NuLev

Generic name: Hyoscyamine sulfateBrand names: NuLev, Levbid, Levsinex, Anaspaz, Levsin

Why is NuLev prescribed?

Levsin is an antispasmodic medication given to help treat various stomach, intestinal, and urinary tract disorders that involve cramps, colic, or other painful muscle contractions. Because Levsin has a drying effect, it may also be used to dry a runny nose or to dry excess secretions before anesthesia is administered.

Together with morphine or other narcotics, Levsin is prescribed for the pain of gallstones or kidney stones. For inflammation of the pancreas, Levsin may be used to help control excess secretions and reduce pain. Levsin may also be taken in Parkinson's disease to help reduce muscle rigidity and tremors and to help control drooling and excess sweating. The drug is sometimes prescribed during treatment for peptic ulcer.

Doctors also give Levsin as part of the preparation for certain diagnostic x-rays (for example, of the stomach, intestines, or kidneys).

Levsin comes in several forms, including regular tablets, tablets to be dissolved under the tongue, tablets that dissolve on the tongue (NuLev), sustained-release capsules (Levsinex Timecaps) and sustained-release tablets (Levbid), liquid, drops, and an injectable solution.

Most important fact about NuLev

Levsin may make you sweat less, causing your body temperature to increase and putting you at the risk of heatstroke. Try to stay inside as much as possible on hot days, and avoid warm places such as very hot baths and saunas.

How should you take NuLev?

If you take Levsin for a stomach disorder, you may also need to take antacid medication. However, antacids make Levsin more difficult for the body to absorb. To minimize this problem, take Levsin before meals and the antacid after meals.

Take Levsin exactly as prescribed. Although the sublingual tablets (Levsin/SL) are designed to be dissolved under the tongue, they may also be chewed or swallowed. The regular tablets should be swallowed. Levbid extended-release tablets should not be crushed or chewed. NuLev tablets should be placed on the tongue, allowed to disintegrate, then swallowed. They can be taken with or without water.

Levsin can cause dry mouth. For temporary relief, suck on a hard candy or chew gum.

• If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

• Storage instructions...Store at room temperature. Protect NuLev tablets from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any side effects develop or change in intensity, tell your doctor immediately. Only your doctor can determine whether it is safe for you to continue taking Levsin.

• Side effects may include:Allergic reactions, bloating, blurred vision, confusion, constipation, decreased sweating, dilated pupils, dizziness, drowsiness, dry mouth, excitement, headache, hives, impotence, inability to urinate, insomnia, itching, heart palpitations, lack of coordination, loss of sense of taste, nausea, nervousness, rapid heartbeat, skin reactions, speech problems, vomiting, weakness

Why should NuLev not be prescribed?

Do not take Levsin if you have ever had an allergic reaction to it or similar drugs such as scopolamine. Also, you should not be given Levsin if you have any of the following:

Bowel or digestive tract obstruction or paralysisGlaucoma (excessive pressure in the eyes)Myasthenia gravis (a disorder in which muscles become weak and tire easily)Ulcerative colitis (severe bowel inflammation)Urinary obstruction

Levsin is not appropriate if you have diarrhea, especially if you have a surgical opening to the bowels (an ileostomy or colostomy).

Special warnings about NuLev

Be careful using Levsin if you have an overactive thyroid gland, heart disease, congestive heart failure, irregular heartbeats, high blood pressure, or kidney disease.

Because Levsin may make you dizzy or drowsy, or blur your vision, do not drive, operate other machinery, or do any other hazardous work while taking NuLev.

While you are taking Levsin, you may experience confusion, disorientation, short-term memory loss, hallucinations, difficulty speaking, lack of coordination, coma, an exaggerated sense of well-being, decreased anxiety, fatigue, sleeplessness and agitation. These symptoms should disappear 12 to 48 hours after you stop taking the drug.

People who must avoid phenylalanine should note that NuLev tablets contain this substance.

Possible food and drug interactions when taking NuLev

If Levsin is taken with certain other drugs, the effects of either drug could be increased, decreased, or altered. It is especially important to check with your doctor before combining Levsin with the following:

AmantadineAntacidsAntidepressant drugs such as amitriptyline, imipramine, phenelzine, and tranylcypromineAntihistamines such as diphenhydramineMajor tranquilizers such as chlorpromazine and haloperidolOther antispasmodic drugs such as dicyclominePotassium supplements

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Although it is not known whether Levsin can cause birth defects, pregnant women should avoid all drugs except those necessary to health.

Levsin appears in breast milk. Your doctor may ask you to forgo breastfeeding when taking NuLev.

Recommended dosage for NuLev

LEVSIN, LEVSIN/SL, AND NULEV TABLETS

Adults and Children 12 Years of Age and Older

The usual dose is 1 to 2 tablets every 4 hours or as needed. Do not take more than 12 tablets in 24 hours.

Children 2 to Under 12 Years of Age

The usual dose is one-half to 1 tablet every 4 hours or as needed. Do not give a child more than 6 tablets in 24 hours.

LEVSIN ELIXIR

Adults and Children 12 Years of Age and Older

The recommended dosage is 1 to 2 teaspoonfuls every 4 hours or as needed, but no more than 12 teaspoonfuls in 24 hours.

Children 2 to 12 Years of Age

Dosage is by body weight. Doses may be given every 4 hours or as needed. Do not give a child more than 6 teaspoonfuls in 24 hours.

WEIGHT	DOSE
22 pounds	1/4 teaspoon
44 pounds	1/2 teaspoon
88 pounds	3/4 teaspoon
110 pounds	1 teaspoon

LEVSIN DROPS

Adults and Children 12 Years of Age and Older

The recommended dosage is 1 to 2 milliliters every 4 hours or as needed, but no more than 12 milliliters in 24 hours.

Children 2 to 12 Years of Age

The usual dosage is one-quarter to 1 milliliter every 4 hours or as needed. Do not give a child more than 6 milliliters in 24 hours.

Children under 2 Years of Age

Your doctor will determine the dosage based on body weight. The doses may be repeated every 4 hours or as needed.

WEIGHT	USUALDOSE	DO NOTEXCEEDIN 24 HOURS
7.5 pounds	4 drops	24 drops
11 pounds	5 drops	30 drops
15 pounds	6 drops	36 drops
22 pounds	8 drops	48 drops

LEVSINEX TIMECAPS

Adults and Children 12 Years of Age and Older

The recommended dosage is 1 to 2 capsules every 12 hours. Your doctor may adjust the dosage to 1 capsule every 8 hours if needed. Do not take more than 4 capsules in 24 hours.

LEVBID EXTENDED-RELEASE TABLETS

Adults and Children 12 Years of Age and Older

The dosage is 1 to 2 tablets every 12 hours. The tablets are scored so that you can break them in half if your doctor wants you to. Do not crush or chew them. You should not take more than 4 tablets in 24 hours.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Levsin overdose may include:Blurred vision, dilated pupils, dizziness, dry mouth, excitement, headache, hot dry skin, nausea, swallowing difficulty, vomiting