Brand and Other Names:Transderm Scop, Scopace, more...Maldemar
- Classes: Antiemetic Agents
Dosing & Uses
Dosage Forms & Strengths
Nausea & Vomiting
0.3-0.65 mg IV/IM/SC; repeat q6-8hr if necessary
Apply 1 patch behind ear at least 4-12 hours (preferably 12 hr) before anticipated exposure to motion, then every 3 days PRN
Nausea & Vomiting Associated With Anesthesia
- Apply 1 patch behind ear on night before scheduled surgery, then leave on for 24 hours after surgery
- Cesarian section: Apply 1 patch behind ear 1 hour before surgery (to minimize newborn exposure, apply no sooner); remove 24 hours after surgery
Chemotherapy Induced Nausea and Vomiting (Off-label)
Apply 1 patch q72hr
Safety & efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Dry mouth (29-67%)
Frequency Not Defined
Pruritus and edema at application site
Dilation of pupil if drug contacts eye
Withdrawal symptoms (eg, dizziness, nausea and vomiting) if used for >3 days
Hypersensitivity to scopolamine, belladonna alkaloids, or any component in formulation
Use caution in patients with open-angle glaucoma, benign prostatic hyperplasia, history of seizures or psychosis, ulcerative colitis, hypertension, hyperthyroidism, Down syndrome, toxin-mediated diarrhea, coronary artery disease, tachyarrhythmia, brain damage or spastic paralysis in children, cardiac conduction disorder, CHF
Children and elderly persons are particularly susceptible to side effects of belladonna alkaloids
Anaphylaxis, including episodes of shock reported, following parenteral administration; monitor for signs and symptoms of hypersensitivity reactions
Lower doses may increase vagal tone and cause paradoxical bradycardia
May cause CNS depression; caution when operating heavy machinery or tasks which require mental alertness
Patients may experience idiosyncratic toxic psychosis, agitation, delusions, confusion, hallucinations, paranoid behavior and rambling speech
Discontinue if patient experiences unusual visual disturbances or pain within the eye
In patients with Parkinson disease, or abrupt discontinuation of large doses may result in adverse effects, including headache, nausea, vomiting, and dizziness; withdrawal symptoms may also appear more than 24 hr after removing transdermal patch
Drug interferes with gastric secretion test
Pregnancy & Lactation
Pregnancy category: C
Lactation: Drug distributed into breast milk; use caution
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.
Mechanism of Action
Anticholinergic belladonna alkaloid
Generally exhibits pharmacologic actions associated with other antimuscarinics
May prevent motion-induced nausea and vomiting by blocking transmission of cholinergic impulse from vestibular nuclei to higher centers in CNS and from reticular formation to vomiting center
Onset: IM, 0.5-1 hr; IV, 10 min
Duration: IM, 4-6 hr; IV, 2 hr
Peak plasma time: 24 hr (transdermal)
Metabolized by liver (via conjugation)
Half-life: 9.5 hr
Excretion: Primarily urine (90% as metabolites)
Additive: Floxacillin, furosemide, meperidine, succinylcholine
Syringe: Atropine, butorphanol, chlorpromazine, cimetidine, diamorphine, dimenhydrinate, diphenhydramine, droperidol, fentanyl, glycopyrrolate, hydromorphone, hydroxyzine, meperidine, metoclopramide, midazolam, morphine hydrochloride, morphine sulfate, nalbuphine, papaveretum, pentazocine, pentobarbital, perphenazine, prochlorperazine, promazine, promethazine, ranitidine, sufentanil, thiopental
Y-site: Fentanyl, heparin, hydrocortisone, hydromorphone, methadone, morphine, potassium chloride, propofol, sufentanil, vitamins B and C
Dilute with sterile water for injection
Prevention of nausea and vomiting associated with anesthesia: Inject IV/IM/SC 30-60 minutes before anticipated induction of anesthesia
Prevention of motion sickness: Inject IM 1 hour before anticipated exposure to motion
Store at room temperature; protect from light
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