Classifications: anticholinergic; antimuscarinic agent; antispasmodic; Therapeutic: antispasmodic
Pregnancy Category: C
7.5 mg, 15 mg tablets
Similar to atropine in peripheral effects. Has potent antimuscarinic activity and ganglionic blocking action.
Decreases motility (smooth muscle tone) in the GI, biliary, and urinary tracts. Results in antispasmodic action.
Adjunct in treatment of peptic ulcer, irritable bowel syndrome, pancreatitis, ureteral and urinary bladder spasm. Also used
prior to radiologic diagnostic procedures to reduce duodenal motility.
Pregnancy (category C); narrow-angle glaucoma; tachycardia, MI; paralytic ileus, GI obstructive disease; myasthenia gravis.
Safety in children is not established.
CAD, CHF, cardiac arrhythmias; liver disease, ulcerative colitis, hiatus hernia, esophagitis; kidney disease; prostatic
hypertrophy; glaucoma; debilitated patients; hyperthyroidism; autonomic neuropathy; brain damage; Down's syndrome; spastic
Route & Dosage
|Irritable Bowel Syndrome
Adult: PO 15 mg 30 min a.c. and 30 mg h.s. (max: 120 mg/d)
Geriatric: PO 7.5 mg 23 times/d a.c. (max: 90 mg/d)
- Give 3060 min before meals and at bedtime. Advise not to chew tablet; drug is bitter.
- Give at least 1 h before or 1 h after an antacid (or antidiarrheal agent).
- Store dry powder and tablets at 15°30° C (59°86° F); protect from freezing and moisture.
Adverse Effects (≥1%)GI: Constipation, dry mouth. Special Senses:
Blurred vision, mydriasis, increased intraocular pressure. CNS:
Decreased sexual activity, difficult urination.
Decreased absorption of ketoconazole; oral potassium
may increase risk of GI ulcers. Food:
Food significantly decreases absorption.
Incompletely from GI tract. Onset:
3045 min. Duration:
46 h. Metabolism:
50% in GI tract before absorption; 50% in liver. Elimination:
Primarily in urine; some in bile. Half-Life:
Assessment & Drug Effects
- Assess bowel sounds, especially in presence of ulcerative colitis, since paralytic ileus may develop, predisposing to toxic
- Be aware that older adult or debilitated patients may respond to a usual dose with agitation, excitement, confusion, drowsiness.
Stop drug and report to physician if these symptoms are observed.
- Check BP, heart sounds and rhythm periodically in patients with cardiac disease.
Patient & Family Education
- Void just prior to each dose to minimize risk of urinary hesitancy or retention. Record daily urinary volume and report
problems to physician.
- Relieve dry mouth by rinsing with water frequently, chewing sugar-free gum or sucking hard candy.
- Maintain adequate fluid and high-fiber food intake to prevent constipation.
- Make all position changes slowly and lie down immediately if faintness, weakness, or palpitations occur. Report symptoms
- Do not drive or engage in potentially hazardous activities until response to drug is known.