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hyoscyamine (Anaspaz, Levsin)

Tradenames: Levsin, Levsinex. Indications: - adjunctive therapy in the management of hypermotility disorders of the lower GI tract - irritable bowel syndrome, diarrhea - infant colic - preoperative medication to inhibit salivation & excessive secretions of the respiratory tract - sialorrhea - drying agent in the symptomatic relief of acute rhinitis - urinary incontinence, neurogenic bladder [4] - treatment of anticholinesterase toxicity, muscarine toxicity - sinus bradycardia [4] Contraindications: 1) angle-closure glaucoma 2) obstructive uropathy 3) obstructive GI tract disease 4) myasthenia gravis 5) hypersensitivity to Belladonna alkaloids Dosage: 0.125-0.25 mg PO/SL TID/QID. Tabs: 0.125 mg. Elixir: 0.125 mg/5 mL. Sustained-release: (Levsinex timecaps) 0.375-0.75 mg PO every 12 hours. Tabs: 0.375 mg. Take 30-60 minutes before a meal. Pharmacokinetics: 1) well distributed throughout the body 2) readily crosses blood brain barrier 3) elimination 1/2life a) 3.5 hours (immediate release) b) 9 hours (extended release) c) prolonged in patients with renal insufficiency 4) metabolized by the liver 5) excreted in the urine unchanged & as metabolites Adverse effects: 1) common (> 10%) - decreased sweating - dry mouth, nose, throat or skin - irritation at the site of injection 2) less common (1-10%) - constipation, difficulty swallowing, blurred vision, photosensitivity, mydriasis 3) uncommon (< 1%) - rash, increased intraocular pressure, orthostatic hypotension, difficult urination, headache, lightheadedness, loss of memory, palpitations, fatigue, tremor, delirium, restlessness, ataxia 4) other - drowsiness - dizziness Mechanism of action: 1) one of the optical isomers of atropine 2) not fully understood 3) may act as a non-selective smooth muscle relaxant 4) little or no anti-muscarinic activity, except at high dose

Interactions

drug interactions drug adverse effects of parasympatholytics

General

antispasmodic antiulcer agent atropine (Atropair, Atropine-Care)

Properties

KINGDOM: plant MISC-INFO: elimination route LIVER KIDNEY 1/2life 3.5 HOURS 9 HOURS pregnancy-category C safety in lactation -

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Deprecated Reference

Component-of

atropine/attapulgite/hyoscyamine/scopolamine (Donnagel) atropine/belladonna/hyoscyamine/phenobarbital/scopolamine (Donnatal) atropine/benzoic acid/hyoscyamine/methenamine/methylene blue/phenyl salicylate atropine/chlorpheniramine/hyoscyamine/pseudoephedrine/scopolamine atropine/hyoscyamine/phenobarbital/scopolamine atropine/hyoscyamine/scopolamine benzoate/hyoscyamine/methenamine/methylene blue/phenyl salicylate benzoic acid/hyoscyamine/methenamine/methylene blue/phenyl salicylate butabarbital/hyoscyamine/phenazopyridine chlorpheniramine/hyoscyamine/phenylephrine/phenylpropanolamine/scopolamine chlorpheniramine/hyoscyamine/phenylephrine/scopolamine chlorpheniramine/hyoscyamine/pseudoephedrine/scopolamine citrate/hyoscyamine citrate/hyoscyamine/phenyltoloxamine hyoscyamine/methenamine/methylene blue/phenyl salicylate hyoscyamine/methenamine/methylene blue/phenyl salicylate/salicylate/sodium phosphate hyoscyamine/methenamine/methylene blue/phenyl salicylate/sodium phosphate hyoscyamine/methenamine/methylene blue/salicylate hyoscyamine/methenamine/methylene blue/salicylate/sodium phosphate hyoscyamine/methenamine/methylene blue/sodium phosphate hyoscyamine/phenobarbital/scopolamine hyoscyamine/phenylephrine/pseudoephedrine/scopolamine hyoscyamine/phenyltoloxamine hyoscyamine/scopolamine