▶BY TRANSDERMAL APPLICATION
▶Child 1 month–2 years: 250 micrograms every 72 hours,
dose equates to a quarter patch
▶Child 3–9 years: 500 micrograms every 72 hours, dose
equates to a half patch
▶Child 10–17 years: 1 mg every 72 hours, dose equates to
one patch
Excessive respiratory secretion (in palliative care)
▶BY SUBCUTANEOUS INJECTION, OR BY INTRAVENOUS INJECTION
▶Child: 10 micrograms/kg every 4 – 8 hours (max. per
dose 600 micrograms)
▶BY CONTINUOUS SUBCUTANEOUS INFUSION, OR BY
INTRAVENOUS INFUSION
▶Child: 40 – 60 micrograms/kg over 24 hours
Bowel colic pain in palliative care
▶BY MOUTH USING SUBLINGUAL TABLETS
▶Child: 10 micrograms/kg 3 times a day (max. per dose
300 micrograms), asKwells®.
Premedication
▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR
INJECTION
▶Child 1–11 years: 15 micrograms/kg (max. per dose
600 micrograms), to be administered 30 – 60 minutes
before induction of anaesthesia
▶Child 12–17 years: 200 – 600 micrograms, to be
administered 30 – 60 minutes before induction of
anaesthesia
▶BY INTRAVENOUS INJECTION
▶Child 1–11 years: 15 micrograms/kg (max. per dose
600 micrograms), to be administered immediately
before induction of anaesthesia
▶Child 12–17 years: 200 – 600 micrograms, to be
administered immediately before induction of
anaesthesialUNLICENSED USENot licensed for use in excessive
respiratory secretions or hypersalivation associated with
clozapine therapy.
IMPORTANT SAFETY INFORMATION
Antimuscarininc drugs used for premedication to
general anaesthesia should only be administered by, or
under the direct supervision of, personnel experienced
in their use.lCAUTIONSEpilepsy
CAUTIONS, FURTHER INFORMATION
▶Anticholinergic syndrome
▶With systemic useIn some children hyoscine may cause the
central anticholinergic syndrome (excitement, ataxia,
hallucinations, behavioural abnormalities, and
drowsiness).
lINTERACTIONS→Appendix 1 : hyoscine
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Common or very commonSkin reactions
SPECIFIC SIDE-EFFECTS
▶Common or very common
▶With transdermal useEye disorders.eyelid irritation.
myopia
▶Rare or very rare
▶With transdermal useConcentration impaired.
disorientation.glaucoma.hallucinations.memory loss.
restlessness
▶Frequency not known
▶With oral useAsthma.cardiovascular disorders.central
nervous system stimulation.gastrointestinal disorder.
hallucination.hypersensitivity.hyperthermia.
hypohidrosis.mydriasis.oedema.respiratory tract
reaction.restlessness.sedation.seizure
▶With parenteral useAgitation.angle closure glaucoma.
arrhythmias.delirium.dysphagia.dyspnoea.epilepsy
exacerbated.hallucination.hypersensitivity.
idiosyncratic drug reaction.loss of consciousness.
mydriasis.neuroleptic malignant syndrome.photophobia
.psychotic disorder.thirst
▶With transdermal useBalance impaired
lPREGNANCYUse only if potential benefit outweighs risk.
Injection may depress neonatal respiration.
lBREAST FEEDINGAmount too small to be harmful.
lHEPATIC IMPAIRMENTUse with caution.
lRENAL IMPAIRMENTUse with caution.
lDIRECTIONS FOR ADMINISTRATION
▶With transdermal usePatchapplied to hairless area of skin
behind ear; if less than whole patch requiredeithercut
with scissors along full thickness ensuring membrane is
not peeled awayorcover portion to prevent contact with
skin.
▶With oral useFor administration bymouth, injection
solution may be given orally.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
chewable tablet formulations may include raspberry.
Palliative careFor further information on the use of
hyoscine hydrobromide in palliative care, see
http://www.palliativedrugs.com/formulary/en/hyoscine-
hydrobromide.html.
lPATIENT AND CARER ADVICE
▶With transdermal useExplain accompanying instructions to
patient and in particular emphasise advice to wash hands
after handling and to wash application site after removing,
and to use one patch at a time.
Driving and skilled tasks▶With transdermal useDrowsiness
may persist for up to 24 hours or longer after removal of
patch; effects of alcohol enhanced.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Hyoscine hydrobromide (Non-proprietary)
Hyoscine hydrobromide 300 microgramHyoscine hydrobromide
300 microgram tablets| 12 tabletpsDT = £ 1. 67
▶Kwells(Bayer Plc)
Hyoscine hydrobromide 150 microgramKwells Kids 150 microgram
tablets| 12 tabletp£ 1. 67 DT = £ 1. 67
Hyoscine hydrobromide 300 microgramKwells 300 microgram
tablets| 12 tabletp£ 1. 67 DT = £ 1. 67
▶Travel Calm(The Boots Company Plc)
Hyoscine hydrobromide 300 microgramTravel Calm
300 microgram tablets| 12 tabletpsDT = £ 1. 67
Solution for injection
▶Hyoscine hydrobromide (Non-proprietary)
Hyoscine hydrobromide 400 microgram per 1 mlHyoscine
hydrobromide 400 micrograms/ 1 ml solution for injection ampoules|
10 ampouleP£ 25. 00 – £ 47. 21 DT = £ 47. 21
Hyoscine hydrobromide 600 microgram per 1 mlHyoscine
hydrobromide 600 micrograms/ 1 ml solution for injection ampoules|
10 ampouleP£ 53. 93 DT = £ 53. 93
Transdermal patch
CAUTIONARY AND ADVISORY LABELS 19
▶Scopoderm(GlaxoSmithKline Consumer Healthcare)
Hyoscine 1 mg per 72 hourScopoderm 1. 5 mg patches| 2 patchp
£ 12. 87 DT = £ 12. 87
Chewable tablet
CAUTIONARY AND ADVISORY LABELS2, 24
▶Joy-Rides(Forest Laboratories UK Ltd)
Hyoscine hydrobromide 150 microgramJoy-rides 150 microgram
chewable tablets sugar-free| 12 tabletp£ 1. 55BNFC 2018 – 2019 Nausea and labyrinth disorders 267
Nervous system4