A-Z Drug Facts > Hyoscyamine Sulfate

Hyoscyamine Sulfate

Pronouncation: (hye-oh-SYE-a-mean)
Class: Belladonna alkaloid

Trade Names:
Anaspaz
- Tablets 0.125 mg

Trade Names:
Cystospaz
- Tablets 0.125 mg

Trade Names:
Donnamar
- Tablets 0.125 mg

Trade Names:
ED-SPAZ
- Tablets 0.125 mg

Trade Names:
Gastrosed
- Tablets 0.125 mg
- Solution 0.125 mg/mL

Trade Names:
Levbid
- Tablets, extended-release 0.375 mg

Trade Names:
Levsin
- Tablets 0.125 mg
- Elixir 0.125 mg/5 mL
- Injection 0.5 mg/mL

Trade Names:
Levsin Drops
- Solution 0.125 mg/mL

Trade Names:
Levsin/SL
- Tablets, sublingual 0.125 mg

Trade Names:
Levsinex Timecaps
- Capsules, timed-release 0.375 mg

Trade Names:
NuLev
- Tablets, orally-disintegrating 0.125 mg

Pharmacology

Inhibits the action of acetylcholine on structures innervated by postganglionic cholinergic nerves and on smooth muscles. These receptors are located in the autonomic effector cells of the smooth muscle, cardiac muscle, sinoatrial node, atrioventricular node, and exocrine glands. Inhibits GI propulsive motility and decreases gastric acid secretion. Controls excessive pharyngeal, tracheal, and bronchial secretions.

Indications and Usage

To control gastric secretion, visceral spasm, hypermotility in spastic colitis, spastic bladder, cystitis, pylorospasm, and associated abdominal cramps; to reduce symptoms of functional intestinal disorders such as those seen with mild dysentery, diverticulitis, and acute enterocolitis; treatment of infant colic; as a “drying” agent in rhinitis; to reduce rigidity and tremors, and to control sialorrhea and hyperhidrosis of Parkinson disease; with morphine or other narcotics for symptomatic relief of biliary and renal colic; poisoning by anticholinesterase agents; adjunct in treatment of peptic ulcer, irritable bowel syndrome, functional GI disorders, neurogenic bladder, and neurogenic bowel disturbances; preoperative to reduce secretions; block cardiac vagal inhibitory reflexes during anesthesia induction and intubation.

Contraindications

Glaucoma; obstructive uropathy; obstructive disease of the GI tract; paralytic ileus; intestinal atony in the elderly or debilitated; unstable CV status in acute hemorrhage; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; myasthenia gravis.

Dosage and Administration

Adults

PO 0.125 to 0.25 mg every 4 h or as needed orally or sublingually (max, 12 tablets per 24 h), 0.375 to 0.75 mg in sustained-release form every 12 h (max, 4 tablets in 24 h).

Children (2 to 12 yr of age)

PO ( 1/ 2 to 1 tablet) 0.0625 to 0.125 mg every 4 h or as needed (max, 6 tablets per 24 h), 0.25 to 1 tsp (0.031 to 0.125 mg) of 0.125 mg/5 mL solution every 4 h or as needed (max, 12 mL in 24 h).

Children (2 yr of age and younger)

PO Dosing of 0.125 mg/mL drops (as based on body weight) every 4 h or as needed (max, 6 doses in 24 h) is:

Children's Dosing in Relation to Body Weight Body weight Usual dosage 2.3 kg (5 lb) 3 drops 3.4 kg (7.5 lb) 4 drops 5 kg (11 lb) 5 drops 7 kg (15 lb) 6 drops 10 kg (22 lb) 0.25 tsp (0.031 mg) or 8 drops 15 kg (33 lb) 11 drops 20 kg (44 lb) 0.5 tsp (0.063 mg) 40 kg (88 lb) 0.75 tsp (0.094 mg) 50 kg (110 lb) 1 tsp (0.125 mg) Adult

Subcutaneous / IM / IV 0.25 to 0.5 mg 2 to 4 times daily as needed.

Drug Interactions

Antacids

Antacids may interfere with absorption of hyoscyamine.

Antimuscarinics, such as amantadine, haloperidol, phenothiazines, MAOIs, tricyclic antidepressants, and some antihistamines

Additive anticholinergic effect when used with these drugs.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Headache; nervousness; drowsiness; weakness; dizziness; confusion, insomnia; fever; excitability; restlessness; tremor; speech disturbance.

Cardiovascular

Palpitations; tachycardia.

Dermatologic

Allergic reactions; urticaria; rash; flushing.

EENT

Nasal congestion; altered taste; mydriasis; cycloplegia; blurred vision; increased ocular tension.

GI

Xerostomia; nausea; vomiting; dysphagia; heartburn constipation, bloated feeling; paralytic ileus.

Genitourinary

Urinary hesitancy and retention; impotence.

Miscellaneous

Suppressed lactation; decreased sweating.

Precautions

Pregnancy

Category C .

Lactation

Excreted in human milk.

Children

Use cautiously in infants.

Special Risk Patients

Use cautiously in patients with autonomic neuropathy, hyperthyroidism, coronary artery disease, CHF, cardiac arrhythmias, tachycardia, hypertension, renal disease, and hiatal hernia associated with reflux esophagitis.

Drug-induced psychosis

Drug-induced psychosis has been reported in sensitive patients.

Diarrhea

Diarrhea may be an early sign of intestinal obstruction; hyoscyamine treatment would be inappropriate.

Heat prostration

Heat prostration may occur at high environmental temperatures.

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