Hyoscine butylbromide

Anticholinergic·Gastrointestinal - IBD & Antidiarrhoeals

Biliary colic, renal colic, IBS cramping, palliative control of respiratory secretions

PBSANTISPASMODICBuscopan10 mg tabletS4+1

Max Dose

100 mg/day

Half-life

5 h

BBB Penetration

POOR

Glaucoma

CONTRAIND.

Rapid Summary

Overview

A peripherally acting antimuscarinic (anticholinergic) agent. Rapidly relaxes smooth muscle in the GI and genitourinary tracts. Superb for colicky pain.

Maximum Dose

Max 100 mg/day.

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.

Formulation & Access

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).

Indications & Use

Primary

PBSTGA

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.

Quick reference

Class & Role

Anticholinergic — A peripherally acting antimuscarinic (anticholinergic) agent.

Route / Formulation

Tablets (10 mg). (Buscopan)

Usual Dose & Max

PO 10-20 mg QID. Max 100 mg/day.

Key Indication Doses

GI / Biliary / Renal Colic: PO 10-20 mg QID. Acute Severe Colic: IV / IM 20 mg STAT. May repeat after 30 mins if needed. Max 100 mg/day. Palliative Care (Secretions): SC / IV 20 mg q4h PRN, or continuous subcutaneous infusion to dry up 'death rattle'.

Best Uses

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.

Avoid / Cautions

Untreated narrow-angle glaucoma, mechanical GI obstruction, myasthenia gravis, paralytic ileus, severe tachycardia. Pregnancy Category B2.

Key Risks

Cardiovascular: Tachycardia (blocks vagal tone to the heart). Ocular: Acute angle-closure glaucoma (pupil dilation blocks drainage). Gastrointestinal: Dry mouth, worsening of constipation/ileus. Genitourinary: Urinary retention (especially in BPH).

Key Interactions

Additive anticholinergic effects with TCAs, antipsychotics, and antihistamines.

Monitoring

Check HR before giving IV. Do not push IV if HR > 110 bpm as it will induce severe tachycardia. No specific routine laboratory tests required.

Clinical Pearl

Do NOT confuse Hyoscine Butylbromide (Buscopan) with Hyoscine Hydrobromide (Kwells/Scopoderm). Hydrobromide crosses the blood-brain barrier and causes profound sedation/delirium. Butylbromide stays peripheral.

Access

Buscopan10 mg tablet

Brand: Buscopan
Formulation: Tablets (10 mg)

Hyoscine butylbromide

Anticholinergic·Gastrointestinal - IBD & Antidiarrhoeals

Biliary colic, renal colic, IBS cramping, palliative control of respiratory secretions

PBSANTISPASMODICBuscopan10 mg tabletS4+1

Max Dose

100 mg/day

Half-life

5 h

BBB Penetration

POOR

Glaucoma

CONTRAIND.

Rapid Summary

Overview

A peripherally acting antimuscarinic (anticholinergic) agent. Rapidly relaxes smooth muscle in the GI and genitourinary tracts. Superb for colicky pain.

Maximum Dose

Max 100 mg/day.

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.

Formulation & Access

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).

Indications & Use

Primary

PBSTGA

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.

Quick reference

Class & Role

Anticholinergic — A peripherally acting antimuscarinic (anticholinergic) agent.

Route / Formulation

Tablets (10 mg). (Buscopan)

Usual Dose & Max

PO 10-20 mg QID. Max 100 mg/day.

Key Indication Doses

Best Uses

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.

Avoid / Cautions

Untreated narrow-angle glaucoma, mechanical GI obstruction, myasthenia gravis, paralytic ileus, severe tachycardia. Pregnancy Category B2.

Key Risks

Key Interactions

Additive anticholinergic effects with TCAs, antipsychotics, and antihistamines.

Monitoring

Check HR before giving IV. Do not push IV if HR > 110 bpm as it will induce severe tachycardia. No specific routine laboratory tests required.

Clinical Pearl

Access

Buscopan10 mg tablet

Brand: Buscopan
Formulation: Tablets (10 mg)