Trade Names:Isopto Hyoscine- Ophthalmic solution 0.25%
Trade Names:Scopace- Tablets, soluble 0.4 mg
Trade Names:Transderm-Scōp- Transdermal system 1.5 mgTransderm-V (Canada)
Competitively inhibits action of acetylcholine at muscarinic receptors. Principal effects are on iris and ciliary body (pupil dilations and blurred vision), secretory glands (dry mouth), drowsiness, euphoria, fatigue, decreased nausea, and vomiting.
Scopolamine is well absorbed percutaneously. T max is reached within 24 h; C max is 87 pg/mL (free scopolamine) and 354 pg/mL (total scopolamine).
Scopolamine crosses the placenta and the blood-brain barrier. It may be reversibly bound to plasma proteins.
Scopolamine is extensively metabolized and conjugated with less than 5% of the total dose appearing unchanged in urine.
Less than 10% of the total dose is excreted in urine as parent and metabolites over 108 h; t ½ is 9.5 h.
As an anticholinergic CNS depressant, symptomatic treatment of postencephalitic parkinsonism and paralysis agitans, in spastic states and locally as a substitute for atropine in ophthalmology, to inhibit excessive motility and hypertonus of the GI tract in such conditions as irritable colon syndrome, mild dysentery, diverticulitis, pylorospasm, and cardiospasm, and may prevent motion sickness (oral); accomplishment of cycloplegia and mydriasis for diagnostic procedures and for preoperative and postoperative states in treatment of iridocyclitis (ophthalmic use); prevention of nausea and vomiting associated with motion sickness and recovery from anesthesia and surgery (transdermal); antiemetic, preanesthetic sedation, antisecretory action, obstetric amnesia in conjunction with analgesics and to calm delirium (parenteral).
Hypersensitivity to any product component, angle-closure glaucoma; adhesions between iris and lens; children with previous severe reaction to atropine.
0.4 to 0.8 mg.OphthalmicAdults
1 to 2 gtt of 1% solution into eye 1 h prior to refraction, or 1 to 2 gtt up to 4 times daily for uveitis.TransdermalAdults
One transdermal patch placed behind ear at least 4 h prior to event. Wear only 1 patch at a time. Approximately 1 mg will be delivered for 3 days. To prevent postoperative nausea and vomiting, apply patch in the evening before scheduled surgery. To minimize exposure of the newborn baby to the drug, apply the patch 1 h prior to cesarean section. Only 1 patch should be worn at any time. Do not cut patch.ParenteralAdults
IM/IV/Subcutaneous 0.32 to 0.65 mg.
IM/IV/Subcutaneous For obstetric amnesia or preoperative sedation, 0.32 to 0.65 mg. For sedation or tranquilization, 0.6 mg 3 or 4 times daily. As an antiemetic, subcutaneous 0.6 to 1 mg.Children
IM/IV/Subcutaneous 0.006 mg/kg (max, 0.3 mg). IM/IV/Subcutaneous As an antiemetic, subcutaneous 0.006 mg/kg.Children 6 mo to 3 yr of age
IM/IV/Subcutaneous 0.1 to 0.15 mg.Children 3 to 6 yr of age
IM/IV/Subcutaneous 0.2 to 0.3 mg.
Store tablets at controlled room temperature (59° to 86°F). Store patches in foil wrapper at controlled room temperature (68° to 77°F). Store ophthalmic solution at controlled room temperature (less than 86°F). Protect from light. Protect injection solution from light with opaque covering until contents have been used. Store vials at controlled room temperature (59° to 86°F). Protect from light.
Worsened schizophrenia, decreased haloperidol levels, and tardive dyskinesia may occur.IV incompatibilities
Solutions are incompatible with alkalies.Other drugs capable of causing CNS effects (eg, alcohol, belladonna alkaloids, muscle relaxants, sedatives, tranquilizers)
Use with caution.Phenothiazines
Actions of phenothiazines may be decreased.
Scopolamine will interfere with the gastric secretion test.
Increased heart rate.
Drowsiness; disorientation; dizziness; delirium; restlessness; tremors; locomotor difficulties.
Contact dermatitis; erythema; flushing.
Blurred vision; stinging; increased IOP; photophobia; conjunctivitis; local irritation including follicular conjunctivitis, vascular congestion, edema, exudates, and an eczematoid dermatitis (ophthalmic use).
Decreased respiratory rate.
Category C .
Excreted in breast milk.
Safety and efficacy not established for transdermal use. Use with caution in children and infants.
Use with caution in elderly patients.
Contact dermatitis for transdermal system has been reported. Potentially alarming idiosyncratic reactions may occur with therapeutic doses.
Use with caution in men with prostatic hypertrophy and in patients with tachycardia or other tachyarrhythmias, coronary heart disease, congestive heart disease, pyloric obstruction, urinary bladder neck obstruction, history of seizures or psychosis, impaired liver or kidney function; use with caution when administering an antiemetic or antimuscarinic agent.
Dim room lights or provide sunglasses if patient experiences photophobia.
Use with caution in those with diabetes.
Use with caution in those with open-angle glaucoma.
Use with caution in thyroid abnormalities.
Dizziness, nausea, vomiting, headache, and disturbances with equilibrium have been reported upon discontinuation after several days of use.
Coma, convulsions, delirium, dilated pupils, disorientation, dizziness, dry mouth, hallucinations, hyperpyrexia, hypertension, memory disturbances, nausea, restlessness, somnolence, supraventricular arrhythmias, tachycardia, vomiting.
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