Classes
DEA Class; Rx
Common Brand Names; Transderm Scop, Scopace, Maldemar
- Antiemetic Agents
Description
Antimuscarinic, mostly used transdermally
Primarily used for the prevention of motion sickness; may be used for post-operative nausea/vomiting (PONV) or procedural sedation
High anticholinergic properties
Indications
For the treatment of nausea/vomiting.
For nausea/vomiting prophylaxis due to motion sickness.
For use in aspiration prophylaxis prior to anesthesia and intubation; for treatment of bradycardia during surgery.
For obstetric amnesia induction.
For the adjunct treatment of alcohol withdrawal (i.e., delirium tremens).
For the adjunctive treatment of mania.
Contraindications
Hypersensitivity to scopolamine, belladonna alkaloids, or any component in formulation
Closed-angle glaucoma
Adverse Effects
- Dry mouth (29-67%)
- Drowsiness (17%)
- Dizziness (12%)
- Blurred vision
- Disorientation
- Confusion
- Pruritus and edema at application site
- Anticholinergic effects
- Dilation of pupil if drug contacts eye
- Withdrawal symptoms (eg, dizziness, nausea and vomiting) if used for >3 days
Warnings
Use caution in patients with benign prostatic hyperplasia, history of seizures or psychosis, ulcerative colitis, hypertension, hyperthyroidism, Down syndrome, toxin-mediated diarrhea, coronary artery disease, tachyarrhythmia, brain damage or spastic paralysis in children, cardiac conduction disorder, CHF
Children and elderly persons are particularly susceptible to side effects of belladonna alkaloids
Anaphylaxis, including episodes of shock reported, following parenteral administration; monitor for signs and symptoms of hypersensitivity reactions
Lower doses may increase vagal tone and cause paradoxical bradycardia
Avoid use in patients with severe preeclampsia
May cause CNS depression; caution when operating heavy machinery or tasks which require mental alertness
Pregnancy and Lactation
Data from observational studies and postmarketing reports have not identified a drug associated risk of major birth defects, miscarriage, or adverse fetal outcomes; avoid use of in pregnant women with severe preeclampsia because eclamptic seizures have been reported after exposure to scopolamine
Drug is present in human milk; there are no available data on effects of scopolamine on breastfed infant or effects on milk production; because there have been no consistent reports of adverse events in breastfed infants over decades of use, developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from treatment or from underlying maternal condition
Maximum Dosage
2.4 mg/day subcutaneously/IM/IV; 8 drops/eye/day; one patch transdermally every 3 days.
2.4 mg/day subcutaneously/IM/IV; 8 drops/eye/day; one patch transdermally every 3 days.
0.6 mg/dose subcutaneously/IM/IV; 3 drops/eye/day.
7 years and older: 0.6 mg/dose subcutaneously/IM/IV; 3 drops/eye/day.
3 to 6 years: 0.3 mg/dose subcutaneously/IM/IV. 3 drops/eye/day.
1 to 2 years: 0.15 mg/dose subcutaneously/IM/IV. 3 drops/eye/day.
6 months and older: 0.15 mg/dose subcutaneously/IM/IV. 3 drops/eye/day.
How supplied
Scopolamine hydrobromide
transdermal patch
- 1mg/72hr
Intramuscular Inj Sol: 0.4mg, 1mL
Intravenous Inj Sol: 0.4mg, 1mL
Subcutaneous Inj Sol: 0.4mg, 1mL
