Hyoscine

Related Terms

Alkaloid, angel's trumpet, anisodamine, anisodine, Atropa belladonna, atropine, Barbidonna?, Barophen?, belladonna, belladonna drugs, Belladonnae folium, Belladonnae radix, Bellatal?, black henbane, bromhidrato de escopolamina (Spanish), burrachero (Spanish - Colombia), Buscopan?, corkwood tree, Datura inoxia, deadly nightshade, Donnagel?, Donnapectolin-PG?, Donnapine?, Donna-Sed?, Donnatal?, Donphen?, Duboisia myoporoides, Ficus septica Burm.f. (Moraceae), henbane, hydrobromide, hyoscine, hyoscine hydrobromide, hyoscyamine, Hyoscyamus, Hyoscyamus niger (henbane), Hyosophen?, ioscina bromidrato (Italian), Isopto? hyoscine, Kapectolin-PG?, Kinesed?, levo-duboisine, Malatal?, maldemar tablets, methylscopolamine, moonflower, Murocoll-2?, nightshade family, Polyalthia microtus Miq. (Annonaceae), Popowia odoardi Diels (Annonaceae), Scop?, Scopace?, scopace tablets, Scopine tropate?, scopolamine bromhydrate, scopolamine hydrobromide, scopolamine hydrobromidum, scopolamine ophthalmicops, Scopolia, Scopolia carniolica, Scopolia root, Scopoliae, Spaslin?, Spasmolin?, Spasmophen?, Spasquid?, Susano?, Transderm Scop? Patch, Transderm-V?.
Selected combination products: Twilight Sleep (morphine and scopolamine). Some older formulations of Percodan? and some European brands of methadone injectable fluid contain scopolamine hydrobromide.

Background

Scopolamine (also called hyoscine) occurs naturally in belladonna plants, such as henbane (Hyoscyamus niger) and deadly nightshade (Atropa belladonna). Scopolamine is available as a prescription drug and has many effects in the body, including decreasing the secretion of stomach fluids, preventing nausea, slowing digestive action of the stomach and intestines, and dilating the pupils. Traditionally, belladonna preparations have been used as both poisons and remedies.
Scopolamine patches placed behind the ear, which deliver a relatively low dose at a constant rate over three days, provide a convenient delivery system with fewer side effects than scopolamine taken by mouth or injected. The most common adverse effects associated with scopolamine are dry mouth, dizziness, drowsiness, and blurred vision. A nasal spray has been tested, and eyedrops are in use.
Due to its effectiveness against seasickness, scopolamine is commonly used by sailors and scuba divers. The U.S. National Aeronautics and Space Administration (NASA) Reduced Gravity Office (RGO) uses scopolamine alone and in combination with dextroamphetamine to treat motion sickness symptoms during test flights.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


There is sufficient evidence to support the use of scopolamine applied to the skin in preventing motion sickness.

 A


There is sufficient evidence to support the use of scopolamine applied to the skin in preventing motion sickness.

 A


When combined with morphine, scopolamine is useful for premedication for surgery or diagnostic procedures and was widely used in obstetrics in the past. The mixture also produces amnesia and a tranquilized state known as "twilight sleep."

 B


When combined with morphine, scopolamine is useful for premedication for surgery or diagnostic procedures and was widely used in obstetrics in the past. The mixture also produces amnesia and a tranquilized state known as "twilight sleep."

 B


There is conflicting evidence from available research to support the use of scopolamine in the treatment of nausea after various surgeries.

 B


There is conflicting evidence from available research to support the use of scopolamine in the treatment of nausea after various surgeries.

 B


Despite a limited number of properly organized studies, it seems that the use of scopolamine in the treatment of drooling has a sound physiological basis.

 B


Despite a limited number of properly organized studies, it seems that the use of scopolamine in the treatment of drooling has a sound physiological basis.

 B


Antispasmodic properties of scopolamine have been shown in preliminary research. Additional studies are needed.

 C


Antispasmodic properties of scopolamine have been shown in preliminary research. Additional studies are needed.

 C


There is insufficient evidence to support the use of scopolamine in the management of cough induced by drugs that act as angiotensin-converting enzyme (ACE) inhibitors.

 C


There is insufficient evidence to support the use of scopolamine in the management of cough induced by drugs that act as angiotensin-converting enzyme (ACE) inhibitors.

 C


Scopolamine has been used in the past to treat addiction to drugs such as heroin and cocaine. Currently, there is insufficient evidence to recommend scopolamine as medication in this condition.

 C


Scopolamine has been used in the past to treat addiction to drugs such as heroin and cocaine. Currently, there is insufficient evidence to recommend scopolamine as medication in this condition.

 C


In several small trials, scopolamine applied to the skin failed to affect pulmonary function and symptoms of reversible airway obstruction. Currently, there is insufficient evidence to support the use of scopolamine for this condition.

 C


In several small trials, scopolamine applied to the skin failed to affect pulmonary function and symptoms of reversible airway obstruction. Currently, there is insufficient evidence to support the use of scopolamine for this condition.

 C


There is not sufficient evidence to recommend scopolamine alone or in combination with tacrine for Alzheimer's disease. High-quality research in humans is required.

 C


There is not sufficient evidence to recommend scopolamine alone or in combination with tacrine for Alzheimer's disease. High-quality research in humans is required.

 C


Previous research suggests that intramuscular scopolamine prevents dreams or remembering dreams in healthy young women undergoing surgery with propofol-nitrous oxide anesthesia. More research is needed in this area.

 C


Previous research suggests that intramuscular scopolamine prevents dreams or remembering dreams in healthy young women undergoing surgery with propofol-nitrous oxide anesthesia. More research is needed in this area.

 C


Although scopolamine has been reported to have antidepressant effects, the evidence in this area is conflicting. High-quality research in humans is required.

 C


Although scopolamine has been reported to have antidepressant effects, the evidence in this area is conflicting. High-quality research in humans is required.

 C


There is insufficient evidence to support the use of scopolamine in the treatment of biliary colic (pain associated with inflammation of the gallbladder or gallstones).

 C


There is insufficient evidence to support the use of scopolamine in the treatment of biliary colic (pain associated with inflammation of the gallbladder or gallstones).

 C


There is insufficient evidence to support the use of scopolamine for bowel conditions. More research is needed in this area.

 C


There is insufficient evidence to support the use of scopolamine for bowel conditions. More research is needed in this area.

 C


There is insufficient evidence to support the use of scopolamine in the treatment of bronchial asthma. More research is needed in this area.

 C


There is insufficient evidence to support the use of scopolamine in the treatment of bronchial asthma. More research is needed in this area.

 C


Scopolamine is frequently given to patients dying in the hospice during the final 24 hours, although there is not high-quality clinical evidence supporting this use.

 C


Scopolamine is frequently given to patients dying in the hospice during the final 24 hours, although there is not high-quality clinical evidence supporting this use.

 C


Currently, there is insufficient evidence to support the use of scopolamine in the treatment of dizziness. High-quality research in humans is required.

 C


Currently, there is insufficient evidence to support the use of scopolamine in the treatment of dizziness. High-quality research in humans is required.

 C


There is insufficient evidence to support the use of scopolamine for the treatment of otitis media (ear infection) in children. More research is needed in this area.

 C


There is insufficient evidence to support the use of scopolamine for the treatment of otitis media (ear infection) in children. More research is needed in this area.

 C


Evidence to support the use of scopolamine for the prevention of fainting is lacking. Additional research is needed.

 C


Evidence to support the use of scopolamine for the prevention of fainting is lacking. Additional research is needed.

 C


There is insufficient evidence to support the use of scopolamine in the treatment of recurrent throbbing headache. More research is needed in this area.

 C


There is insufficient evidence to support the use of scopolamine in the treatment of recurrent throbbing headache. More research is needed in this area.

 C


There is insufficient evidence to recommend the routine use of a low dose of scopolamine for myocardial infarction (heart attack) patients. High-quality research in humans is required.

 C


There is insufficient evidence to recommend the routine use of a low dose of scopolamine for myocardial infarction (heart attack) patients. High-quality research in humans is required.

 C


Currently, there is insufficient evidence to support the use of scopolamine in treating chronic heart failure. More research is needed in this area.

 C


Currently, there is insufficient evidence to support the use of scopolamine in treating chronic heart failure. More research is needed in this area.

 C


Currently, there is insufficient evidence to support the use of scopolamine in the treatment of high blood pressure. More research is needed.

 C


Currently, there is insufficient evidence to support the use of scopolamine in the treatment of high blood pressure. More research is needed.

 C


There is insufficient evidence to support the use of scopolamine in the routine treatment of an abnormally slow heartbeat. High-quality research in humans is required.

 C


There is insufficient evidence to support the use of scopolamine in the routine treatment of an abnormally slow heartbeat. High-quality research in humans is required.

 C


There is conflicting preliminary evidence as to whether scopolamine is effective in the management of irritable bowel syndrome. More research is needed.

 C


There is conflicting preliminary evidence as to whether scopolamine is effective in the management of irritable bowel syndrome. More research is needed.

 C


Scopolamine shows promising results for use in labor and delivery. However, further studies are needed before conclusions can be made about its safety and effectiveness.

C


Scopolamine shows promising results for use in labor and delivery. However, further studies are needed before conclusions can be made about its safety and effectiveness.

C


Although several studies demonstrate that scopolamine affords significant pain relief for those with kidney stones, several other drugs appear to be superior to scopolamine. More high-quality research in humans is required.

 C


Although several studies demonstrate that scopolamine affords significant pain relief for those with kidney stones, several other drugs appear to be superior to scopolamine. More high-quality research in humans is required.

 C


There is insufficient scientific evidence supporting the effectiveness of scopolamine in treating people with involuntary movements caused by antipsychotic drugs. High-quality research in humans is required.

 C


There is insufficient scientific evidence supporting the effectiveness of scopolamine in treating people with involuntary movements caused by antipsychotic drugs. High-quality research in humans is required.

 C


The results of several studies on the effectiveness of scopolamine in the treatment of peptic ulcer are conflicting. Currently, there is insufficient evidence to recommend the use of scopolamine as routine medication for this condition.

 C


The results of several studies on the effectiveness of scopolamine in the treatment of peptic ulcer are conflicting. Currently, there is insufficient evidence to recommend the use of scopolamine as routine medication for this condition.

 C


Because scopolamine's ability to cross the blood-brain barrier is better than that of atropine, it has been suggested that it should be used in patients with organophosphate poisoning who have central nervous system symptoms. Further research is needed in this area.

 C


Because scopolamine's ability to cross the blood-brain barrier is better than that of atropine, it has been suggested that it should be used in patients with organophosphate poisoning who have central nervous system symptoms. Further research is needed in this area.

 C


There is conflicting evidence concerning the use of scopolamine for the treatment of pain after laparoscopic sterilization or open prostatectomy. Further studies are needed in this area.

 C


There is conflicting evidence concerning the use of scopolamine for the treatment of pain after laparoscopic sterilization or open prostatectomy. Further studies are needed in this area.

 C


Limited research suggests that scopolamine is able to relieve anxiety and cause sedation when used as a premedicant, although with less effectiveness than other drugs. Currently, there is insufficient evidence to support the use of scopolamine for this condition.

 C


Limited research suggests that scopolamine is able to relieve anxiety and cause sedation when used as a premedicant, although with less effectiveness than other drugs. Currently, there is insufficient evidence to support the use of scopolamine for this condition.

 C


Currently, there is insufficient evidence to recommend the use of a scopolamine skin patch in the treatment of certain types of seizures. Additional research is needed in this area.

 C


Currently, there is insufficient evidence to recommend the use of a scopolamine skin patch in the treatment of certain types of seizures. Additional research is needed in this area.

 C


The results of a limited number of studies on the efficacy of a scopolamine skin patch in the treatment of overactive bladder are inconclusive. There is not sufficient evidence to recommend scopolamine as a medication for this condition.

 C


The results of a limited number of studies on the efficacy of a scopolamine skin patch in the treatment of overactive bladder are inconclusive. There is not sufficient evidence to recommend scopolamine as a medication for this condition.

 C


There is insufficient evidence from available studies to support the use of scopolamine in controlling vomiting induced by the anticancer drug cisplatin. More research is needed.

 C


There is insufficient evidence from available studies to support the use of scopolamine in controlling vomiting induced by the anticancer drug cisplatin. More research is needed.

 C


Limited research suggests that scopolamine N-butyl bromide should not be used in the treatment of gastroesophageal reflux disease (GERD).

 D


Limited research suggests that scopolamine N-butyl bromide should not be used in the treatment of gastroesophageal reflux disease (GERD).

 D
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
For refraction (a diagnostic procedure), one or two drops of scopolamine have been placed in the eye before the procedure. For uveitis and iridocyclitis (eye inflammations), one or two drops of scopolamine have been placed in the eye up to four times daily.
For abdominal pain, 60 milligrams of scopolamine-N-butylbromide has been taken by mouth daily for seven days.
As an antidepressant, intravenous doses of four micrograms of scopolamine hydrobromide per kilogram has been given in a series of three sessions, 3-5 days apart.
For bladder disorders (overactive bladder without neurological cause), scopolamine patches have been applied behind the ear and been changed every three days, for a total of four applications.
For dizziness, a Transderm-V? patch (currently named Transderm-Scop?, Ciba Pharmaceutical Co.) has been applied to the skin with a release rate of approximately 0.17 milligrams daily, for seven days. One or two patches containing 0.5 milligrams of scopolamine have been applied to the skin and replaced every three days for one week.
For fainting, a Transderm-Scop? patch (Ciba-Geigy, Palo Alto, CA) has been applied to the skin.
For heart failure (chronic), a patch of Scopoderm? TTS (unknown dose) has been applied to the skin.
For heart attack, a single transdermal therapeutic system (TTS) patch (Ciba Consumer Pharmaceuticals) has been applied behind the ear for 24 hours.
For kidney stones, a single dose of 20 milligrams of scopolamine N-butylbromide has been injected intravenously.
For labor and delivery, scopolamine butylbromide has been given intravenously once women entered active labor.
For motion sickness, one dose of 0.3 milligrams of scopolamine hydrobromide has been taken by mouth three times daily for five days; 0.6 milligrams of scopolamine has been taken by mouth every six hours; and a single dose of 0.3-0.6 milligrams of scopolamine hydrobromide has been taken by mouth. Scopolamine applied to the skin 8-12 hours before departure for the sea provided controlled delivery of 0.5-1.5 milligrams over three days. Nasal sprays containing 0.1 and 0.2% scopolamine have been tested for an unreported amount of time.
For nausea (morphine-induced), a scopolamine patch applied to the skin released a starting dose of 140 micrograms, followed by a release of five micrograms per hour over three days.
For peptic ulcer disease, 40 milligrams of scopolamine- N-butyl bromide (Buscopan?) has been taken by mouth five times daily for 10 days.
For postoperative nausea and vomiting, a scopolamine patch, such as Scopoderm? or Transderm Scop? (both delivering a loading dose of 140 micrograms and then five micrograms per hour for up to 72 hours, giving an average absorption rate of 500 micrograms over three days), has been applied the evening before surgery and kept in place for 24 hours following surgery. A patch containing a dose of 0.75 or 0.375 milligrams has been applied to the skin.
For postoperative pain, Scopoderm? (Ciba-Geigy Ltd., Basel, Switzerland), providing continuous delivery of 0.5 milligrams of scopolamine daily over three days, has been applied on the morning of the operation. Buscopan? (20 milligrams) has been given intravenously or intramuscularly at the end of surgery.
For preoperative sedation, the recommended dosage of scopolamine hydrobromide is 0.3-0.6 milligrams given intramuscularly or intravenously, 45-60 minutes prior to anesthesia.
For saliva production control, 0.02 milligrams of scopolamine hydrobromide solution per kilogram has been taken by mouth as a single dose.
For uveitis, iridocyclitis (eye inflammation), one or two drops of scopolamine were placed in the eye up to four times daily.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Scopolamine may cause high or low blood pressure. Caution is advised in patients taking other drugs that affect blood pressure.
Scopolamine may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan?) or diazepam (Valium?), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Scopolamine may also interact with agents that affect the nervous system, agents that increase movement in the stomach, alcohol, anesthetics, antidepressants, antihistamines, barbiturates, caffeine, drugs that dry up secretions, heart rate-regulating agents, hormonal agents, morphine, muscle relaxants, and potassium.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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