment is typically required for mild to moderate hepatic impairment. Data for severe impairment is limited. Monitor for increased anticholinergic effects.
## Contraindications
* Hypersensitivity to hyoscine butylbromide or any component of the formulation.
* Myasthenia gravis.
* Glaucoma (specifically angle-closure glaucoma).
* Megaloblastic anemia.
* Tachyarrhythmias.
* Ileus or atony of the gastrointestinal tract.
* Paralytic ileus.
* Toxic megacolon.
* Prostatic hypertrophy with urinary retention.
* Bladder neck obstruction.
* Pyloric stenosis.
* Infants under 1 month of age due to risk of paralytic ileus and respiratory issues.
## Adverse Effects
Common adverse effects are anticholinergic in nature and include: dry mouth, blurred vision, constipation, urinary retention, tachycardia, drowsiness, dizziness, and sweating impairment. Rare but serious effects include allergic reactions.
## Key Drug Interactions
* **Other Anticholinergics:** Additive anticholinergic effects (e.g., tricyclic antidepressants, antihistamines, antipsychotics, atropine).
* **Dopamine Antagonists (e.g., metoclopramide):** Reduced efficacy of both drugs.
* **Opioid Analgesics:** May increase the risk of severe constipation.
* **Prokinetic agents:** May reduce the efficacy of prokinetic agents.
## Monitoring
* Monitor for signs and symptoms of anticholinergic side effects (e.g., dry mouth, blurred vision, difficulty urinating, constipation, confusion).
* Monitor for efficacy in relieving abdominal pain and spasms.
* In infants and young children, monitor respiratory status and for signs of ileus.
## Clinical Pearls
* Oral formulations are generally preferred for milder symptoms.
* Parenteral administration is for more severe or acute spasms or when oral administration is not feasible.
* Effects are primarily peripheral, with minimal central nervous system penetration when given orally or intramuscularly, thus leading to fewer CNS side effects compared to other anticholinergics like scopolamine.
* If symptoms persist or worsen, further medical investigation is warranted to rule out other serious conditions.
***
*This information is intended for healthcare professionals. Always consult the most current prescribing information and local protocols for definitive guidance.*
