L Hyoscyamine

L Hyoscyamine Brand Names

Anaspaz | A-Spas S/L | Colidrops Pediatric | Colytrol Pediatric | Cystospaz 

What is L Hyoscyamine

L Hyoscyamine is an oral and parenteral tertiary amine anticholinergic gastrointestinal agent. It is one of the optical isomers of atropine (dl-hyoscyamine). 

L hyoscyamine possesses all of the antimuscarinic activity; d-hyoscyamine essentially has no peripheral antimuscarinic activity.

Hyoscyamine has been used as adjunct therapy in the management of peptic ulcer disease, hypermotility disorders of the lower urinary tract, infant colic, and as a preoperative medication to control salivation and excessive secretions.

As with other antimuscarinic agents, there are no conclusive data from well-controlled studies that indicate that hyoscyamine aids in the healing, decreases the rate of occurrence, or prevents complications of peptic ulcers; more effective agents are available.

Other indications for which hyoscyamine is FDA approved but have been replaced by more effective agents include biliary tract disorders, cystitis, and severe allergic rhinitis.

Hyoscyamine has been available since before 1938. An orally disintegrating tablet was approved July 2000.

Indications

  1. aspiration prophylaxis
  2. bradycardia
  3. cholinesterase inhibitor-induced muscarinic effects prophylaxis
  4. duodenal ulcer
  5. gastric ulcer
  6. irritable bowel syndrome
  7. organophosphate insecticide toxicity
  8. radiographic examination

To control gastric secretion, visceral spasm, and hypermotility in spastic colitis, spastic bladder, cystitis, pylorospasm, and associated abdominal cramps; as adjunctive therapy in gastrointestinal disorders (e.g., duodenal ulcer, gastric ulcer, and irritable bowel syndrome) as well as neurogenic bladder and bowel disturbances; to reduce symptoms in mild dysenteries, diverticulitis, and acute enterocolitis; to treat infant colic; for relief of symptoms of acute allergic rhinitis or acute vasomotor rhinitis; for use as an antidote for poisoning by anticholinesterase agents; and to reduce rigidity and tremors of parkinsonism

Side Effects

  1. anhidrosis
  2. blurred vision
  3. confusion
  4. constipation
  5. cycloplegia
  6. dizziness
  7. drowsiness
  8. dysgeusia
  9. dyspepsia
  10. dysphagia
  11. flushing
  12. headache
  13. ileus
  14. impotence (erectile dysfunction)
  15. insomnia
  16. lactation suppression
  17. mydriasis
  18. nausea
  19. palpitations
  20. photophobia
  21. psychosis
  22. sinus tachycardia
  23. urinary retention
  24. urticaria
  25. vomiting
  26. weakness
  27. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • ambient temperature increase
  • anticholinergic medications
  • autonomic neuropathy
  • bladder obstruction
  • bleeding
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • children
  • contact lenses
  • coronary artery disease
  • driving or operating machinery
  • dysentery
  • esophagitis
  • fever
  • gastroenteritis
  • gastroesophageal reflux disease (GERD)
  • geriatric
  • GI obstruction
  • glaucoma
  • heart failure
  • hepatic disease
  • hiatal hernia
  • hyperthyroidism
  • ileus
  • infants
  • mitral stenosis
  • myasthenia gravis
  • neonates
  • pregnancy
  • prostatic hypertrophy
  • pseudomembranous colitis
  • psychosis
  • pulmonary disease
  • renal disease
  • renal impairment
  • tachycardia
  • toxic megacolon
  • ulcerative colitis
  • urinary tract obstruction

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Aclidinium
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albuterol; Ipratropium
  • Alfentanil
  • Alosetron
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amantadine
  • Ambenonium Chloride
  • Amoxapine
  • Antacids
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Oxycodone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Botulinum Toxins
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Butorphanol
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlorcyclizine
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Cholinergic agonists
  • Cisapride
  • Clemastine
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crofelemer
  • Cyclizine
  • Cyclobenzaprine
  • Cyproheptadine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Donepezil
  • Donepezil; Memantine
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Edrophonium
  • Eluxadoline
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Ezogabine
  • Fentanyl
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluticasone; Umeclidinium; Vilanterol
  • Galantamine
  • Glucagon
  • Glycopyrronium
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Haloperidol
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Ipratropium
  • Itraconazole
  • Levocetirizine
  • Levodopa
  • Levorphanol
  • Linaclotide
  • Loperamide
  • Loperamide; Simethicone
  • Loxapine
  • Lubiprostone
  • Lurasidone
  • Macimorelin
  • Magnesium Hydroxide
  • Maprotiline
  • Meclizine
  • Memantine
  • Meperidine
  • Meperidine; Promethazine
  • Methacholine
  • Methadone
  • Metoclopramide
  • Mirtazapine
  • Molindone
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Neostigmine
  • Nitrofurantoin
  • Olanzapine
  • Omeprazole; Sodium Bicarbonate
  • Orphenadrine
  • Oxycodone
  • Oxymorphone
  • Paroxetine
  • Pentazocine
  • Pentazocine; Naloxone
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Physostigmine
  • Potassium
  • Pramlintide
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Proton pump inhibitors
  • Pyridostigmine
  • Quetiapine
  • Quinidine
  • Rasagiline
  • Remifentanil
  • Revefenacin
  • Rivastigmine
  • Secretin
  • Sedating H1-blockers
  • Sincalide
  • Sodium Bicarbonate
  • Solifenacin
  • Sufentanil
  • Tacrine
  • Tapentadol
  • Tegaserod
  • Thiazide diuretics
  • Thioridazine
  • Thiothixene
  • Tiotropium
  • Tiotropium; Olodaterol
  • Tolterodine
  • Topiramate
  • Tramadol
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimethobenzamide
  • Triprolidine
  • Trospium
  • Umeclidinium
  • Umeclidinium; Vilanterol
  • Zonisamide