Hyoscyamine Sulfate (L-Hyoscyamine)(high ah’ ska meen)
IB-Stat, LevbidDNC, Levsin/SL, Mar-Spas, Neosol, NuLev, Symax Duotab, Symax Fastab, Symax-SLDNC, Symax-SRDNC
PREGNANCY CATEGORY C
Drug Classes
Anticholinergic
Antimuscarinic
Antispasmodic
Belladonna alkaloid
Parasympatholytic
Therapeutic Actions
Direct GI smooth muscle relaxant; competitively blocks the effects of acetylcholine at muscarinic cholinergic receptors that mediate the effects of parasympathetic postganglionic impulses, thus relaxing the GI tract. Also has antisecretory effects along the GI.
Indications
Adjunctive therapy in IBS, peptic ulcer, spastic or functional GI disorders, cystitis, neurogenic bladder or bowel disorders, parkinsonism, biliary or renal colic
Treatment of rhinitis and anticholinesterase poisoning
Reduction of rigidity and tremors and control of sialorrhea and hyperhidrosis associated with parkinsonism
Treatment of partial heart block associated with vagal activity
Preoperatively to decrease secretions
Parenterally to improve radiologic imaging tests
Contraindications and Cautions
Contraindicated with hypersensitivity to anticholinergic drugs, glaucoma, adhesions between iris and lens, stenosing peptic ulcer, pyloroduodenal obstruction, paralytic ileus, intestinal atony, severe ulcerative colitis, toxic megacolon, symptomatic prostatic hypertrophy, bladder neck obstruction, bronchial asthma, COPD, myocardial ischemia, myasthenia gravis, tachycardia, renal disease.
Use cautiously with high environmental temperatures, fever, diarrhea, hyperthyroidism, CV disease, hypertension, heart failure, arrhythmias, renal disease, hiatal hernia, pregnancy, lactation.
Available Forms
Tablets—0.125 mg, 0.15 mg; sublingual tablets—0.125 mg; ER tabletsDNC—0.375 mg; ER capsulesDNC—0.375 mg; orally disintegrating tablets—0.125 mg; oral spray—0.125 mg/mL; elixir—0.125 mg/5 mL; solution—0.125 mg/mL; injection—0.5 mg/mL
Dosages
Adults
Oral or sublingual
0.125–0.25 mg PO every 4 hr or as needed.
Oral solution: 1–2 mL PO every 4 hr as needed; do not exceed 12 mL per day.
Oral spray: 1–2 sprays PO every 4 hr as needed; do not exceed 12 sprays per day.
Orally disintegrating tablets: ½–1 tablet PO three-to four times per day 30 min–1 hr before meals and at bedtime.
Elixir: 1–2 teaspoons PO every 4 hr as needed; do not exceed 12 teaspoons per day.
ER
0.375–0.75 mg PO every 12 hr. May give 1 capsule every 8 hr if needed; do not exceed 4 capsules per day.
Parenteral
GI disorders: 0.25–0.5 mg subcutaneously, IM, or IV 2–4 times per day at 4-hr intervals as needed.
Preanesthetic: 0.005 mg/kg IV or IM 30–60 min before induction.
Treatment of bradycardia: 0.125 mg (0.25 mL) IV. Repeat as needed.
Reversal of neuromuscular blockade: 0.2 mg IV, IM, or subcutaneously for every 1 mg neostigmine.
Pediatric patients
Regular and sublingual tablets, orally disintegrating tablets (except Mar-Spas)
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