Scopolamine

Products

Scopolamine is currently sold in many countries exclusively in the form of eye drops. The transdermal patch Scopoderm TTS and other medications are no longer available. In some countries, other medicines containing scopolamine are available, such as Kwells motion sickness tablets and the Transderm Scop transdermal patch. This article refers to peroral use. In contrast, the derivative scopolamine butylbromide (Buscopan) is commercially available and, because of its different structure, is primarily effective in the intestine rather than centrally. The name of the active ingredient comes from the plant of the nightshade family. Scopolamine is also known as hyoscine.

Structure and properties

Scopolamine (C17H21NO4, Mr = 303.4 g/mol) exists as a white crystalline powder or as colorless crystals and is soluble in water. Even more soluble is the salt scopolamine hydrobromide. Scopolamine is a natural tropane alkaloid found in nightshade plants such as belladonna, datura, angel’s trumpet, and black henbane.

Effects

Scopolamine (ATC A04AD01) has parasympatholytic (anticholinergic), antiemetic, sedative, spasmolytic, and mydriatic properties. The effects are due to antagonism at muscarinic acetylcholine receptors. The half-life is approximately 9.5 hours. Rapid onset antidepressant effects have also been demonstrated in scientific studies.

Indications

  • Motion sickness
  • Nausea
  • Smooth muscle spasms in the gastrointestinal tract and bile ducts
  • Ocular indications
  • Hypersalivation

Dosage

According to the professional information. Use depends on the product. Scopolamine is administered perorally, transdermally, parenterally, and ocularly.

Abuse

Scopolamine can be abused as a hallucinogen. However, since the dose required for this usually involves intoxication, it is strongly discouraged. Scopolamine has also been abused in the past for crimes and poisonous murders.

Contraindications

  • Hypersensitivity
  • Prostate enlargement
  • Paralytic intestinal obstruction
  • Pyloric stenosis
  • Narrow-angle glaucoma
  • Myasthenia gravis
  • Cardiac arrhythmias

For complete precautions, see the drug label.

Interactions

Drug-drug interactions include those with anticholinergics, MAO inhibitors, central depressant medications, alcohol, H2 antihistamines, and prokinetics.

Adverse effects

Possible adverse effects include:

  • Hyperthermia
  • Visual disturbances, accommodation disorders, pupil dilation.
  • Dry mouth
  • Drowsiness, dizziness, sedation, drowsiness, central stimulation, agitation, hallucinations, confusion.
  • Skin rashes

Scopolamine can cause amnesia. Symptoms of overdose include rapid heartbeat, cardiac arrhythmias, visual disturbances, agitation, excitement, photophobia, urinary retention, hallucinations, delirium, coma, and respiratory paralysis. An overdose is acutely life-threatening.