Hyoscyamine

Hyoscyamine is a prescription medicine used for the treatment of Gastrointestinal Disorders, Hypermotility of the Lower Urinary Tract, Peptic Ulcer Disease, and Irritable Bowel Syndrome (IBS).

• Hyoscyamine is available under the following different brand names: Levbid, Levsin, Anaspaz, Cystospaz, NuLev, Symax Duotab

Adult and pediatric dosage

Capsule/tablet, extended-release

• 0.375mg

Elixir

• 0.125mg/5mL

Injection solution

• 0.5mg/mL

Oral drops

• 0.125mg/mL

Tablet

• 0.125mg

Gastrointestinal Disorders

Adult dosage

• Immediate release: 0.125-0.25 mg orally via sublingual route every 4 hours or as needed; no more than1.5 mg/day
• Extended-release: 0.375-0.75 mg orally every 12 hours; no more than 1.5 mg/day
• IM/SC/IV: 0.25-0.5 mg every 4 hours or as needed; no more than 4 times per day

Pediatric dosage

Children below 2 years (oral drops)

• Children weighing between 2.3-3.3 kg: 3 drops orally every 4 hours or as needed; no more than 18 drops/day
• Children weighing between 3.4-4 kg: 4 drops orally every 4 hours or as needed; no more than 24 drops/day
• Children weighing between 5-6 kg: 5 drops orally every 4 hours or as needed; no more than 30 drops/day
• Children weighing between 7-9 kg: 6 drops orally every 4 hours or as needed; no more than 36 drops/day
• Children weighing between 10-14 kg: 8 drops orally every 4 hours or as needed; no more than 48 drops/day
• Children weighing more than 15 kg: 11 drops orally every 4 hours or as needed; no more than 66 drops/day
• Children 2-12 years (tablet)

Immediate-release/SL: 0.0625-0.125 mg orally every 4 hours or as needed; no more than 0.75mg/day

Extended-release: 0.375 orally every 12 hours; no more than 0.75 mg/day

• Children 2-12 years (elixir)
• Children weighing between 10-19 kg: 1/4 tsp (1.25 mL) orally every 4 hours or as needed
• Children weighing between 20-39 kg: 1/2 tsp (2.5 mL) orally every 4 hours or as needed
• Children weighing between 40-49 kg: 3/4 tsp (3.75 mL) orally every 4 hours or as needed
• Children weighing more than 50 kg: 1 tsp (5 mL) orally every 4 hours or as needed
• IV/IM/SQ
• Children above 12 years:  0.025-0.5 mg every 4 hours or as needed; no more than 4 times daily

Hypermotility of Lower Urinary Tract

Adult dosage

Adjunctive treatment

• Immediate release: 0.15-0.3 mg orally via sublingual route every 6 hours
• Extended-release: 0.375 mg orally every 12 hours
• Geriatric dosage
• Immediate release: 0.125-0.25 mg orally via sublingual route every 6 hours
• Extended release: 0.375 mg orally every 12 hours

Peptic Ulcer Disease

Adult dosage

Adjunctive treatment

• 0.125-0.25 mg orally via sublingual route every 4 hours or as needed; no more than 1.5 mg/day

Irritable Bowel Syndrome

Adult dosage

Adjunctive treatment

• 0.125-0.25 mg orally via sublingual route every 4 hours or as needed; no more than 1.5 mg/day

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Hyoscyamine include:

• dizziness,
• drowsiness,
• weakness or tiredness,
• decreased sweating,
• decreased urination,
• blurred vision,
• rash,
• dry mouth,
• decreased sense of taste,
• stomach pain,
• nausea,
• vomiting,
• bloating,
• diarrhea,
• constipation,
• headache,
• sleep problems (insomnia),
• impotence,
• loss of interest in sex, and
• trouble having an orgasm.

Serious side effects of Hyoscyamine include:

• anxiety,
• confusion,
• hallucinations,
• unusual thoughts or behavior,
• weakness,
• memory problems,
• slurred speech,
• problems with balance or muscle movement,
• diarrhea, and
• pounding heartbeats or fluttering in the chest. 

Rare side effects of Hyoscyamine include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Hyoscyamine has severe interactions with no other drugs.
• Hyoscyamine has serious interactions with the following drugs:
  • glucagon
  • glucagon intranasal
  • glycopyrronium tosylate topical
  • pramlintide
  • revefenacin
  • secretin
  • umeclidinium bromide/vilanterol inhaled
• Hyoscyamine has moderate interactions with at least 96 other drugs.
• Hyoscyamine has minor interactions with the following drugs:
  • dimenhydrinate
  • donepezil
  • galantamine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to hyoscyamine or related compounds
• Closed-angle glaucoma
• Myasthenia gravis
• Hemorrhage with cardiovascular instability
• Paralytic ileus
• Intestinal atony of elderly/debilitated patient
• Obstructive uropathy
• Toxic megacolon
• GI obstruction
• Tachycardia secondary to cardiac insufficiency or thyrotoxicosis
• Breastfeeding

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Hyoscyamine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Hyoscyamine?”

Cautions

• Discontinue treatment if diarrhea occurs; it may be a sign of incomplete intestinal obstruction, especially in colostomy or ileostomy
• May cause drowsiness; caution patients about performing a hazardous task, like driving heavy machinery, that requires mental alertness
• Use caution in hot weather or exercise; heat prostration reported in the presence of increased environmental temperature
• Psychosis reported in patients susceptible to anticholinergic effects; usually resolved within 12-48 hours after therapy discontinuation
• Use caution in patients with hyperthyroidism, prostatic hyperplasia, renal impairment, hiatal hernia, or cardiovascular disease, including heart failure, tachyarrhythmias, hypertension, or coronary artery disease; evaluate tachycardia before initiating therapy

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Enters breast milk; use not recommended