For You
News & Perspective
Drugs & Diseases
CME & Education
Academy
Video
Decision Point
Edition: English

Medscape

English
Deutsch
Español
Français
Português
UKNew

Univadis

Sign Up It's Free!
English Edition

Medscape

Univadis

X
Univadis from Medscape

No Results

    For You News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
    Drugs & Diseases

    hyoscyamine (Rx)

    Brand and Other Names:Levbid, Levsin, more...Anaspaz, Cystospaz, NuLev, Symax Duotab
    • Print

    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

    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

    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)

    Next:

    Interactions

    Interaction Checker

    and hyoscyamine

    No Results

       activity indicator 
      No Interactions Found
      Interactions Found

      Contraindicated

        Serious - Use Alternative

          Significant - Monitor Closely

            Minor

              All Interactions Sort By:
               activity indicator 

              Contraindicated (0)

                Serious - Use Alternative (7)

                • glucagon

                  glucagon increases toxicity of hyoscyamine 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 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. 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. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

                • revefenacin

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

                • secretin

                  hyoscyamine 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, 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 (96)

                • abobotulinumtoxinA

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

                • aclidinium

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

                • amantadine

                  hyoscyamine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

                • amitriptyline

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

                • amoxapine

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

                • anticholinergic/sedative combos

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

                • aripiprazole

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

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

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

                • atracurium

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

                • atropine

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

                • atropine IV/IM

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

                • belladonna alkaloids

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

                • belladonna and opium

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

                • benperidol

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

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

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

                • benztropine

                  benztropine and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

                • bethanechol

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

                • cevimeline

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

                • chlorpromazine

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

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

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

                • cisatracurium

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

                • clomipramine

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

                • clozapine

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

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

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

                • cyclizine

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

                • cyclobenzaprine

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

                • darifenacin

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

                • desipramine

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

                • dicyclomine

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

                • diphenhydramine

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

                • donepezil

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

                • dosulepin

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

                • doxepin

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

                • droperidol

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

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

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

                • echothiophate iodide

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

                • fesoterodine

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

                • flavoxate

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

                • fluphenazine

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

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

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

                • galantamine

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

                • glycopyrrolate

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

                • glycopyrrolate inhaled

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

                • haloperidol

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

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

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

                • henbane

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

                • homatropine

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

                • huperzine A

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

                • iloperidone

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

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

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

                • imipramine

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

                • ipratropium

                  hyoscyamine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

                • levodopa

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

                • loxapine

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

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

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

                • loxapine inhaled

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

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

                • maprotiline

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

                • meclizine

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

                • methscopolamine

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

                • metoclopramide intranasal

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

                • nortriptyline

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

                • olanzapine

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

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

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

                • oliceridine

                  hyoscyamine 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 both decrease cholinergic effects/transmission. Use Caution/Monitor.

                • orphenadrine

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

                • oxybutynin

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

                • oxybutynin topical

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

                • oxybutynin transdermal

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

                • paliperidone

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

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

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

                • pancuronium

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

                • perphenazine

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

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

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

                • physostigmine

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

                • pilocarpine

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

                • pimozide

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

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

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

                • prabotulinumtoxinA

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

                • prochlorperazine

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

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

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

                • promethazine

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

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

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

                • propantheline

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

                • protriptyline

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

                • pyridostigmine

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

                • quetiapine

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

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

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

                • rapacuronium

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

                • risperidone

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

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

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

                • rocuronium

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

                • scopolamine

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

                • solifenacin

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

                • succinylcholine

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

                • thioridazine

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

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

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

                • thiothixene

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

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

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

                • tiotropium

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

                • tolterodine

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

                • trazodone

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

                • trifluoperazine

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

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

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

                • trihexyphenidyl

                  hyoscyamine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

                • trimipramine

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

                • trospium chloride

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

                • umeclidinium bromide

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

                • vecuronium

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

                • ziprasidone

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

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

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

                • zotepine

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

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

                Minor (3)

                • dimenhydrinate

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

                • donepezil

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

                • galantamine

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

                Previous
                Next:

                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

                Previous
                Next:

                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

                Discontinue treatment if diarrhea occurs; it may be a sign of incomplete intestinal obstruction, especially in colostomy or ileostomy

                May cause drowsiness; caution patients about performing a hazardous task, like driving heavy machinery, that requires mental alertness

                Use caution in hot weather or exercise; heat prostration reported in the presence of increased environmental temperature

                Psychosis reported in patients susceptible to anticholinergic effects; usually resolved within 12-48 hr after therapy discontinuation

                Use caution in patients with hyperthyroidism, prostatic hyperplasia, renal impairment, hiatal hernia, or cardiovascular disease, including heart failure, tachyarrhythmias, hypertension, or coronary artery disease; evaluate tachycardia prior to initiating therapy

                Previous
                Next:

                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.

                Previous
                Next:

                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

                Previous
                Next:

                Images

                No images available for this drug.
                Previous
                Next:

                Patient Handout

                A Patient Handout is not currently available for this monograph.
                Previous
                Next:

                Formulary

                FormularyPatient Discounts

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

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Create Your List of Plans

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                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.

                View explanations for tiers and restrictions
                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.
                CLOSE
                Additional Offers
                CLOSE
                Email to Patient

                From:

                To:

                The recipient will receive more details and instructions to access this offer.

                By clicking send, you acknowledge that you have permission to email the recipient with this information.

                CLOSE
                Email Forms to Patient

                From:

                To:

                The recipient will receive more details and instructions to access this offer.

                By clicking send, you acknowledge that you have permission to email the recipient with this information.

                Previous
                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
                Find Us On
                About
                About Medscape Privacy Policy Editorial Policy Cookies Terms of Use Advertising Policy Help Center
                Membership
                Become a Member About You Professional Information Newsletters & Alerts
                Apps
                Medscape CME & Education
                WebMD Network
                Medscape Live Events WebMD MedicineNet eMedicineHealth RxList WebMD Corporate
                Editions
                English Deutsch Español Français Português
                All material on this website is protected by copyright, Copyright © 1994-2022 by WebMD LLC. This website also contains material copyrighted by 3rd parties.