Scopolamine (scopolamine)

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Scopolamine hydrobromide is administered orally or by IM, direct IV, or subcutaneous injection. Scopolamine is administered percutaneously by topical application of a transdermal system (Transderm Scop(R)).

For direct IV administration, scopolamine hydrobromide injection should be diluted with sterile water for injection prior to administration. When given as a preoperative medication, scopolamine hydrobromide injection is given 30-60 minutes prior to the anticipated time of induction of anesthesia or at the time other preanesthetic medications (e.g., opiates, sedatives) are administered. When scopolamine hydrobromide is administered orally or IM for the prevention of motion sickness, the drug should generally be administered 1 hour (range: 0.5-1.5 hours) before anticipated exposure to motion.

When scopolamine is administered percutaneously as the transdermal system for the prevention of motion sickness, the system should be applied topically at least 4 hours (e.g., 4-24 hours) before anticipated exposure to motion.

For prevention of postoperative nausea and vomiting, transdermal scopolamine should be applied the evening before scheduled surgery. If transdermal scopolamine is used prophylactically in patients undergoing cesarean section, the drug should be applied one hour prior to surgery to minimize exposure of the fetus to the drug. Patients should be carefully instructed in the use of transdermal scopolamine. To obtain optimum results, patients also should be given a copy of the patient instructions provided by the manufacturer. The scopolamine transdermal system should not be cut, and only one transdermal system should be worn at any time.

Prior to administration of the transdermal system, the area behind the ear should be wiped with a clean, dry tissue to ensure that the area is dry. To expose the adhesive surface of the system, the clear plastic protective strip should be peeled and discarded prior to administration; finger contact with the exposed adhesive layer should be avoided to prevent contamination of the fingers with scopolamine. The transdermal system is applied topically to a dry, hairless area of skin behind the ear (postauricular) by firmly pressing the system with the adhesive side touching the skin. Patients should be warned to thoroughly wash their hands after handling (e.g., initial application, removal) the scopolamine transdermal system, since contamination of fingers and subsequent contact with the eyes may result in cycloplegia (i.e., mydriasis and blurred vision). Individuals who assist the patient in the application or removal of the transdermal system also should thoroughly wash their hands with soap and water afterwards. If the system becomes dislodged during the intended period of use (up to 72 hours), it should be removed and replaced with another system at a different postauricular site. The system is generally not affected by limited exposure to water (e.g., during bathing or swimming). Following removal of the transdermal system, the application site should be thoroughly washed with soap and water to remove any traces of scopolamine that might remain on the skin.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

Reproduction studies in rats and rabbits using IV scopolamine hydrobromide at dosages producing plasma concentrations of the drug 100 times greater than those achievable after application of the transdermal system in humans have shown a marginal embryotoxic effect in rabbits; no teratogenic effects were observed in rats. Scopolamine does not increase the duration of labor or affect uterine contractions during labor following parenteral administration; however, the drug crosses the placenta. Although one manufacturer states that adverse fetal effects have not been reported to date when scopolamine was used during labor and delivery, fetal toxicity, including tachycardia, fever, and lethargy, which responded to treatment with physostigmine, were reported in one infant following maternal administration of a total dosage of 1.8 mg of scopolamine during labor and delivery. Decreased heart rate variability and decreased heart rate deceleration also have been reported in infants of mothers who received scopolamine during labor and delivery. However, in one clinical study in women undergoing cesarean sections, adverse effects, including CNS depression, were not observed in neonates when transdermal scopolamine was used concomitantly with epidural anesthesia and opiate analgesics. There are no adequate and controlled studies to date using scopolamine in pregnant women, and the drug should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.

Scopolamine is distributed into milk. Although some manufacturers recommend that scopolamine be used with caution in nursing women, no observable change in infants associated with such exposure has been reported to date, and the American Academy of Pediatrics (AAP) considers scopolamine to be usually compatible with breast-feeding.

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