buscopan

Buscopan is a brand name for hyoscine butylbromide (also known as scopolamine butylbromide), a short-acting antispasmodic used to relieve painful cramps from smooth muscle spasms in the gastrointestinal and genitourinary tracts. It is a quaternary ammonium compound, which limits its penetration into the central nervous system, so central nervous system side effects are less common than with some other antimuscarinics.

Mechanism and use: Hyoscine butylbromide blocks muscarinic acetylcholine receptors on smooth muscle, reducing contractions and spasms. By relaxing the gut, biliary and urinary tract smooth muscles, it can alleviate cramping and associated pain.

Forms and availability: Buscopan is marketed in various forms, including tablets, enteric-coated tablets, injectable solutions, and suppositories. It is sold as hyoscine butylbromide in many markets, including as a Boehringer Ingelheim brand in some countries.

Indications: The primary use is the symptomatic relief of cramps due to irritable bowel syndrome, gastroenteritis, diverticular disease, biliary or renal colic, and other gastrointestinal or genitourinary tract spasms. It may be used before procedures to reduce spasms.

Contraindications and precautions: It is not suitable for people with intestinal obstruction, glaucoma, severe urinary retention, severe ulcerative colitis, or certain myasthenic conditions. Use in pregnancy and lactation only if clearly needed and after medical advice. Caution is advised in the elderly.

Adverse effects and interactions: Possible dry mouth, blurred vision, constipation, tachycardia, dizziness, or urinary retention. Because of its limited CNS penetration, central side effects are less common. Interactions can occur with other anticholinergic drugs (antihistamines, tricyclic antidepressants, some antipsychotics).