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Hyoscine (Buscopan) 💊
⚠️ Do not confuse doses of Hyoscine butylbromide (Buscopan) with the much lower doses of Hyoscine hydrobromide.
📖 About
Always check the BNF links for up-to-date prescribing advice.
- 👓 Can cause blurred vision → may affect driving.
- Both are antimuscarinics (anticholinergics) but differ in sedation and clinical use.
⚙️ Mode of Action
- Blocks muscarinic receptors → ↓ parasympathetic activity.
- Effects: relaxation of smooth muscle, ↓ secretions, mydriasis, ↑ heart rate.
💊 Indications & Doses – Hyoscine Butylbromide (Buscopan)
- 🧘 Less sedative than hydrobromide.
- 💢 Bowel spasm, colic, excess secretions: 20 mg PO QDS.
- 💧 IBS: 10–20 mg PO TDS–QDS.
- ⚡ Acute spasm: 20 mg IM or slow IV, may repeat after 30 min.
- 🤲 Palliative excess secretions: 20–120 mg/24 h via SC infusion.
- 🤲 Palliative bowel colic: 60–300 mg/24 h via SC infusion.
💊 Indications & Doses – Hyoscine Hydrobromide
- 💤 More sedative than butylbromide (sometimes paradoxical agitation).
- 🤲 Palliative excess secretions: 1.2–2 mg/24 h SC infusion.
- 🤲 Palliative bowel colic: 1.2–2 mg/24 h SC infusion.
🔄 Interactions
⚠️ Cautions
- 🚗 Driving – may impair vision.
- 👴 Elderly more sensitive to confusion/drowsiness.
- 🤰 Use in pregnancy → seek specialist advice.
⛔ Contraindications
- ❤️ Tachycardia, thyrotoxicosis.
- 👨 Prostatism → risk of retention.
- 💪 Myasthenia gravis.
- 👁️ Closed-angle glaucoma.
🤒 Side Effects
- 👄 Dry mouth, ↓ secretions.
- 😴 Sedation, dizziness (more with hydrobromide).
- 👓 Blurred vision, dilated pupils.
- ❤️ Tachycardia, palpitations.
- 🚽 Urinary retention, ↓ sweating.
- 🩹 Allergic skin reactions (rare).
🧠 Teaching Pearls
💡 Buscopan (butylbromide) is widely used for bowel colic and IBS – it works peripherally and is not sedating.
💡 Hydrobromide is mainly palliative (secretions/colic), crosses the blood–brain barrier → more sedative.
👉 Exam trick: doses differ by a factor of ~100 (Buscopan mg vs Hydrobromide mcg–mg). Always double-check before prescribing.
📚 References
- BNF: Hyoscine butylbromide
- BNF: Hyoscine hydrobromide
- Katzung BG. Basic & Clinical Pharmacology, 15th Ed.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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