hyoscyamine (Rx)

Brand and Other Names:Levbid, Levsin, more...Anaspaz, Cystospaz, NuLev, Symax Duotab
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule/tablet, extended release

  • 0.375mg

elixir

  • 0.125mg/5mL

injection solution

  • 0.5mg/mL

oral drops

  • 0.125mg/mL

tablet

  • 0.125mg
more...

Gastrointestinal Disorders

Immediate release: 0.125-0.25 mg PO/SL q4hr PRN; no more than 1.5 mg/day

Extended release: 0.375-0.75 mg PO q12hr; no more than 1.5 mg/day

IM/SC/IV: 0.25-0.5 mg q4hr PRN; no more than 4 times per day

Hypermotility of Lower Urinary Tract

Adjunctive treatment

Immediate release: 0.15-0.3 mg PO/SL q6hr

Extended release: 0.375 mg PO q12hr

Peptic Ulcer Disease

Adjunctive treatment

0.125-0.25 mg PO/SL q4hr PRN; no more than 1.5 mg/day

Irritable Bowel Syndrome

Adjunctive treatment

0.125-0.25 mg PO/SL q4hr PRN; no more than 1.5 mg/day

Dosage Forms & Strengths

capsule/tablet, extended release

  • 0.375mg

elixir

  • 0.125mg/5mL

injection solution

  • 0.5mg/mL

oral drops

  • 0.125mg/mL

tablet

  • 0.125mg
more...

Gastrointestinal Disorders

<2 years (oral drops)

  • 2.3-3.3 kg: 3 drops PO q4hr PRN; no more than 18 drops/day
  • 3.4-4 kg: 4 drops PO q4hr PRN; no more than 24 drops/day
  • 5-6 kg: 5 drops PO q4hr PRN; no more than 30 drops/day
  • 7-9 kg: 6 drops PO q4hr PRN; no more than 36 drops/day
  • 10-14 kg: 8 drops PO q4hr PRN; no more than 48 drops/day
  • ≥15 kg: 11 drops PO q4hr PRN; no more than 66 drops/day

2-12 years (tablet)

  • Immediate release/SL: 0.0625-0.125 mg PO q4hr PRN; no more than 0.75mg/day
  • Extended release: 0.375 PO q12hr; no more than 0.75 mg/day

2-12 years (elixir)

  • 10-19 kg: 1/4 tsp (1.25 mL) PO q4hr PRN
  • 20-39 kg: 1/2 tsp (2.5 mL) PO q4hr PRN
  • 40-49 kg: 3/4 tsp (3.75 mL) PO q4hr PRN
  • ≥50 kg: 1 tsp (5 mL) PO q4hr PRN

IV/IM/SQ

  • >12 years: 0.025-0.5 mg q4hr PRN; no more than 4 times daily

Hypermotility of lower urinary tract

Immediate release: 0.125-0.25 mg PO/SL q6hr

Extended release: 0.375 mg PO q12hr

Dosing considerations

Avoid except in short-term situations to decrease secretions; high incidence of anticholinergic effects (Beers criteria)

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Interactions

Interaction Checker

and hyoscyamine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Dry skin

            1-10%

            Blurred vision

            Constipation

            Dysphagia

            Photosensitivity

            <1%

            Headache

            Orthostatic hypotension

            Tachycardia

            Frequency Not Defined

            Xerostomia

            Urinary hesitancy/retention

            HTN

            Dysphagia

            Respiratory depression

            CNS stimulation

            Fever

            Ataxia

            Excitation

            Lethargy

            Palpitations

            Mydriasis

            Cycloplegia

            Increased IOP

            Weakness

            Bloated feeling

            Suppression of lactation

            Impotence

            Anhidrosis

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            Warnings

            Contraindications

            Hypersensitivity to hyoscyamine or related compounds

            Closed-angle glaucoma

            Myasthenia gravis

            Hemorrhage with cardiovascular instability

            Paralytic ileus

            Intestinal atony of elderly/debilitated patient

            Obstructive uropathy

            Toxic megacolon

            GI obstruction

            Tachycardia secondary to cardiac insufficiency or thyrotoxicosis

            Breastfeeding

            Cautions

            Renal/hepatic impairment

            BPH

            CHF

            Coronary artery disease

            HTN

            COPD

            Hiatal hernia

            Reflux esophagitis

            Mitral stenosis

            Brain damage or spastic paralysis in children

            Salivary secretion disorder

            Down syndrome

            Autonomic neuropathy

            Hyperthyroidism

            Tachyarrhythmia

            Toxin-mediated diarrhea

            Elderly (see Beers criteria)

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Enters breast milk; use not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Parasympatholytic, atropine-like effects, especially peripherally; blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and CNS

            Absorption

            Bioavailability: Tab (100%), SR (81%)

            Onset: IV/IM/SC (2-3 min), SL (5-20 min), tab/SR (20-30 min)

            Duration: IV/IM/SC/tab/SL (up to 4 hr), SR (12 hr)

            Peak plasma time: Tab/SR (2.5 hr)

            Distribution

            Protein bound: 50%

            Vd: 1.2-1.9 L/kg (adults); 1.1-3.7 L/kg (children aged 4-16 years)

            Metabolism

            Hepatic

            Metabolites: Tropic acid, tropine, hyoscyamine glucuronide

            Elimination

            Half-life: Tab (3.5 hr), SR (5-9 hr)

            Dialyzable: Yes; removed by hemodialysis and peritoneal dialysis

            Excretion: Majority excreted in urine as unchanged drug

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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