Agents | Adult dose |
Glycopyrrolate (glycopyrronium)[1,2]
| 0.1 to 0.2 mg SubQ or IV every 4 to 6 hours as needed or 0.1 to 0.2 mg SubQ or IV once; followed after 30 minutes by continuous SubQ or IV continuous infusion of 0.6 to 1.2 mg over 24 hours or 0.1 mg sublingual every 6 hours as needed (may use 0.5 mL per dose of commercially available 0.2 mg/mL oral solution) |
Scopolamine transdermal patch | Apply one patch (each delivers 1 mg scopolamine base over 3 days) behind ear for up to 72 hours; if needed for more than 72 hours, remove old patch and place new one behind other ear. |
Scopolamine (hyoscine¶) BUTYLbromide[2-4]
Refer to NOTE | 20 mg SubQ or IV every 4 to 6 hours as needed (maximum 100 mg daily) or 20 mg SubQ or IV once; followed after 30 minutes by SubQ or IV continuous infusion of 20 to 60 mg over 24 hours |
Methscopolamine bromide | 2.5 mg orally every 6 hours as needed |
Scopolamine (hyoscine¶) HYDRObromide[1-3] Parenteral formulation is not available in United States; an oral preparation may be available from a compounding pharmacy Least preferred alternative due to CNS adverse effects (refer to NOTE) | 0.4 mg SubQ every 4 to 6 hours as needed or 0.4 mg SubQ once followed by SubQ continuous infusion of 1.2 mg over 24 hours |
CNS: central nervous system; IV: intravenous; SubQ: subcutaneous.
* Also known as "death rattle." Anticholinergic (antimuscarinic) effects may contribute to patient discomfort (eg, dryness, urinary retention) and do not dry secretions already present. Refer to UpToDate content on palliative care in last hours and days of life for guidance on use and limitations of anticholinergic therapy.
¶ Scopolamine is also known as "hyoscine" in many countries.Data from: UpToDate Lexidrug. More information available at https://online.lexi.com/.
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