hyoscyamine spray (Rx)

Brand and Other Names:IBStat
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

oral spray

  • 0.125 mg/mL (0.125 mg/spray)

Excessive Gastric Secretion

1-2 oral sprays (0.125-0.25 mg) q4hr PRN, not to exceed 12 sprays/day

Other Indications & Uses

Peptic ulcer disease, abdominal cramps, spastic bladder, cystitis, pylorospasm, IBS, biliary and renal colic, urinary incontinence, Parkinsonism, acute rhinitis, sialorrhea, hyperhidrosis, cholinergic poisoning

Heat prostration may be caused due to suppression of sweating

Dosage Forms & Strengths

oral spray

  • 0.125 mg/mL (0.125 mg/spray)

Excessive Gastric Secretion

<12 years: Safety and efficacy not established

12 years or older: 1-2 oral sprays (0.125-0.25 mg) q4hr PRN, not to exceed 12 sprays/day

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

Excessive gastric secretion: 1-2 oral sprays (0.125-0.25 mg) q4hr PRN, not to exceed 12 sprays/day

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Interactions

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              Serious - Use Alternative (7)

              • glucagon

                glucagon increases toxicity of hyoscyamine spray by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glucagon intranasal

                glucagon intranasal increases toxicity of hyoscyamine spray by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, hyoscyamine spray. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • pramlintide

                pramlintide, hyoscyamine spray. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

              • revefenacin

                revefenacin and hyoscyamine spray both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

              • secretin

                hyoscyamine spray decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.

              • umeclidinium bromide/vilanterol inhaled

                hyoscyamine spray, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Concomitant use with other anticholinergic-containing drugs may lead to additive anticholinergic adverse effects.

              Monitor Closely (97)

              • abobotulinumtoxinA

                abobotulinumtoxinA increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

              • aclidinium

                hyoscyamine spray and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amantadine

                hyoscyamine spray, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

              • amitriptyline

                hyoscyamine spray and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amoxapine

                hyoscyamine spray and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • aripiprazole

                aripiprazole increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

              • atracurium

                atracurium and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine

                atropine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna alkaloids

                belladonna alkaloids and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna and opium

                hyoscyamine spray and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • benperidol

                benperidol increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              • benztropine

                benztropine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • bethanechol

                bethanechol increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • buprenorphine, long-acting injection

                buprenorphine, long-acting injection increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of buprenorphine with anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • carbachol

                carbachol increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • cevimeline

                cevimeline increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • chlorpromazine

                chlorpromazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • cisatracurium

                cisatracurium and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clomipramine

                hyoscyamine spray and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clozapine

                clozapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

              • cyclizine

                cyclizine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • cyclobenzaprine

                cyclobenzaprine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • darifenacin

                darifenacin and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • desipramine

                hyoscyamine spray and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • dicyclomine

                dicyclomine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • donepezil

                donepezil increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • dosulepin

                hyoscyamine spray and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • doxepin

                hyoscyamine spray and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • droperidol

                droperidol increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              • echothiophate iodide

                echothiophate iodide increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • fesoterodine

                fesoterodine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • flavoxate

                flavoxate and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • fluphenazine

                fluphenazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • galantamine

                galantamine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • glycopyrrolate

                glycopyrrolate and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • glycopyrrolate inhaled

                glycopyrrolate inhaled and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • haloperidol

                haloperidol increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

              • henbane

                henbane and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • homatropine

                homatropine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • huperzine A

                huperzine A increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • iloperidone

                iloperidone increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              • imipramine

                hyoscyamine spray and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ipratropium

                hyoscyamine spray and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • levodopa

                hyoscyamine spray, levodopa. Other (see comment). Use Caution/Monitor. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

              • lofepramine

                hyoscyamine spray and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • loxapine

                loxapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

              • loxapine inhaled

                loxapine inhaled increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

              • maprotiline

                hyoscyamine spray and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • meclizine

                hyoscyamine spray and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • methscopolamine

                hyoscyamine spray and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • metoclopramide intranasal

                hyoscyamine spray will decrease the level or effect of metoclopramide intranasal by Other (see comment). Use Caution/Monitor. Coadministration of metoclopramide intranasal with drugs that impair GI motility may decrease systemic absorption of metoclopramide. Monitor for reduced therapeutic effect.

              • neostigmine

                neostigmine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • nortriptyline

                hyoscyamine spray and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • olanzapine

                olanzapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

              • oliceridine

                hyoscyamine spray increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

              • onabotulinumtoxinA

                onabotulinumtoxinA and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • orphenadrine

                hyoscyamine spray and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin

                hyoscyamine spray and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin topical

                hyoscyamine spray and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin transdermal

                hyoscyamine spray and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • paliperidone

                paliperidone increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              • pancuronium

                hyoscyamine spray and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • perphenazine

                perphenazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • physostigmine

                physostigmine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pilocarpine

                pilocarpine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pilocarpine ophthalmic

                pilocarpine ophthalmic increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pimozide

                pimozide increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

              • prabotulinumtoxinA

                hyoscyamine spray, prabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • pralidoxime

                hyoscyamine spray and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • prochlorperazine

                prochlorperazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • promethazine

                promethazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • propantheline

                hyoscyamine spray and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • protriptyline

                hyoscyamine spray and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • pyridostigmine

                pyridostigmine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • quetiapine

                quetiapine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

              • rapacuronium

                hyoscyamine spray and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • rimantadine

                hyoscyamine spray, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

              • risperidone

                risperidone increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

              • rivastigmine

                rivastigmine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • rocuronium

                hyoscyamine spray and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • scopolamine

                hyoscyamine spray and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • solifenacin

                hyoscyamine spray and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • succinylcholine

                succinylcholine increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • thioridazine

                thioridazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • thiothixene

                thiothixene increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

              • tiotropium

                hyoscyamine spray and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • tolterodine

                hyoscyamine spray and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trazodone

                hyoscyamine spray and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trifluoperazine

                trifluoperazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              • trihexyphenidyl

                hyoscyamine spray and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trimipramine

                hyoscyamine spray and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trospium chloride

                hyoscyamine spray and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • umeclidinium bromide

                umeclidinium bromide and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents

              • vecuronium

                hyoscyamine spray and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ziprasidone

                ziprasidone increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                hyoscyamine spray decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                hyoscyamine spray decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

              Minor (4)

              • dimenhydrinate

                dimenhydrinate increases toxicity of hyoscyamine spray by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              • donepezil

                donepezil decreases effects of hyoscyamine spray by pharmacodynamic antagonism. Minor/Significance Unknown.

              • galantamine

                galantamine decreases effects of hyoscyamine spray by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rimantadine

                rimantadine increases effects of hyoscyamine spray by pharmacodynamic synergism. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Headache

              Nervousness

              Blurred vision

              Cycloplegia/mydriasis

              Increased IOP

              Tachycardia

              Urinary retention

              Xerostomia

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              Warnings

              Contraindications

              Glaucoma, obstructive uropathy, GI obstruction, myasthenia gravis, toxic megacolon, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis

              Cautions

              Autonomic neuropathy, hiatal hernia, reflux esophagitis, renal dz, hyperthyroidism, tachyarrhythmia, CHF, salivary secretion disorder, BPH

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: excreted in breast milk, use caution (may suppress lactation)

              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 ACh at parasympathetic sites in smooth muscle, secretory glands, and CNS

              Pharmacokinetics

              Absorption: rapid & complete

              Half-Life: 2-3.5 hr

              Protein Bound: 50%

              Metabolism: Partially hydrolyzed to tropic acid & tropine

              Excretion: Urine

              Vd

              • Adults: 1.2-1.9 L/kg
              • Children 3.5-16 yo: 1.1-3.7 L/kg
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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Oscimin oral
              -
              0.125 mg tablet
              Ed-Spaz oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.375 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.375 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg tablet
              hyoscyamine sulfate oral
              -
              0.125 mg/5 mL elixir
              hyoscyamine sulfate oral
              -
              0.125 mg/mL drops
              Levsin oral
              -
              0.125 mg tablet
              Levbid oral
              -
              0.375 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              hyoscyamine sulfate sublingual
              -
              0.125 mg tablet
              Symax-SR oral
              -
              0.375 mg tablet
              Symax-SL sublingual
              -
              0.125 mg tablet
              Hyosyne oral
              -
              0.125 mg/5 mL elixir
              Hyosyne oral
              -
              0.125 mg/mL drops
              Symax Duotab oral
              -
              0.125 mg-0.25 mg (0.375 mg) tablet
              NuLev oral
              -
              0.125 mg tablet
              Anaspaz oral
              -
              0.125 mg tablet
              Levsin/SL sublingual
              -
              0.125 mg tablet
              Symax Fastabs oral
              -
              0.125 mg tablet

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              Patient Handout

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              Patient Education
              hyoscyamine sulfate oral

              HYOSCYAMINE ELIXIR - ORAL

              (hi-oh-SYE-uh-meen)

              COMMON BRAND NAME(S): Hyosyne, Levsin

              USES: Hyoscyamine is used to treat a variety of stomach/intestinal problems such as cramps, infant colic, and irritable bowel syndrome. It is also used to treat other conditions such as bladder and bowel control problems, cramping pain caused by kidney stones and gallstones, and Parkinson's disease. In addition, it is used to decrease side effects of certain medications (drugs used to treat myasthenia gravis) and insecticides.This medication works by decreasing acid production in the stomach, slowing down the natural movements of the gut, and relaxing muscles in many organs (such as the stomach, intestines, bladder, kidney, gallbladder). Hyoscyamine also lessens the amount of certain body fluids (such as saliva, sweat). This medication belongs to a class of drugs known as anticholinergics/antispasmodics.

              HOW TO USE: Take this medication by mouth as prescribed, usually 30-60 minutes before meals, or as directed by your doctor. Measure the dose out carefully with a medication spoon/cup.Dosage is based on your medical condition and response to therapy. In children, the dosage is also based on weight. Do not increase your dose or take it more often than prescribed without consulting your doctor. Adults and children 12 years and older should not take more than 1.5 milligrams in 24 hours. Children aged 2 to 12 years should not take more than 0.75 milligrams in 24 hours. Ask your doctor or pharmacist for more information.Antacids lower the absorption of hyoscyamine. If you use antacids, take them after meals and take hyoscyamine before meals; or take antacids at least 1 hour after taking hyoscyamine.Drink plenty of fluids while taking this medication unless your doctor directs you otherwise.Inform your doctor if your condition persists or worsens.

              SIDE EFFECTS: Dizziness, drowsiness, blurred vision, dry mouth, headache, trouble sleeping, constipation, flushing, dry skin, and decreased sweating may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (e.g., confusion, unusual excitement), fast/irregular heartbeat, difficulty urinating, decreased sexual ability, loss of coordination, trouble speaking, vomiting.Get medical help right away if you have any very serious side effects, including: eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night).A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking hyoscyamine, tell your doctor or pharmacist if you are allergic to it; or to atropine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: personal or family history of glaucoma (angle-closure type), enlarged prostate, urinary blockage problems, certain stomach/intestinal problems (e.g., slow gut, blockage, severe ulcerative colitis, infection), heart problems due to severe bleeding.Before using this medication, tell your doctor or pharmacist your medical history, especially of: overactive thyroid, other heart problems (e.g., coronary heart disease, congestive heart failure, fast heartbeat, arrhythmias), high blood pressure, kidney disease, heartburn problems (acid reflux, hiatal hernia), certain nervous system problem (autonomic neuropathy), myasthenia gravis.Contact lens wearers may need to use wetting eye drops since this medication can cause dry eyes.This medication may contain alcohol. Caution is advised if you have alcohol dependence or liver disease. Ask your doctor or pharmacist about the safe use of this product.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This drug may increase the risk for heatstroke because it decreases sweating. Avoid becoming overheated in hot weather, saunas, and during exercise or other strenuous activity.Older adults may be more sensitive to the side effects of this drug, especially confusion, drowsiness, unusual excitement, constipation, and difficulty urinating. Confusion and drowsiness can increase the risk of falling.Children may be more sensitive to the effects of this drug.During pregnancy, hyoscyamine should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: certain anti-arrhythmic drugs (e.g., disopyramide, quinidine), anticholinergic drugs (e.g., atropine, glycopyrrolate, scopolamine), antispasmodic drugs (e.g., clidinium, dicyclomine, propantheline), certain anti-Parkinson's drugs (e.g., trihexyphenidyl), certain azole anti-fungal drugs (ketoconazole, itraconazole), belladonna alkaloids, bisphosphonate drugs (e.g., alendronate, risedronate), corticosteroids (e.g., prednisone), digoxin (slow-dissolving tablets), MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), potassium tablets/capsules, pramlintide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include hot/dry skin, fever, unusual excitement, fast/irregular heartbeat, seizures.

              NOTES: Do not share this medication with others.Management of digestive disorders may include lifestyle changes such as stress reduction programs, exercise, stopping smoking, and dietary changes to increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              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.
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              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
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              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
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              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.