hyoscyamine (Anaspaz, Levsin)
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Introduction
Tradenames: Levsin, Levsinex.
Indications
- adjunctive therapy in the management of hypermotility disorders of the lower GI tract
- infant colic
- preoperative medication to inhibit salivation & excessive secretions of the respiratory tract
- drying agent in the symptomatic relief of acute rhinitis
- urinary incontinence, neurogenic bladder[4]
- treatment of anticholinesterase toxicity, muscarine toxicity
- sinus bradycardia[4]
Contraindications
- angle-closure glaucoma
- obstructive uropathy
- obstructive GI tract disease
- myasthenia gravis
- hypersensitivity to Belladonna alkaloids
Dosage
Tabs: 0.125 mg.
Sustained-release: (Levsinex timecaps) 0.375-0.75 mg PO every 12 hours. Tabs: 0.375 mg.
Take 30-60 minutes before a meal.
Pharmacokinetics
- well distributed throughout the body
- readily crosses blood brain barrier
- elimination 1/2life
- 3.5 hours (immediate release)
- 9 hours (extended release)
- prolonged in patients with renal insufficiency
- metabolized by the liver
- excreted in the urine unchanged & as metabolites
elimination via liver
elimination via kidney
1/2life = 3.5 hours
1/2life = 9 hours
Adverse effects
- common (> 10%)
- decreased sweating
- dry mouth, nose, throat or skin
- irritation at the site of injection
- less common (1-10%)
- constipation, difficulty swallowing, blurred vision, photosensitivity, mydriasis
- uncommon (< 1%)
- rash, increased intraocular pressure, orthostatic hypotension, difficult urination, headache, lightheadedness, loss of memory, palpitations, fatigue, tremor, delirium, restlessness, ataxia
- other
Mechanism of action
- one of the optical isomers of atropine
- not fully understood
- may act as a non-selective smooth muscle relaxant
- little or no anti-muscarinic activity, except at high dose
More general terms
Component of
- hyoscyamine/scopolamine
- hyoscyamine/phenylephrine/pseudoephedrine/scopolamine
- hyoscyamine/methenamine/methylene blue/sodium phosphate
- hyoscyamine/methenamine/methylene blue/phenyl salicylate/sodium phosphate
- hyoscyamine/methenamine/methylene blue/phenyl salicylate
- citrate/hyoscyamine/phenyltoloxamine
- chlorpheniramine/hyoscyamine/pseudoephedrine/scopolamine
- chlorpheniramine/hyoscyamine/phenylephrine/scopolamine
- chlorpheniramine/hyoscyamine/phenylephrine/phenylpropanolamine/scopolamine
- benzoic acid/hyoscyamine/methenamine/methylene blue/phenyl salicylate
- atropine/benzoic acid/hyoscyamine/methenamine/methylene blue/phenyl salicylate
- hyoscyamine/phenyltoloxamine
- hyoscyamine/methenamine/methylene blue/phenyl salicylate/salicylate/sodium phosphate
- benzoate/hyoscyamine/methenamine/methylene blue/phenyl salicylate
- citrate/hyoscyamine
- hyoscyamine/methenamine/methylene blue/salicylate/sodium phosphate
- butabarbital/hyoscyamine/phenazopyridine
- hyoscyamine/methenamine/methylene blue/salicylate
- hyoscyamine/phenobarbital/scopolamine
- atropine/belladonna/hyoscyamine/phenobarbital/scopolamine (Donnatal)
- atropine/attapulgite/hyoscyamine/scopolamine (Donnagel)
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 4.2 Deprecated Reference