glycopyrrolate

Generic Name: glycopyrrolate (glye koe PIE roe late)Brand Names: Robinul, Robinul Forte

What is glycopyrrolate?

Glycopyrrolate reduces the secretions of certain organs in the body.

Glycopyrrolate helps to control conditions such as peptic ulcers that involve excessive stomach acid production.

The injectable form of glycopyrrolate is also used to reduce saliva, nasal, lung, and stomach secretions and to help control heart rate during surgery.

Glycopyrrolate may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about glycopyrrolate?

Use caution when driving, operating machinery, or performing other hazardous activities. Glycopyrrolate may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking glycopyrrolate.

Avoid becoming overheated in hot weather. Glycopyrrolate increases the risk of heat stroke because it causes decreased sweating.

Who should not take glycopyrrolate?

Do not take glycopyrrolate if you have

• kidney disease;

• a blockage of your urinary tract (difficulty urinating);

• a blockage in your intestines, severe ulcerative colitis, or ulcerative colitis complicated by toxic megacolon;

• glaucoma; or

• myasthenia gravis.

Before taking this medication, tell your doctor if you have

• numbness or tingling in your hands or feet;

• liver disease;

• ulcerative colitis;

• thyroid problems;

• high blood pressure, an irregular heartbeat, or any type of heart disease;

• hiatal hernia or reflux disease;

• enlargement of the prostate; or

• asthma, chronic lung disease, or allergies.

You may not be able to take glycopyrrolate, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

It is not known whether glycopyrrolate will harm an unborn baby. Do not take glycopyrrolate without first talking to your doctor if you are pregnant. It is not known whether glycopyrrolate passes into breast milk. Do not take glycopyrrolate without first talking to your doctor if you are breast-feeding a baby.

How should I take glycopyrrolate?

Take glycopyrrolate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Glycopyrrolate is usually taken two or three times a day. Follow your doctor's instructions.

Store glycopyrrolate at room temperature away from moisture and heat.

See also: Glycopyrrolate dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a glycopyrrolate overdose include headache; nausea; vomiting; dry mouth; difficulty swallowing; blurred vision; dilated pupils; hot, dry skin; dizziness; drowsiness; confusion; anxiety; seizures; weak pulse; and an irregular heartbeat.

What should I avoid while taking glycopyrrolate?

Use caution when driving, operating machinery, or performing other hazardous activities. Glycopyrrolate may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking glycopyrrolate.

Avoid becoming overheated in hot weather. Glycopyrrolate increases the risk of heat stroke because it causes decreased sweating.

Glycopyrrolate side effects

If you experience any of the following serious side effects, stop taking glycopyrrolate and seek emergency medical attention:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• an irregular or fast heart rate;

• rash or flushing; or

• eye pain.

Other, less serious side effects may be more likely to occur. Continue to take glycopyrrolate and talk to your doctor if you experience

• headache, dizziness, or lightheadedness;

• weakness or nervousness;

• blurred vision, large pupils, or sensitivity of the eyes to bright light;

• nausea, bloating, heartburn, or constipation;

• changes in taste;

• difficulty urinating;

• decreased sweating; or

• nasal congestion, stuffiness, or a dry mouth.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Glycopyrrolate Dosing Information

Usual Adult Dose for Anesthesia:

Preanesthetic: 0.004 mg (0.02 mL)/kg IM 30 to 60 minutes prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered.Intraoperative: 0.1 mg (0.5 mL) IV repeated as needed every 2 to 3 minutes.Reversal of neuromuscular blockade: 0.2 mg (1.0 mL) IV for each 1.0 mg of neostigmine or 5 mg of pyridostigmine.

Usual Adult Dose for Peptic Ulcer:

Parenteral: 0.1 mg (0.5 mL) IV or IM every 4 hours, 3 to 4 times daily. If a more profound effect is required the dose may be increased to 0.2 mg (1 mL).1 mg oral tablet:Initial dose: 1 mg orally 3 times daily or 1 mg in the morning, 1 mg in the early afternoon, and 2 mg at bedtime.Maintenance dose: 1 mg orally twice daily to a maximum of 8 mg per day.2 mg oral tablet: 2 mg orally 2 to 3 times daily to a maximum of 8 mg per day.

Usual Pediatric Dose for Anesthesia:

Preanesthetic: 0.004 mg (0.02 mL)/kg IM 30 to 60 minutes prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered. Children under 2 years of age may require up to 0.009 mg (0.45 mL)/kg.Intraoperative: 0.004 mg (0.02 mL)/kg IV not to exceed 0.1 mg (0.5 ml) in a single dose, repeated as needed every 2 to 3 minutes.Reversal of neuromuscular blockade: 0.4 mg (2 mL)/kg IV for each 1 mg of neostigmine or 5 mg of pyridostigmine.

What other drugs will affect glycopyrrolate?

Many other drugs may increase the side effects of glycopyrrolate. Before taking this medication, tell your doctor if you are taking any of the following medicines:

• amantadine (Symmetrel);

• quinidine (Quinaglute, Cardioquin, Quinora, Quinidex);

• antihistamines such as diphenhydramine (Benadryl, many others), brompheniramine (Dimetapp, Bromphen, many others), triprolidine (Actifed, others), and chlorpheniramine (Chlor-Trimeton, others), which are found in many over-the-counter and prescription cough, cold, and allergy medications;

• decongestants and appetite suppressants such as phenylpropanolamine (Dexatrim, others), phenylephrine (Neo-Synephrine, others), and pseudoephedrine (Sudafed, others), which are also found in many over-the-counter and prescription products;

• phenothiazines such as chlorpromazine (Thorazine) and prochlorperazine (Compazine);
• other commonly used phenothiazines, including fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), thioridazine (Mellaril), trifluoperazine (Stelazine), and promazine (Sparine);
• tricyclic antidepressants such as amitriptyline (Elavil, Endep), doxepin (Sinequan), and nortriptyline (Pamelor); or
• other commonly used tricyclic antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), protriptyline (Vivactil), and trimipramine (Surmontil).

Glycopyrrolate may increase the level of digoxin (Lanoxin, Lanoxicaps) in your blood. Tell your doctor if you are taking digoxin so that your digoxin levels can be monitored and changes in your dosage can be made if necessary.

Drugs other than those listed here may also interact with glycopyrrolate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has more information about glycopyrrolate written for health professionals that you may read.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.05. Revision Date: 4/12/2009 4:38:54 PM.