Hyoscine Butylbromide

Note: this monograph does not apply to hyoscine hydrobromide (see next entry)

ADMINISTRATION ROUTES:

IV, PO, IM, SC

ALTERNATIVE NAMES:

Buscopan, Gastro-Soothe

ICU INDICATIONS:

1. Gastrointestinal tract spasm

PRESENTATION AND ADMINISTRATION:

IV:

20 mg in 1 mL (solution)

Room temperature. Protect from light.

Dilute required dose to 10 mL with Normal saline. Inject slowly over 3-5 minutes.

Compatible with the following IV fluids: Normal saline, 5% Glucose, Glucose and sodium chloride/

May be given into the side arm when the above IV fluids are being infused.

IM or SC:

Inject undiluted into a large muscle mass or subcutaneously

PO:

Buscopan 10 mg (white) Gastro-Soothe 10 mg (white)

DOSAGE:

IV, IM, SC, PO:

20-40 mg 6-8 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

IV

0.5 mg/kg 6-8 hourly

CLINICAL PHARMACOLOGY:

Buscopan exerts a spasmolytic action on the smooth muscle of the gastrointestinal, biliary and urinary tracts. As a quaternary ammonium derivative, hyoscine-N-butylbromide does not enter the central nervous system so anticholinergic side effects at the central nervous system do not occur. Peripheral anticholinergic effects result from a ganglion-blocking action within the visceral wall as well as from anti- muscarinic activity.

CONTRAINDICATIONS:

1. Myasthenia gravis
2. Mechanical gastrointestinal tract obstruction

WARNINGS:

Tachycardia:

Hyoscine butylbromide may cause marked tachycardia

Urinary retention:

Hyoscine butylbromide may precipitate urinary retention

PRECAUTIONS:

General:

Hyoscine butylbromide should not be given by intramuscular injection to patients being treated with anticoagulant drugs as intramuscular haematomas may occur. In these patients, the subcutaneous or intravenous routes should be used

Laboratory Tests:

No tests in addition to routine ICU tests are required

Drug/Laboratory Test Interactions: None known

IMPORTANT DRUG INTERACTIONS IN ICU:

The anticholinergic effect of drugs such as tricyclic antidepressants, antihistamines, quinidine, amantadine, disopyramide and other anticholinergics (tiotropium, ipratropium) may be intensified by Hyoscine-N-butylbromide.

Concomitant treatment with dopamine antagonists such as metoclopramide may result in diminution of the effects of both drugs on the gastrointestinal tract.

The tachycardic effects of beta-adrenergic agents may be enhanced by Hyoscine-N-butylbromide.

ADVERSE REACTIONS:

Body as a Whole:

Anaphylactic shock, anaphylactoid reactions and other hypersensitivity, skin reactions

Cardiovascular:

Tachycardia, hypotension, dizziness, flushing

Respiratory:

Dyspnoea

Gastrointestinal:

Dry mouth

Renal and urinary disorders:

Urinary retention