Other Names/Brands

Scopoderm, Kwells, Transderm Scop, and Scopamin

Mechanism of Action

Hyoscine hydrobromide works by blocking the action of acetylcholine, a neurotransmitter involved in signal transmission between nerves and muscles, particularly in the parasympathetic nervous system. This medication suppresses the activity of the vomiting center in the brain and reduces smooth muscle movement in the gastrointestinal tract, effectively relieving nausea, vomiting, and motion sickness symptoms, as well as reducing muscle spasms in the gastrointestinal tract.

Indications

Hyoscine hydrobromide is indicated for the treatment of nausea and vomiting, particularly those caused by motion sickness. It is also used to relieve spasms or cramps in the gastrointestinal tract, such as those caused by irritable bowel syndrome or colic. Injectable form, hyoscine hydrobromide is sometimes used preoperatively to reduce saliva production or as a mild sedative.

Contraindications

Hyoscine hydrobromide is contraindicated in patients with a history of hypersensitivity to this medication or any of its components. It should also not be used in patients with angle-closure glaucoma, as it may increase intraocular pressure.

Other contraindications include gastrointestinal obstruction, paralytic ileus, urinary retention due to prostate disorders, and myasthenia gravis. Use in children, pregnant women, or breastfeeding women should be undertaken with extreme caution and under medical supervision.

Side Effects

Hyoscine hydrobromide can cause several side effects, primarily related to its anticholinergic activity. Common side effects include dry mouth, blurred vision, dizziness, drowsiness, and constipation.

In some people, this medication can also cause urinary retention, palpitations, or confusion, especially in the elderly. In rare cases, allergic reactions such as rash or shortness of breath may occur. Long-term use or high doses require monitoring to prevent excessive systemic effects.

Preparations

Hyoscine hydrobromide is available in various dosage forms to suit medical needs. Common dosage forms include oral tablets, lozenges, injections, and transdermal patches applied behind the ear.

Tablets are typically used for the prevention and treatment of motion sickness, while the injectable form is more commonly used in healthcare settings for specific indications such as gastrointestinal spasms or as premedication before surgery. Transdermal patches provide a slow release of medication and last up to 72 hours, making them suitable for long-term motion sickness prevention.

Dosage

The dosage of hyoscine hydrobromide varies depending on the dosage form, the patient's age, and the indication for use.

• For the prevention of motion sickness in adults, the usual oral dose is 300 to 600 micrograms, taken approximately 30 minutes before travel, and may be repeated every 6 to 8 hours if needed, but not exceeding the maximum daily dose.
• In children, the dose should be adjusted and administered with caution. For the transdermal patch, typically one patch (containing 1.5 mg) is used every 72 hours.
• The injectable dose is administered in a medical facility under the supervision of a healthcare professional. Always follow your doctor's instructions or the information on the medication package.

Safety of Drugs

Hyoscine hydrobromide is classified as pregnancy category C by the FDA, meaning animal studies have shown adverse effects on the fetus, but there are no controlled studies in humans. Therefore, its use during pregnancy is recommended only if the potential benefits outweigh the potential risks to the fetus.

Furthermore, because this drug passes into breast milk, its use in nursing mothers should be considered with caution. Always consult a doctor before using this medication during pregnancy or breastfeeding.

Drug Interactions

Hyoscine hydrobromide can interact with various other drugs that have a depressant effect on the central nervous system, such as alcohol, tranquilizers, antihistamines, and antidepressants, increasing drowsiness or sedation.

Interactions can also occur with other anticholinergic drugs, which can exacerbate side effects such as dry mouth, constipation, or visual disturbances. Concomitant use with drugs such as metoclopramide or domperidone, which increase gastrointestinal motility, can reduce the effectiveness of each other.

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