HYOSCINE HYDROBROMIDE

Dosage Adults For pre-medication a dose of 200 to 600 micrograms is given by the subcutaneous or intramuscular route 30 to 60 minutes before induction of anaesthesia. The injection may if required also be given by the intravenous route for acute use.

Children A dose of 15 micrograms/kg is recommended in children. Elderly Hyoscine is not recommended for use in the elderly.

Many of the listed undesirable effects can be assigned to the anticholinergic properties of hyoscine. g. urticaria, rash, erythema, pruritus) and other hypersensitivity Psychiatric disorders: mental confusion or excitement, psychotic disorder, delirium, hallucinations Nervous system disorders: drowsiness, dizziness, headache, loss of consciousness, neuroleptic malignant syndrome Eye disorders: blurred vision, dilation of the pupils, with loss of accommodation, photophobia, angle-closure glaucoma Cardiac disorders: transient bradycardia, tachycardia, palpitations, arrhythmias Vascular disorders: blood pressure decreased, flushing Gastrointestinal disorders: dry mouth, constipation, nausea, vomiting, difficulty in swallowing Skin and subcutaneous tissue disorders: dyshidrosis, skin dryness Renal and urinary disorders: difficulty with micturition General disorders and administration site conditions: idiosyncratic reactions, injection site pain, particularly after intramuscular use, occurs, thirst Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard.

g. acute myocardial infarction, hypertension and conditions associated with tachycardia (including hyperthyroidism, cardiac insufficiency, and cardiac surgery)), Down's Syndrome, renal or hepatic impairment. Increased seizure frequency in epileptic patients.

Use in caution with patients with diarrhoea. Hyoscine should be used with caution in patients with ulcerative colitis as use may lead to ileus or megacolon. Hyoscine may aggravate gastro-oespophageal reflux. In case severe unexplained abdominal pain persists or worsens or occurs together with symptoms like fever, nausea, vomiting, changes in bowl movements, abdominal tenderness, decreased blood pressure, fainting or blood in stool, appropriate diagnostic measures are needed to investigate the aetiology of the symptoms.

Heat prostration can occur at high ambient temperatures, due to decreased sweating. Hyoscine should be administered with caution to patients with pyrexia. Elevation of intraocular pressure may be produced by the administration of anticholinergic agents such as hyoscine in patients with undiagnosed and therefore untreated angle-closure glaucoma.

Urgent ophthalmological advice should be sought in case patients should develop a painful, red eye with loss of vision after the injection of hyoscine. After parenteral administration of hyoscine, cases of anaphylaxis including episodes of shock have been observed.

As with all drugs causing such reactions, patients receiving hyoscine by injection should be kept under observation.

Children:

Use with caution in children as they may be more susceptible to adverse effects.

1. Hyoscine should not be administered to patients with myasthenia gravis, megacolon, angle-closure glaucoma, tachycardia, prostatic enlargement with urinary retention, gastrointestinal obstruction, mechanical stenosis in the region of the gastrointestinal tract or paralytic ileus.

Hyoscine should not be given by intramuscular injection to patients being treated with anticoagulant drugs since intramuscular haematoma may occur.