Dosing & Uses
Dosage Forms & Strengths
transdermal patch
- 1mg/72hr
Nausea & Vomiting
Treatment
0.3-0.65 mg IV/IM/SC; repeat q6-8hr if necessary
Motion Sickness
Prophylaxis
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
Prophylaxis
Transdermal patch
- 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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (13)
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and scopolamine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine subdermal implant
buprenorphine subdermal implant and scopolamine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine transdermal
buprenorphine transdermal and scopolamine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and scopolamine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- glucagon
glucagon increases toxicity of scopolamine 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 scopolamine 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. .
- macimorelin
scopolamine, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that may blunt the growth hormone (GH) response to macrimorelin may impact the accuracy of the diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.
- metoclopramide intranasal
scopolamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- olopatadine intranasal
scopolamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- pramlintide
pramlintide, scopolamine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and scopolamine both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- secretin
scopolamine 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
scopolamine, 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 (111)
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- aclidinium
scopolamine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- acrivastine
acrivastine and scopolamine both increase sedation. Use Caution/Monitor.
- amantadine
scopolamine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.
- amisulpride
amisulpride and scopolamine both increase sedation. Use Caution/Monitor.
- amitriptyline
scopolamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
scopolamine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- aripiprazole
scopolamine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - asenapine
asenapine and scopolamine both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and scopolamine both increase sedation. Use Caution/Monitor.
- atracurium
atracurium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- avapritinib
avapritinib and scopolamine both increase sedation. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
scopolamine decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benztropine
benztropine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- bethanechol
bethanechol increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexanolone
brexanolone, scopolamine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and scopolamine both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and scopolamine both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and scopolamine both increase sedation. Use Caution/Monitor.
- carbachol
carbachol increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cenobamate
cenobamate, scopolamine. Either increases effects of the other by sedation. Use Caution/Monitor.
- cevimeline
cevimeline increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
scopolamine decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cisatracurium
cisatracurium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clomipramine
scopolamine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clozapine
scopolamine decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclizine
cyclizine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- daridorexant
scopolamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- desipramine
scopolamine and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dicyclomine
dicyclomine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- difelikefalin
difelikefalin and scopolamine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- donepezil
donepezil increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
scopolamine and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxepin
scopolamine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- droperidol
scopolamine decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, scopolamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- fesoterodine
fesoterodine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
flavoxate and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fluphenazine
scopolamine decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - galantamine
galantamine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ganaxolone
scopolamine and ganaxolone both increase sedation. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
scopolamine decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
henbane and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine
hyoscyamine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
scopolamine decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
scopolamine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ipratropium
ipratropium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.
- lasmiditan
lasmiditan, scopolamine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant will increase the level or effect of scopolamine by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- lofepramine
scopolamine and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- loxapine
scopolamine decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
scopolamine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - lurasidone
lurasidone, scopolamine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
scopolamine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclizine
meclizine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methscopolamine
methscopolamine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, scopolamine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- neostigmine
neostigmine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
scopolamine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- olanzapine
scopolamine decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - onabotulinumtoxinA
onabotulinumtoxinA and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- orphenadrine
scopolamine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin
oxybutynin and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- paliperidone
scopolamine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
pancuronium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- perphenazine
scopolamine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - physostigmine
physostigmine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
scopolamine decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pralidoxime
pralidoxime and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- prochlorperazine
scopolamine decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
scopolamine decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
propantheline and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- protriptyline
scopolamine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
scopolamine decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rapacuronium
rapacuronium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- risperidone
scopolamine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rocuronium
rocuronium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- solifenacin
scopolamine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- stiripentol
stiripentol, scopolamine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- succinylcholine
succinylcholine increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
scopolamine decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
scopolamine decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
scopolamine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tolterodine
scopolamine and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trazodone
scopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trifluoperazine
scopolamine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trihexyphenidyl
scopolamine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimipramine
scopolamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trospium chloride
scopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- umeclidinium bromide
umeclidinium bromide and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. If possible, avoid coadministration of additional anticholinergic agents
- vecuronium
scopolamine and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ziprasidone
scopolamine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
scopolamine decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (4)
- dimenhydrinate
dimenhydrinate increases toxicity of scopolamine by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of scopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of scopolamine by pharmacodynamic antagonism. Minor/Significance Unknown.
- levodopa
scopolamine, levodopa. Other (see comment). Minor/Significance Unknown. 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. .
Adverse Effects
>10%
Dry mouth (29-67%)
Drowsiness (17%)
Dizziness (12%)
Blurred vision
Frequency Not Defined
Disorientation
Confusion
Pruritus and edema at application site
Anticholinergic effects
Dilation of pupil if drug contacts eye
Withdrawal symptoms (eg, dizziness, nausea and vomiting) if used for >3 days
Warnings
Contraindications
Hypersensitivity to scopolamine, belladonna alkaloids, or any component in formulation
Closed-angle glaucoma
Cautions
Use caution in patients with 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
Avoid use in patients with severe preeclampsia
May cause CNS depression; caution when operating heavy machinery or tasks which require mental alertness
May cause psychiatric and cognitive effects, seizures and impair mental and/or physical abilities; monitor patients for new or worsening psychiatric symptoms during treatment and during concomitant treatment with other drugs that are associated with similar psychiatric effects
Monitor for increased intraocular pressure in patients with open-angle glaucoma and adjust glaucoma therapy as needed; discontinue if signs or symptoms of acute angle closure glaucoma develop or if patient experiences unusual visual disturbances or pain within the eye
Avoid contact with 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
Consider more frequent monitoring during treatment in patients suspected of having intestinal obstruction; patients with pyloric obstruction, urinary bladder neck obstruction or receiving other anticholinergic drugs; discontinue if patient develops difficulty in urination
Anticholinergic symptoms may occur 24 hours or more after removal of transdermal system
Drug interferes with gastric secretion test
Remove transdermal system prior to MRI scan
Pregnancy & Lactation
Pregnancy
Data from observational studies and postmarketing reports have not identified a drug associated risk of major birth defects, miscarriage, or adverse fetal outcomes; avoid use of in pregnant women with severe preeclampsia because eclamptic seizures have been reported after exposure to scopolamine
Animal data
- In animal studies, showed no evidence of adverse developmental effects with intravenous administration in rats; embryotoxicity was observed in rabbits at intravenous doses producing plasma levels approximately 100 times the levels achieved in humans using transdermal system
Lactation
Drug is present in human milk; there are no available data on effects of scopolamine on breastfed infant or effects on milk production; because there have been no consistent reports of adverse events in breastfed infants over decades of use, developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from treatment or from underlying maternal condition
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.Pharmacology
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
Absorption
Onset: IM, 0.5-1 hr; IV, 10 min
Duration: IM, 4-6 hr; IV, 2 hr
Peak plasma time: 24 hr (transdermal)
Metabolism
Metabolized by liver (via conjugation)
Elimination
Half-life: 9.5 hr
Excretion: Primarily urine (90% as metabolites)
Administration
IV Incompatibilities
Alkalies, methohexital
IV Compatibilities
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
IV Preparation
Dilute with sterile water for injection
IV/IM Administration
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
Storage
Store at room temperature; protect from light
Images
Formulary
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