Transderm Scop, Transderm-V
Hyoscine, Isopto-Hyoscine, Scopace, Murocoll, Triptone
Classifications: anticholinergic; antimuscarinic; antispasmodic; antivertigo; Therapeutic: antispasmodic; antiemetic; antivertigo
Pregnancy Category: C
Scopolamine: 1.5 mg transdermal patch;
Scopolamine HBr: 0.4 mg tablets; 0.3 mg/mL, 0.4 mg/mL, 0.86 mg/mL, 1 mg/mL injection; 0.25% ophthalmic solution
Antimuscarinic agent that inhibits the action on acetylcholine (ACh) on postganglionic cholinergic nerves as well as on
smooth muscles that lack cholinergic innervation.
More potent than atropine in mydriatic and cycloplegic effects. Produces CNS depression with marked sedative and tranquilizing
effects for use in anesthesia. Effective as a preanesthetic agent to control bronchial, nasal, pharyngeal, and salivary secretions.
In obstetrics with morphine to produce amnesia and sedation ("twilight sleep") and as preanesthetic medication.
To control spasticity (and drooling) in postencephalitic parkinsonism, paralysis agitans, and other spastic states, as prophylactic
agent for motion sickness and as mydriatic and cycloplegic in ophthalmology. Therapeutic system (Transderm Scop) is used to prevent nausea and vomiting associated with motion sickness.
Hypersensitivity to anticholinergic drugs; hypersensitive to belladonna or barbiturates; asthma; hepatitis; narrow-angle
glaucoma; GI or urogenital obstructive diseases; myasthenia gravis; pregnancy (category C); toxemia of pregnancy.
Coronary heart disease, CHF, cardiac arrhythmias, tachycardia, hypertension; infants, children, Down's syndrome; patients
>40 y, pyloric obstruction, urinary bladder neck obstruction; autonomic neuropathy; angle-closure glaucoma, thyrotoxicosis,
liver disease; paralytic ileus; hiatal hernia, ulcerative colitis, gastric ulcer; older adults, parkinsonism; COPD, asthma
or allergies; hyperthyroidism; brain damage, spastic paralysis; tartrazine or sulfite sensitivity.
Route & Dosage
Adult: PO 0.40.8 mg IM/SC/IV 0.30.6 mg q46h
Child: PO/IM/SC/IV 6 mcg/kg q68h (max: 0.3 mg/dose)
Adult: Topical 1 patch q72h starting 12 h before anticipated travel
Child: PO 6 mcg/kg 1 h before anticipated travel
Adult: Ophthalmic 12 drops in eye 1 h before refraction
Adult: Ophthalmic 12 drops in eye up to q.i.d.
- Minimize possibility of systemic absorption by applying pressure against lacrimal sac during and for 1 or 2 min following
instillation of eye drops.
- Apply transdermal disc system (Transderm Scop, a controlled-release system) to dry surface behind the ear.
- Replace with another disc on another site behind the ear if disc system becomes dislodged.
PREPARE: Direct: Dilute required dose with an equal volume of sterile water for injection.
ADMINISTER: Direct: Give a single dose slowly over 23 min.
- Preserve in tight, light-resistant containers.
Adverse Effects (≥1%)Body as a Whole: Fatigue
, dizziness, drowsiness,
disorientation, restlessness, hallucinations, toxic psychosis. GI: Dry mouth and throat, constipation. Urogenital:
Urinary retention. CV:
Decreased heart rate. Special Senses:
Dilated pupils, photophobia, blurred vision, local irritation,
. Respiratory: Depressed respiration. Skin:
Local irritation from patch adhesive, rash.
InteractionsDrug: Amantadine, antihistamines
, tricyclic antidepressants
, quinidine, disopyramide, procainamide
add to anticholinergic effects; decreases levodopa
may precipitate extrapyramidal effects; decreases antipsychotic effects (decreased absorption) of phenothiazines
. Food: Grapefruit juice
(>1 qt/d) may increase plasma
concentrations and adverse effects.
Readily from GI tract and percutaneously. Peak:
2060 min. Duration:
57 d. Distribution:
Crosses placenta; distributed to CNS
In liver. Elimination:
Assessment & Drug Effects
- Observe patient closely; some patients manifest excitement, delirium, and disorientation shortly after drug is administered
until sedative effect takes hold.
- Use of side rails is advisable, particularly for older adults, because of amnesic effect of scopolamine.
- In the presence of pain, scopolamine may cause delirium, restlessness, and excitement unless given with an analgesic.
- Be aware that tolerance may develop with prolonged use.
- Terminate ophthalmic use if local irritation, edema, or conjunctivitis occur.
Patient & Family Education
- Vision may blur when used as mydriatic or cycloplegic; do not drive or engage in potentially hazardous activities until
- Place disc on skin site the night before an expected trip or anticipated motion for best therapeutic effect.
- Wash hands carefully after handling scopolamine. Anisocoria (unequal size of pupils, blurred vision can develop by rubbing
eye with drug-contaminated finger).