Robinul, Robinul Forte
Classifications: anticholinergic; antimuscarinic; antispasmodic; Therapeutic: gi antispasmodic
Pregnancy Category: B
1 mg, 2 mg tablets; 0.2 mg/mL injection
Synthetic anticholinergic (antimuscarinic) compound with pharmacologic effects similar to those of atropine. Inhibits muscarinic
action of acetylcholine on autonomic neuroeffector sites innervated by postganglionic cholinergic nerves.
Inhibits motility of GI tract and genitourinary tract and decreases volume of gastric and pancreatic secretions, saliva, and
Adjunctive management of peptic ulcer and other GI disorders associated with hyperacidity, hypermotility, and spasm. Also
used parenterally as preanesthetic and intraoperative medication and to reverse neuromuscular blockade.
Glaucoma; asthma; prostatic hypertrophy, obstructive uropathy; obstructive lesions or atony of GI tract; achalasia; severe
ulcerative colitis; myasthenia gravis; BPH; urinary tract obstruction; during cyclopropane anesthesia; neonates <1 mo.
Autonomic neuropathy, hepatic or renal disease; cardiac arrhythmias; pregnancy (category B), lactation.
Route & Dosage
Adult: PO 1 mg t.i.d or 2 mg b.i.d. or t.i.d. in equally divided intervals (max: 8 mg/d), then decrease to 1 mg b.i.d. IM/IV 0.10.2 mg 34 times/day
Reversal of Neuromuscular Blockade
Adult/Child: IV 0.2 mg administered with 1 mg of neostigmine or 5 mg pyridostigmine
Child: PO 40100 mcg/kg t.i.d.q.i.d. IM 410 mcg/kg q34h
Adult: IM 4 mcg/kg 3060 min before procedure
- Give without regard to meals.
- Give undiluted, deep into a large muscle.
PREPARE: Direct: Give undiluted. ??Inspect for cloudiness and discoloration. Discard if present.
ADMINISTER: Direct: Give 0.2 mg or fraction thereof over 12 min.
INCOMPATIBILITIES Solution/additive: Chloramphenicol, dexamethasone, diazepam, dimenhydrinate, methohexital, methylprednisolone, pentazocine, phenobarbital, secobarbital, sodium bicarbonate, thiopental. Y-site: Propofol.
- Store at 20°25° C (68°77° F).
Adverse Effects (≥1%)Body as a Whole: Decreased sweating,
Dizziness, drowsiness, overdosage (neuromuscular blockade
with curare-like action leading to muscle weakness and paralysis
is possible). CV:
Palpitation, tachycardia. GI: Xerostomia, constipation
. GU: Urinary hesitancy or retention
. Special Senses:
Blurred vision, mydriasis.
Interactions Drug: Amantadine, antihistamines
, tricyclic antidepressants
, quinidine, disopyramide, procainamide
compound anticholinergic effects; decreases levodopa
may precipitate extrapyramidal effects; decreases antipsychotic effects (decreased absorption) of phenothiazines
Poorly and incompletely absorbed from GI tract. Onset:
1 min IV; 1530 min IM/SC; 1 h PO. Peak:
3045 min IM/SC; 1 h PO. Duration:
27 h IM/SC; 812 h PO. Distribution:
Crosses placenta. Metabolism:
Minimally in liver. Elimination:
85% in urine. Half-Life:
3070 min (adult), 2099 min (child), 20120 min (infant).
Assessment & Drug Effects
- Incidence and severity of adverse effects are generally dose related.
- Monitor I&O ratio and pattern particularly in older adults. Watch for urinary hesitancy and retention.
- Monitor vital signs, especially when drug is given parenterally. Report any changes in heart rate or rhythm.
Patient & Family Education
- Avoid high environmental temperatures (heat prostration can occur because of decreased sweating).
- Do not drive or engage in other potentially hazardous activities requiring mental alertness until response to drug is known.
- Use good oral hygiene, rinse mouth with water frequently and use a saliva substitute to lessen effects of dry mouth.