Scopolamine Hydrobromide (Hyoscine HBr)(skoe pol’ a meen)
Parenteral: Scopolamine HBr
Transdermal system: Transderm-Scop, Transderm-V (CAN)
Ophthalmic solution: Isopto Hyoscine Ophthalmic
PREGNANCY CATEGORY C
Drug Classes
Anticholinergic
Antiemetic
Anti–motion-sickness drug
Antimuscarinic
Antiparkinsonian
Antispasmodic
Belladonna alkaloid
Parasympatholytic
Therapeutic Actions
Mechanism of action as anti–motion-sickness drug not understood; antiemetic action may be mediated by interference with cholinergic impulses to the vomiting center (CTZ); has sedative and amnesia-inducing properties; blocks effects of acetylcholine at muscarinic cholinergic receptors that mediate effects of parasympathetic postganglionic impulses, thus depressing salivary and bronchial secretions, inhibiting vagal influences on the heart, relaxing the GI and GU tracts, inhibiting gastric acid secretion, relaxing the pupil of the eye (mydriatic effect), and preventing accommodation for near vision (cycloplegic effect).
Indications
Transdermal system: Prevention and control of nausea and vomiting associated with motion sickness and recovery from surgery
Injection: Preanesthetic medication to control bronchial, nasal, pharyngeal, and salivary secretions; prevent bronchospasm and laryngospasm; block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation; produce sedation
Injection: Induction of obstetric amnesia with analgesics calming delirium
Oral: Treatment of postencephalitic parkinsonism and paralysis agitans; relief of symptoms in spastic states; maniacal states; delirium tremens
Ophthalmic solution: Diagnostically to produce mydriasis and cycloplegia
Ophthalmic solution: Preoperative and postoperative states in the treatment of iridocyclitis
Unlabeled uses: Sialorrhea (transdermal), postoperative and chemotherapy-induced nausea and vomiting (oral)
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, cardiac arrhythmias, tachycardia, myocardial ischemia; impaired metabolic, liver, or renal function (increased likelihood of adverse CNS effects); myasthenia gravis; pregnancy (causes respiratory depression in neonates, contributes to neonatal hemorrhage); lactation.
Use cautiously with Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism; glaucoma or tendency to glaucoma (ophthalmic solution).
Available Forms
Injection—0.4, 1 mg/mL; transdermal system—1.5 mg; ophthalmic solution—0.25%
