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Scopolamine

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(CAS: 51-34-3)

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CAS: 51-34-3

Chemical Name: (alpha)-(hydroxymethyl) benzeneacetic acid 9-methyl-3-oxa-9-azatricyclo [3.3.1.0 2,4 ] non-7-yl ester

Formula: C17H21NO4

Structure:

What is the most important information I should know about scopolamine?

# Use caution when driving, operating machinery, or performing other hazardous activities. Scopolamine may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities.
# Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while using scopolamine.
# In rare cases, unusual reactions to ordinary doses of scopolamine have occurred including confusion, agitation, rambling speech, hallucinations, paranoid behaviors, and delusions. In the case of such a reaction, stop using scopolamine and seek medical attention.

What is scopolamine?

# Scopolamine is an anticholinergic medicine. Scopolamine has many effects in the body including decreasing the secretion of fluids, slowing the stomach and intestines, and dilation of the pupils.
# Scopolamine is used to relieve nausea, vomiting, and dizziness associated with motion sickness and recovery from anesthesia and surgery. Scopolamine may also be used in the treatment of parkinsonism, spastic muscle states, irritable bowel syndrome, diverticulitis, and other conditions.
# Scopolamine may also be used for purposes other than those listed in this medication guide.

Who should not use scopolamine?

# Do not use scopolamine without first talking to your doctor if you have
, kidney disease,
, liver disease,
, an enlarged prostate,
, difficulty urinating,
, a stomach obstruction,
, heart disease,
, bladder problems, or
, glaucoma.
# You may not be able to use scopolamine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
# Scopolamine is in the FDA pregnancy category C. This means that it is not known whether scopolamine will harm an unborn baby. Do not use scopolamine without first talking to your doctor if you are pregnant.
# It is not known whether scopolamine passes into breast milk. Do not use scopolamine without first talking to your doctor if you are breast-feeding a baby.
# Scopolamine is not recommended for use by children. Children are more sensitive to the side effects of scopolamine.
# Elderly individuals may be more likely to experience side effects from scopolamine.

How should I use scopolamine?

# Use scopolamine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
# Take each dose with a full glass of water.
# Store scopolamine at room temperature away from moisture and heat.

What happens if I miss a dose?

# Use the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and use only the next regularly scheduled dose. Do not use a double dose of this medication.

What happens if I overdose?

# Seek emergency medical attention.
# Symptoms of a scopolamine overdose include drowsiness, dizziness, agitation, fever excitability, seizures or convulsions, hallucinations, coma, and death.

What should I avoid while using scopolamine?

# Use caution when driving, operating machinery, or performing other hazardous activities. Scopolamine may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities.
# Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while using scopolamine.

What are the possible side effects of scopolamine?

# Stop using scopolamine and seek emergency medical attention or contact your doctor immediately if you experience:
, an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
, pain and redness of the eyes with dilated pupils; or
, difficulty urinating.
# In rare cases, unusual reactions to ordinary doses of scopolamine have occurred including confusion, agitation, rambling speech, hallucinations, paranoid behaviors, and delusions. In the case of such a reaction, stop using scopolamine and seek medical attention.
# Other, less serious side effects may be more likely to occur. Continue to use scopolamine and talk to your doctor if you experience
, drowsiness;
, dizziness;
, dry mouth;
, restlessness;
, blurred vision;
, dilated pupils;
, dry or itchy eyes;
, flushing; or
, fast heartbeats.
# Nausea, vomiting, dizziness, headache, and poor coordination have been reported when treatment that has lasted more than a few days is discontinued. If you use scopolamine for more than a few days, be aware that these side effects may occur when you stop.
# Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect scopolamine?

# Scopolamine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines (including meclizine), sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are using, and do not use any other prescription or over-the-counter medicines without first talking to your doctor.
# Drugs other than those listed here may also interact with scopolamine. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines.

What is the scopolamine recommend dosage?

Initiation of Therapy: To prevent the nausea and vomiting associated with motion sickness, one Transderm Scop patch (programmed to deliver approximately 1.0 mg of scopolamine over 3 days) should be applied to the hairless area behind one ear at least 4 hours before the antiemetic effect is required. To prevent post operative nausea and vomiting, the patch should be applied the evening before scheduled surgery. To minimize exposure of the newborn baby to the drug, apply the patch one hour prior to cesarean section. Only one patch should be worn at any time. Do not cut the patch.

Handling: After the patch is applied on dry skin behind the ear, the hands should be washed thoroughly with soap and water and dried. Upon removal, the patch should be discarded. To prevent any traces of scopolamine from coming into direct contact with the eyes, the hands and the application site should be washed thoroughly with soap and water and dried. (A patient brochure is available).

Continuation of Therapy: Should the patch become displaced, it should be discarded, and a fresh one placed on the hairless area behind the other ear. For motion sickness, if therapy is required for longer than 3 days, the first patch should be removed and a fresh one placed on the hairless area behind the other ear. For perioperative use, the patch should be kept in place for 24 hours following surgery at which time it should be removed and discarded.

Where can I get more information?

# Your pharmacist has more information about scopolamine written for health professionals that you may read.

REFERENCES

  1. McEvoy, G.K. (ed.); AHSF Drug Information; American Society of Hospital Pharmacists, Bethesda, MD, pp. 608-611 (1990).
  2. Gilman, A.G. et al (ed.); The pharmacological Basis of Therapeutics (8th Ed.); Pergamon Press, New York, NY, pp. 150-165 (1990).
  3. Pharmacokinetic clinical data on file.
  4. Kotelko, D.M. et al; "Transdermal scopolamine decreases nausea and vomiting following cesarean section in patients receiving epidural morphine". Anesthesiology 71(5): 675-678 (1989).
  5. Bailey, P.L. et al; "Transdermal scopolamine reduces nausea and vomiting after outpatient laparoscopy". Anesthesiology 72(6): 977-980 (1990).
  6. Clinical safety data on file.