Hyoscyamine sulfate
Hyoscyamine sulfate (Levsin)
Hyoscyamine sulfate
(high-oh- SIGH-ah-meen)
Pregnancy Category: C Anaspaz Cystospaz-M Espasmotex Levbid Levsin Levsinex Levsin SL Spasdel (Rx)

Classification: Cholinergic blocking agent

See Also: See also Cholinergic Blocking Agents.

Action/Kinetics: One of the belladonna alkaloids; acts by blocking the action of acetylcholine at the postganglionic nerve endings of the parasympathetic nervous system. t 1/2: 3 1/2 hr for tablets, 7 hr for extended-release capsules, and 9 hr for extended-release tablets. Majority of the drug is excreted in the urine unchanged.

Uses: To control gastric secretion, visceral spasm, and hypermotilitiy in spastic colitis, spastic bladder, cystitis, pylorospasm, and associated abdominal cramps. Adjunctive therapy to treat irritable bowel syndrome and functional GI disorders. Adjunctive therapy in neurogenic bladder and neurogenic bowel disturbances. Treat infant colic (use elixir or solution). Use with morphine or other narcotics for symptomatic relief of biliary and renal colic. In Parkinsonism to reduce rigidity and tremors and to control sialorrhea and hyperhidrosis. To treat poisoning by anticholinesterase agents. To reduce GI motility to facilitate diagnostic procedures, such as endoscopy or hypersecretion in pancreatitis. To treat selected cases of partial heart block associated with vagal activity. Used as a preoperative medication to reduce salivary, tracheobronchial, and pharyngeal secretions.

Special Concerns: Heat prostration may occur if the drug is taken in the presence of high environmental temperatures. Use with caution during lactation.

Side Effects: See Cholinergic Blocking Agents.

How Supplied: Capsule, Extended Release: 0.375 mg; Elixir: 0.125 mg/5 mL; Injection: 0.5 mg/mL; Liquid: 0.125 mg/mL; Tablet: 0.125 mg; Tablet, Extended Release: 0.375 mg.

Dosage
?Extended-Release Capsules (0.375 mg) or Extended-Release Tablets (0.375 mg)
Adults and children over 12 years of age: 0.375-0.750 mg q 12 hr, not to exceed 1.5 mg in 24 hr.
?Tablets (0.125 mg)
Adults and children over 12 years of age: 0.125-0.25 mg q 4 hr or as needed, not to exceed 1.5 mg in 24 hr.
?Elixir (0.125 mg/5 mL)
Adults and children over 12 years of age: 0.125 mg-0.25 mg (5-10 mL) q 4 hr, not to exceed 1.5 mg (60 mL) in 24 hr. Children, 2 to 12 years of age: 10 kg: 1.25 mL (0.031 mg) q 4 hr; 20 kg: 2.5 mL (0.062 mg) q 4 hr; 40 kg: 3.75 mL (0.093 mg) q 4 hr; 50 kg: 5 mL (0.125 mg) q 4 hr.
?Drops (0.125 mg/mL)
Adults and children over 12 years of age: 0.125-0.25 mg 5-10 mL q 4 hr, not to exceed 1.5 mg (12 mL) in 24 hr. Children, 2 to 12 years of age: 0.031-0.125 mg (0.251 mL)q 4 hr or as needed, not to exceed 0.75 mg (6 mL) in 24 hr. Children, under 2 years of age: 3.4 kg: 4 drops q 4 hr, not to exceed 24 drops in 24 hr; 5 kg: 5 drops q 4 hr, not to exceed 30 drops in 24 hr; 7 kg: 6 drops q 4 hr, not to exceed 36 drops in 24 hr; 10 kg: 8 drops q 4 hr, not to exceed 48 drops in 24 hr.
?Injection (0.5 mg/mL) GI disorders.
Adults: 0.25-0.5 mg (0.5-1 mL). Some clients need only one dose while others require doses 2, 3, or 4 times a day at 4 hr intervals.
Diagnostic procedures.
Adults: 0.25-0.5 mg (0.5-1 mL) given IV 5 to 10 min prior to the procedure.
Preanesthetic medication.
Adults and children over 2 years of age: 0.005 mg/kg 30-60 min prior to the time of induction of anesthesia. May also be given at the time the preanesthetic sedative or narcotic is given.
During surgery to reduce drug-induced bradycardia.
Adults and children over 2 years of age: Increments of 0.125 mg (0.25 mL) IV repeated as needed.
Reverse neuromuscular blockade.
Adults and children over 2 years of age: 0.2 mg (0.4 mL) for every 1 mg neostigmine or equivalent dose of physostigmine or pyridostigmine.