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Anticholinergic·Gastrointestinal - IBD & Antidiarrhoeals
Biliary colic, renal colic, IBS cramping, palliative control of respiratory secretions
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Max Dose
100 mg/day
Half-life
5 h
BBB Penetration
POOR
High risk: Glaucoma
CONTRAIND.
Avoid / Cautions
Untreated narrow-angle glaucoma, mechanical GI obstruction, myasthenia gravis, paralytic ileus, severe tachycardia. Pregnancy Category B2.
Overview
A peripherally acting antimuscarinic (anticholinergic) agent. Rapidly relaxes smooth muscle in the GI and genitourinary tracts. Superb for colicky pain.
Clinical Focus
Because it is a quaternary ammonium compound, it does NOT cross the blood-brain barrier, making it completely free of the delirium/sedation seen with central anticholinergics.
Bottom Line
Hyoscine butylbromide is a first-line antispasmodic for abdominal and renal colic, but does not cross the blood-brain barrier (no central sedation) and is contraindicated in bowel obstruction.
Brand Names
Buscopan
Oral Routes
Tablets (10 mg).
Parenteral
Ampoule (20 mg/1 mL) for IV, IM, or SC.
Prescribing & PBS
Pharmacy Medicine (S2 PO). Prescription (S4 Ampoules).
Primary
Biliary colic, renal colic, IBS cramping, palliative control of respiratory secretions.
Clinical Place
First-line for acute smooth muscle spasms. Outstanding for drying excessive terminal respiratory secretions.
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