Hyoscyamine

Related Terms

Anaspaz?, Anisodus tanguticus, anticholinergics, Atropa belladonna, atropine, belladonna, bellafolin, Cystospaz?, Cystospaz-M?, Datura stramonium, Datura wrightii, deadly nightshade, Egazil?, epoxide, Gastrosed?, henbane, hydroxyhyoscyamine, hyoscyamine beta-hydroxylase (H6H), hyoscyamine butylbromide, hyoscyamine sulfate, Hyoscyamus niger, Hyoscyamus reticulates, Hyoscyamini sulfas, Hyoscyaminum sulfuricum, iosciamina solfato (Italian), jimson weed, Levbid?, Levsin?, L-hyoscyamine, Mandragora officinarum, mandrake, scopolamine, Solanaceae (family).
Combination product examples: Belloid (hyoscyamine sulphate, ergotoxine, butabarbital), Donnatal? (atropine sulfate, hyoscyamine sulfate, phenobarbital, scopolamine hydrobromide), scopolia extract (SE) (hyoscyamine, scopolamine).
Note: This monograph does not include atropine. Atropine is a racemic mixture of D- and L-hyoscyamine.

Background

Hyoscyamine is a chemical found in certain plants of the Solanaceae family, including henbane (Hyoscyamus niger), mandrake (Mandragora officinarum), and deadly nightshade (Atropa belladonna). High amounts of hyoscyamine are present in the stems and leaves of young jimson weed (Datura stramonium) plants.
Extracts of the henbane plant containing hyoscyamine have been used for thousands of years to treat depression. The dried leaves of hyoscyamine-containing plants were smoked for the relief of acute asthma. Jimson weed, which contains high amounts of hyoscyamine, has been commonly used by Native Americans and Native Mexicans as a hallucinogen during various rituals. Hyoscyamine and other belladonna alkaloids were used to treat Parkinson's disease in the early 1900s.
Hyoscyamine has been used to relieve symptoms of various gastrointestinal disorders, including spasms, peptic ulcers, irritable bowel syndrome, pancreatitis, colic, and cystitis.
At this time, high-quality human trials supporting the use of hyoscyamine for any indication are lacking. In general, the use of hyoscyamine has been replaced by therapies with fewer adverse effects.

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 conflicting evidence from available trials to support the use of hyoscyamine to stop colon spasms during colonoscopy. Additional research is needed in this area.

 C


There is conflicting evidence from available trials to support the use of hyoscyamine to stop colon spasms during colonoscopy. Additional research is needed in this area.

 C


Some studies have found that hyoscyamine may be of use in certain diagnostic procedures involving the gastrointestinal system. Further research is needed in this area.

 C


Some studies have found that hyoscyamine may be of use in certain diagnostic procedures involving the gastrointestinal system. Further research is needed in this area.

 C


Hyoscyamine has been taken by mouth to assess its effectiveness in the reduction of abdominal discomfort and colonic spasm during a barium enema. Further research is needed in this area.

 C


Hyoscyamine has been taken by mouth to assess its effectiveness in the reduction of abdominal discomfort and colonic spasm during a barium enema. Further research is needed in this area.

 C


The ability of hyoscyamine to inhibit intestinal motility during diagnostic procedures has been studied. Further research is needed in this area.

 C


The ability of hyoscyamine to inhibit intestinal motility during diagnostic procedures has been studied. Further research is needed in this area.

 C


Topical application of Unguentum lymphaticum? (UL) (containing hyoscyamine) may be beneficial in patients with stage II postinflammatory obstructive lymphedema. Additional research is necessary in this area.

 C


Topical application of Unguentum lymphaticum? (UL) (containing hyoscyamine) may be beneficial in patients with stage II postinflammatory obstructive lymphedema. Additional research is necessary in this area.

 C


Myasthenia gravis is an autoimmune disorder of the nervous system. In limited research, treatment with hyoscyamine resulted in complete resolution of atrioventricular (AV) heart block. Additional research is needed in this area.

 C


Myasthenia gravis is an autoimmune disorder of the nervous system. In limited research, treatment with hyoscyamine resulted in complete resolution of atrioventricular (AV) heart block. Additional research is needed in this area.

 C


Combination therapy using hyoscyamine and desmopressin acetate appears safe for treating nocturnal enuresis (bedwetting) in older children who have had no success with other treatments. Additional research is needed.

 C


Combination therapy using hyoscyamine and desmopressin acetate appears safe for treating nocturnal enuresis (bedwetting) in older children who have had no success with other treatments. Additional research is needed.

 C


Chlorprothixene and intramuscular hyoscyamine given to children before anesthesia may be useful before surgery. Further research is needed in this area.

 C


Chlorprothixene and intramuscular hyoscyamine given to children before anesthesia may be useful before surgery. Further research is needed in this area.

 C


Several single and combination therapies utilizing hyoscyamine for ulcers have been used. Further research is necessary.

 C


Several single and combination therapies utilizing hyoscyamine for ulcers have been used. Further research is necessary.

 C


Anticholinergics are commonly used for the treatment of urinary frequency, urgency, and urge incontinence in elderly women. Hyoscyamine has been shown to benefit patients with this condition, but larger studies are necessary to confirm these findings.

 C


Anticholinergics are commonly used for the treatment of urinary frequency, urgency, and urge incontinence in elderly women. Hyoscyamine has been shown to benefit patients with this condition, but larger studies are necessary to confirm these findings.

 C


At this time, evidence supporting the use of hyoscyamine for ureteral colic pain is lacking.

 D


At this time, evidence supporting the use of hyoscyamine for ureteral colic pain is lacking.

 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)
It has been reported that the highest tolerable dose of L-hyoscyamine in sustained-release tablets varies from 0.4 to 2.8 milligrams every eight hours.
For colonoscopy preparation, two hyoscyamine tablets (0.125 milligrams per tablet) have been placed under the tongue and taken by mouth 10 minutes before sigmoidoscopy. A 0.25 milligram hyoscyamine spray (IB-Stat?, Inkine Pharmaceutical) has been taken by mouth under the tongue 15-30 minutes before colonoscopy. Hyoscyamine (0.25 milligrams) has been taken by mouth 20-40 minutes before colonoscopy. Hyoscyamine sulfate (0.5 milligrams; Levsin?) has been given intravenously before colonoscopy. Hyoscyamine (0.25 milligrams) has also been administered intravenously 20-40 minutes before colonoscopy.
For diagnostic procedures, 40 milligrams of hyoscyamine butylbromide has been given intravenously immediately before injection of 160 milliliters of intravenous contrast medium for helical computed tomography (CT) of the pancreas.
For enema (colon surgery preparation), a 0.125 milligram L-hyoscyamine sulfate tablet has been placed under the tongue and taken by mouth 15-30 minutes before the examination.
For gastrointestinal motility, 0.5 milligrams of L-hyoscyamine has been taken by mouth under the tongue before endoscopic retrograde cholangiopancreatography. Intravenous Levsin? has been given before endoscopic retrograde cholangiopancreatography (information on the dose is lacking).
For ulcers, L-hyoscyamine has been taken by mouth in a sustained-release form three times daily for one year at varying doses. In patients with duodenal ulcers, sustained-release L-hyoscyamine was taken by mouth at 2.7 milligrams daily without the appearance of side effects, compared to regular L-hyoscyamine tablets (1.6 milligrams daily).
For ureteral colic pain, a single dose of 0.125 milligrams of hyoscyamine sulfate has been placed under the tongue and taken by mouth.
For urinary incontinence, 0.375 milligrams of sustained-release hyoscyamine has been taken by mouth twice daily for a minimum of one month.

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
Hyoscyamine may affect blood pressure. Caution is advised in patients taking medications that also affect blood pressure.
Hyoscyamine may also interact with alcohol, aluminum, anticholinergics, anti-inflammatory agents, calcium, central nervous system depressants, cisapride, magnesium, or topiramate.

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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