Version July 2025
Dosage guidance:
Dosing: Transdermal patch is designed to deliver 1 mg over 3 days. Do not cut patch to obtain smaller increments; remove only portions of the backing required for the dose (eg, if 1/2 patch is needed, remove only 1/2 of the backing prior to application), cover with occlusive dressing to keep in place (Ref).
Chronic drooling: Limited data available: Children ≥3 years and Adolescents: Transdermal: Initial: Apply 1/4 patch every 3 days for 1 week; may titrate to effect (control of secretions) by increasing by 1/4 patch every 7 days as tolerated. Maximum dose: 1 patch applied every 3 days (Ref).
Postoperative nausea and vomiting, prevention: Limited data available (Ref):
Children <2 years: Transdermal: Apply 1/4 patch several hours before surgery (as early as the night before surgery).
Children 2 to <6 years: Transdermal: Apply 1/2 several hours before surgery (as early as the night before surgery).
Children 6 to <12 years: Transdermal: Apply 1/2 to 1 patch several hours before surgery (as early as the night before surgery).
Children ≥12 years and Adolescents: Transdermal: Apply 1 patch several hours before surgery (as early as the night before surgery).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling. However, caution is recommended due to increased risks of adverse effects.
There are no dosage adjustments provided in the manufacturer's labeling. However, caution is recommended due to increased risks of adverse effects.
(For additional information see "Scopolamine (hyoscine): Drug information")
Dosage guidance:
Dosing: Each transdermal patch delivers ~1 mg scopolamine base over 3 days.
Dosage form information: In Canada, additional formulations include parenteral and oral scopolamine butylbromide (also known as hyoscine butylbromide) as well as parenteral scopolamine hydrobromide (also known as hyoscine hydrobromide). Scopolamine butylbromide and scopolamine hydrobromide formulations are not equivalent and are not interchangeable on a milligram-to-milligram basis.
Clinical considerations: Parenteral scopolamine hydrobromide is approved in Canada as an adjunct to anesthesia for sedation and amnesia; however, this use may no longer represent current clinical practice (Ref); refer to manufacturer's labeling for additional information. Scopolamine butylbromide salt is a quaternary derivative with fewer CNS effects compared with scopolamine hydrobromide and base (patch) formulations (Ref).
GI/GU spasm:
Note: American College of Gastroenterology guidelines recommend against use of antispasmodics such as scopolamine for treatment of global symptoms of irritable bowel syndrome (IBS) (Ref).
Scopolamine (hyoscine) butylbromide [Canadian product]: Oral: 10 to 20 mg 3 to 5 times/day as needed; maximum: 60 mg/day (Ref). Note: When used for chronic symptom control, 10 mg 3 to 5 times/day as needed is recommended (Ref).
Scopolamine (hyoscine) butylbromide [Canadian product]: IM/IV/SUBQ: 10 to 20 mg once; if needed, may repeat at intervals of ≥30 minutes; maximum: 100 mg/day. Note: To avoid a potentially severe infusion reaction (ie, hypotension), a maximum rate of 20 mg/minute is preferred.
Malignant bowel obstruction, inoperable (off-label use):
Note: Decreases gastric secretions, nausea, and vomiting; often given as part of a combination regimen (eg, with analgesic, antiemetic, or corticosteroid) (Ref).
Scopolamine (hyoscine) butylbromide [Canadian product]: SUBQ : Initial: 20 mg once followed by 60 mg over 24 hours as a continuous SUBQ infusion (Ref).
Motion sickness, prevention:
Scopolamine base: Transdermal: Apply 1 patch (1 mg/3 days) behind ear at least 4 hours prior to required antiemetic effect for use up to 72 hours; if needed for >72 hours, remove old patch and place new one behind other ear. If symptoms are not adequately controlled with use of 1 patch, may consider using 2 patches (Ref).
Postoperative nausea and/or vomiting, prevention:
Scopolamine base: Transdermal: Apply 1 patch (1 mg/3 days) behind ear at least 1 to 2 hours prior to anesthesia or night before, and remove 24 hours after procedure (Ref).
Reduction of secretions at end of life (alternative agent) (off-label use):
Note: Does not dry secretions already present and typically ineffective for lower respiratory tract secretions (Ref). Other agents are preferred over the transdermal patch and scopolamine hydrobromide due to CNS effects (eg, delirium, agitation) of scopolamine (Ref).
Scopolamine base: Transdermal: Apply 1 patch (1 mg/3 days) behind ear for up to 72 hours; if needed for >72 hours, remove old patch and place new one behind other ear (Ref).
Scopolamine (hyoscine) butylbromide [Canadian product]: Various regimens described; refer to local protocols. Example regimens include: IV, SUBQ: 20 mg every 4 to 6 hours as needed. Alternatively, administer 20 mg once followed by a continuous IV/SUBQ infusion of 20 to 60 mg over 24 hours (Ref). Maximum dose: 100 mg/day (Ref).
Scopolamine (hyoscine) hydrobromide [Canadian product]: SUBQ: 0.4 mg every 4 to 6 hours as needed or 0.4 mg followed by continuous infusion of 1.2 mg over 24 hours (Ref).
Sialorrhea (alternative agent) (off-label use):
Note: May be used to control excessive salivation associated with neuromuscular disorders (eg, cerebral palsy, amyotrophic lateral sclerosis [ALS]) (Ref).
Scopolamine base: Transdermal: Apply 1 patch (1 mg/3 days) behind ear; after 3 days, remove old patch and place new one behind other ear (Ref).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
Altered kidney function:
Oral: Scopolamine (hyoscine) butylbromide [Canadian product]: No dosage adjustment likely to be necessary due to limited systemic absorption (Ref).
Parenteral: Scopolamine (hyoscine) butylbromide [Canadian product]: There are no specific dosage adjustments provided in the manufacturer's labeling (has not been studied). Use with caution (~42% to 61% of a total dose is excreted in the urine) with frequent monitoring for adverse effects. If using for >48 hours in patients with eGFR <50 mL/minute/1.73 m2, consider reducing the dose or prolonging the dosing interval to prevent accumulation (Ref).
Transdermal: Scopolamine base: No dosage adjustment likely to be necessary (<10% of a total dose is excreted in the urine) (Ref). Use with caution and frequent monitoring in patients with severe kidney disease due to possible increased risk of CNS adverse effects (Ref).
Hemodialysis, intermittent (thrice weekly): Dialyzability unknown:
Oral: Scopolamine (hyoscine) butylbromide [Canadian product] : No dosage adjustment likely to be necessary due to limited systemic absorption (Ref).
Parenteral: Scopolamine (hyoscine) butylbromide [Canadian product] : There are no specific dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution (~42% to 61% of a total dose is excreted in the urine) with frequent monitoring for adverse effects. If using for >48 hours, consider reducing the dose or prolonging the dosing interval to prevent accumulation (Ref).
Transdermal: Scopolamine base: No dosage adjustment likely to be necessary (<10% of a total dose is excreted in the urine) (Ref). Use with caution with frequent monitoring for adverse effects due to possible increased risk of CNS adverse effects (manufacturer's labeling); a case of ventricular tachycardia has also been reported in a patient with end-stage kidney disease (ESKD) and concomitant hepatic dysfunction (Ref).
Peritoneal dialysis: Dialyzability unknown:
Oral: Scopolamine (hyoscine) butylbromide [Canadian product] : No dosage adjustment likely to be necessary due to limited systemic absorption (Ref).
Parenteral: Scopolamine (hyoscine) butylbromide [Canadian product] : There are no specific dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution (~42% to 61% of a total dose is excreted in the urine) with frequent monitoring for adverse effects. If using for >48 hours, consider reducing the dose or prolonging the dosing interval to prevent accumulation (Ref).
Transdermal: Scopolamine base: No dosage adjustment likely to be necessary (<10% of a total dose is excreted in the urine) (Ref). Use with caution with frequent monitoring for adverse effects due to possible increased risk of CNS adverse effects (Ref); a case of ventricular tachycardia has also been reported in a patient with ESKD and concomitant hepatic dysfunction (Ref).
CRRT:
Oral: Scopolamine (hyoscine) butylbromide [Canadian product] : No dosage adjustment likely to be necessary due to limited systemic absorption (Ref).
Parenteral: Scopolamine (hyoscine) butylbromide [Canadian product] : There are no specific dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution with frequent monitoring for adverse effects. If using for >48 hours, consider reducing the dose or prolonging the dosing interval to prevent accumulation (Ref).
Transdermal: Scopolamine base: No dosage adjustment likely to be necessary (Ref).
PIRRT (eg, sustained, low-efficiency diafiltration):
Oral: Scopolamine (hyoscine) butylbromide [Canadian product] : No dosage adjustment likely to be necessary due to limited systemic absorption (Ref).
Parenteral: Scopolamine (hyoscine) butylbromide [Canadian product] : There are no specific dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution with frequent monitoring for adverse effects. If using for >48 hours, consider reducing the dose or prolonging the dosing interval to prevent accumulation (Ref).
Transdermal: Scopolamine base: No dosage adjustment likely to be necessary (Ref).
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). However, caution is recommended due to increased risks of adverse effects.
Scopolamine is associated with anticholinergic effects, including xerostomia (Ref), visual disturbances (eg, blurred vision, mydriasis) (Ref), and urinary retention (Ref) in adult and pediatric patients. Anticholinergic effects may contribute to nonadherence or discontinuation (Ref).
Mechanism: Related to the pharmacologic action. Directly related to antagonism of muscarinic receptors (Ref).
Onset: Rapid; visual disturbances occurred within 1 to 2 days of patch application (Ref).
Risk factors:
• Concurrent medications that cause anticholinergic adverse reactions (eg, antihistamines, meclizine, tricyclic antidepressants, muscle relaxants)
• Older patients (Ref)
• Pediatric patients (Ref)
CNS effects, such as drowsiness and fatigue, may occur with scopolamine (Ref).
Mechanism: Related to the pharmacologic action. Directly related to the antagonism of muscarinic receptors (Ref).
Risk factors:
• Concurrent alcohol or medications that cause CNS effects (eg, sedatives, hypnotics, opiates, anxiolytics)
• Older patients (Ref)
• Pediatric patients (Ref)
Scopolamine may cause psychiatric effects, including acute psychosis (ie, delusion, hallucination), amnesia/memory impairment, agitation, confusion, and speech disturbance, in adult and pediatric patients (Ref). Psychiatric effects are rare and reversible with discontinuation; may take 1 to 2 days to resolve following discontinuation (Ref).
Mechanism: Dose-related; related to the pharmacologic action. Directly related to the antagonism of muscarinic receptors (Ref).
Onset: Rapid; abnormal behaviors and psychosis may begin within 1 to 3 days of patch application (Ref).
Risk factors:
• Higher doses (Ref)
• Cognitive impairment or dementia (Ref)
• Older patients (Ref)
• Pediatric patients (Ref)
Withdrawal symptoms following scopolamine discontinuation may include diaphoresis, dizziness, drowsiness, fatigue, headache, hypotension, and nausea in adult and pediatric patients (Ref). Resolution of symptoms occurs within several days to weeks (Ref).
Mechanism: Withdrawal; may be related to muscarinic receptor sensitization, leading to rebound overstimulation of the vestibular nuclei and reticular formation of the vomiting center with discontinuation (Ref).
Onset: Rapid; occurs within 18 to 72 hours after removal of the patch (Ref).
Risk factors:
• Prolonged use (≥3 days) (Ref)
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported with transdermal administration in adults.
>10%:
Gastrointestinal: Xerostomia (29% to 67%) (table 1)
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
Comments |
|---|---|---|---|---|---|
|
67% |
N/A |
Nausea and vomiting associated with motion sickness |
N/A |
N/A |
~2/3 |
|
29% |
16% |
Post-operative nausea and vomiting |
461 |
457 |
N/A |
Nervous system: Dizziness (12%) (table 2), drowsiness (8% to 17%) (table 3)
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
|---|---|---|---|---|
|
12% |
7% |
Post-operative nausea and vomiting |
461 |
457 |
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
Comments |
|---|---|---|---|---|---|
|
17% |
N/A |
Nausea and vomiting associated with motion sickness |
N/A |
N/A |
<1/6 |
|
8% |
4% |
Post-operative nausea and vomiting |
461 |
457 |
N/A |
1% to 10%:
Nervous system: Agitation (6%) (table 4), confusion (4%) (table 5)
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
|---|---|---|---|---|
|
6% |
4% |
Post-operative nausea and vomiting |
461 |
457 |
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
|---|---|---|---|---|
|
4% |
3% |
Post-operative nausea and vomiting |
461 |
457 |
Ophthalmic: Mydriasis (4%) (table 6), visual impairment (5%) (table 7)
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
|---|---|---|---|---|
|
4% |
0% |
Post-operative nausea and vomiting |
461 |
457 |
|
Drug (Scopolamine) |
Placebo |
Indication |
Number of Patients (Scopolamine) |
Number of Patients (Placebo) |
|---|---|---|---|---|
|
5% |
3% |
Post-operative nausea and vomiting |
461 |
457 |
Respiratory: Pharyngitis (3%)
Postmarketing:
Cardiovascular: Hypotension (associated with withdrawal) (Ref)
Dermatologic: Diaphoresis (associated with withdrawal) (Ref), erythema of skin, skin irritation, skin rash
Gastrointestinal: Nausea (associated with withdrawal) (Ref)
Genitourinary: Dysuria, urinary retention (Ref)
Local: Application-site reaction (including application-site blistering, application-site burning, application-site pruritus, application-site rash)
Nervous system: Acute psychosis (Ref), amnesia (Ref), ataxia (Ref), delirium (Ref), delusion (Ref), disorientation (Ref), disturbance in attention, fatigue (Ref), hallucination (Ref), headache (Ref), insomnia (Ref), memory impairment (Ref), paranoid ideation, restlessness (Ref), seizure, speech disturbance, vertigo
Ophthalmic: Amblyopia, angle-closure glaucoma, blurred vision (Ref), dry eye syndrome, eye pruritus, eyelid pain (irritation), strabismus (Ref)
Injection:
Hyoscine butylbromide [Canadian product]: Hypersensitivity to hyoscine butylbromide, atropinics, or any component of the formulation; untreated narrow-angle glaucoma; megacolon, prostatic hypertrophy with urinary retention; stenotic lesions or mechanical stenosis of the GI tract; myasthenia gravis; tachycardia, angina, heart failure; paralytic or obstructive ileus; IM administration in patients receiving anticoagulant therapy.
Scopolamine hydrobromide [Canadian product]: Hypersensitivity to scopolamine or any component of the formulation; glaucoma or predisposition to narrow-angle glaucoma; paralytic ileus; prostatic hypertrophy; pyloric obstruction; tachycardia secondary to cardiac insufficiency or thyrotoxicosis.
Oral [Canadian product]: Hypersensitivity to hyoscine butylbromide, atropinics, or any component of the formulation; glaucoma, megacolon, mechanical stenosis in the GI tract, myasthenia gravis, obstructive prostatic hypertrophy, paralytic or obstructive ileus.
Transdermal: Hypersensitivity to scopolamine, other belladonna alkaloids, or any component of the formulation; narrow-angle glaucoma
Concerns related to adverse effects:
• Anaphylaxis: Anaphylaxis including episodes of shock has been reported following parenteral administration; observe for signs/symptoms of hypersensitivity following parenteral administration. Patients with a history of allergies or asthma may be at increased risk of hypersensitivity reactions.
• Bradycardia (paradoxical): Lower doses (0.1mg) may have vagal mimetic effects (eg, increase vagal tone causing paradoxical bradycardia); these effects are likely mediated by blockade of muscarinic receptors at the level of the brain.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with coronary artery disease, tachyarrhythmias, heart failure, or hypertension; evaluate tachycardia prior to administration.
• Gastrointestinal (GI) obstruction: Use with caution in patients with GI obstruction; when used for the treatment of smooth muscle spasm of the GI tract avoid continuous (daily) or prolonged use without evaluating source of abdominal pain. Patients should be instructed to report persistent or worsening abdominal pain with or without other symptoms (eg, nausea/vomiting, irregular bowel movements, bloody stool, hypotension).
• Genitourinary (GU) disease/obstruction: Use with caution in patients with GU obstruction, prostatic hyperplasia, or urinary retention; when used for the treatment of smooth muscle spasm of the GU tract, avoid continuous (daily) or prolonged use without evaluating source of the spasm.
• Glaucoma: Use transdermal product with caution in patients with open-angle glaucoma; may increase intraocular pressure; adjust glaucoma therapy as necessary.
• Hepatic impairment: Use with caution in patients with hepatic impairment.
• Hiatal hernia: Use with caution in patients with hiatal hernia with reflux esophagitis.
• Hyperthyroidism: Use caution in patients with hyperthyroidism; may have increased risk for arrhythmias.
• Parkinson disease: Adverse events (including dizziness, headache, nausea, vomiting) may occur following abrupt discontinuation in patients with Parkinson disease.
• Psychosis: Use with caution in patients with a history of psychosis; may exacerbate condition.
• Renal impairment: Use with caution in patients with renal impairment.
• Seizure disorders: Use with caution in patients with a history of seizure disorder; may exacerbate condition.
• Ulcerative colitis: Use with caution in patients with ulcerative colitis; may precipitate/aggravate toxic megacolon.
Special populations:
• Pediatric: Use with caution in pediatric patients since they may be more susceptible to the anticholinergic, neurologic, and psychiatric adverse reactions of scopolamine.
Dosage form specific issues:
• Fructose: Tablets may contain sucrose; avoid use of tablets in patients who are fructose intolerant.
• Product interchangeability: Scopolamine (hyoscine) hydrobromide should not be interchanged with scopolamine butylbromide formulations; dosages are not equivalent.
• Transdermal patch: May contain conducting metal (eg, aluminum); remove patch prior to MRI.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Patch 72 Hour, Transdermal:
Transderm Scop (1.5 MG): 1 MG/3DAYS (4 ea [DSC])
Transderm-Scop: 1 MG/3DAYS (1 ea [DSC], 10 ea [DSC], 24 ea [DSC])
Generic: 1 MG/3DAYS (4 ea, 10 ea, 24 ea)
Yes
Patch, 72-hour (Scopolamine Transdermal)
1 mg/3days (per each): $11.40 - $24.28
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Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Injection, as butylbromide:
Buscopan: 20 mg/mL (1 mL)
Generic: 20 mg/mL (1 mL)
Solution, Injection, as hydrobromide:
Generic: 0.4 mg/mL (1 mL); 0.6 mg/mL (1 mL)
Tablet, Oral, as butylbromide:
Buscopan: 10 mg [contains corn starch]
Generic: 10 mg
Transdermal: Apply patch to hairless area behind 1 ear. Do not wear more than 1 patch at a time. Wash hands before and after application of disc to avoid drug contact with eyes. Transdermal patch is designed to deliver 1 mg over 3 days. Once patch has been affixed behind the ear, do not touch while being worn since pressure may cause scopolamine to release at the edge. Do not use any patch that has been damaged, cut, or manipulated in any way. If necessary to use smaller patch increments, do not cut patch; remove only portions of the backing required for the dose (eg, if 1/2 patch is needed, remove only 1/2 of the backing prior to application), cover with occlusive dressing to keep in place (Ref). If patch becomes displaced, discard and apply a new patch behind the other ear. Once removed, fold the used patch in half with the sticky side together; dispose of used patches in the trash out of reach from children and pets.
Note: Butylbromide [Canadian product] or hydrobromide [Canadian product] may be administered by IM, IV, or SubQ injection.
IM: Butylbromide: Intramuscular injections should be administered 10 to 15 minutes prior to radiological/diagnostic procedures.
IV:
Butylbromide: No dilution is necessary prior to injection; inject at a rate of 1 mL/minute
Hydrobromide: No dilution is necessary prior to injection.
Oral [Canadian product]: Tablet should be swallowed whole and taken with a full glass of water.
Transdermal: Apply to hairless area of skin behind the ear. Wear only one patch at a time; remove first patch and apply new patch behind the other ear. Wash hands before and after applying the patch to avoid drug contact with eyes. Do not cut the patch. Once patch has been affixed behind the ear, do not touch while being worn since pressure may cause scopolamine to release at the edge. Topical patch is programmed to deliver 1 mg over 3 days. Once applied, do not remove the patch for 3 full days (motion sickness). When used postoperatively for nausea/vomiting, the patch should be removed 24 hours after surgery. If patch becomes displaced, discard and apply a new patch. Once removed, fold the used patch in half with the sticky side together; dispose of used patches in the trash out of reach from children and pets.
Injection:
Butylbromide [Canadian product]: Store at 15°C to 30°C (59°F to 86°F). Do not freeze. Protect from light and heat. Stable in D5W, D10W, NS, Ringer's solution, and LR for up to 8 hours.
Hydrobromide [Canadian product]: Store at 15°C to 30°C (59°F to 86°F). Protect from light. Do not freeze.
Tablet [Canadian product]: Store at 15°C to 30°C (59°F to 86°F). Protect from light and heat.
Transdermal system: Store at 20°C to 25°C (68°F to 77°F).
Transdermal: Prevention of nausea/vomiting associated with motion sickness and recovery from anesthesia and surgery (FDA approved in adults); has also been used for chronic drooling.
Beers Criteria: Scopolamine is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) due to its highly anticholinergic properties and uncertain effectiveness as an antispasmodic (Beers Criteria [AGS 2023]).
Scopolamine is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) for lower urinary tract symptoms with benign prostatic hyperplasia (BPH) and high post-void residual volume, ie, >200 mL. Some disease states of concern include delirium, dementia, chronic cognitive impairment, narrow-angle glaucoma, overactive bladder, urge incontinence, and chronic constipation (O’Mahony 2023).
Transdermal patch may contain conducting metal (eg, aluminum); remove patch prior to MRI.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program
Acetylcholinesterase Inhibitors: May decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Acetylcholinesterase Inhibitors. Risk C: Monitor
Aclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid
Acrivastine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Acrivastine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Agents with Clinically Relevant Anticholinergic Effects: May increase anticholinergic effects of Scopolamine. Risk C: Monitor
Alcohol (Ethyl): CNS Depressants may increase CNS depressant effects of Alcohol (Ethyl). Risk C: Monitor
Alizapride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Amantadine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Amisulpride (Oral): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Articaine: May increase CNS depressant effects of CNS Depressants. Management: Consider reducing the dose of articaine if possible when used in patients who are also receiving CNS depressants. Monitor for excessive CNS depressant effects with any combined use. Risk D: Consider Therapy Modification
Azelastine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Benperidol: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Benperidol. Risk C: Monitor
Benperidol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Benztropine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Benztropine. Risk C: Monitor
Biperiden: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Biperiden. Risk C: Monitor
Blonanserin: CNS Depressants may increase CNS depressant effects of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider Therapy Modification
Bornaprine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bornaprine. Risk C: Monitor
Botulinum Toxin-Containing Products: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Brexanolone: CNS Depressants may increase CNS depressant effects of Brexanolone. Risk C: Monitor
Brimonidine (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Bromopride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Bromperidol: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Buclizine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Buclizine. Risk C: Monitor
Buclizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Buprenorphine: CNS Depressants may increase CNS depressant effects of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider Therapy Modification
BusPIRone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Cannabinoid-Containing Products: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of Cannabinoid-Containing Products. Risk C: Monitor
Cannabinoid-Containing Products: CNS Depressants may increase CNS depressant effects of Cannabinoid-Containing Products. Risk C: Monitor
Cetirizine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk D: Consider Therapy Modification
Chloral Hydrate/Chloral Betaine: CNS Depressants may increase CNS depressant effects of Chloral Hydrate/Chloral Betaine. Management: Consider alternatives to the use of chloral hydrate or chloral betaine and additional CNS depressants. If combined, consider a dose reduction of either agent and monitor closely for enhanced CNS depressive effects. Risk D: Consider Therapy Modification
Chlormethiazole: May increase CNS depressant effects of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider Therapy Modification
Chlorphenesin Carbamate: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor
Chlorprothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Chlorprothixene. Risk C: Monitor
Cimetropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Cimetropium. Risk X: Avoid
CloZAPine: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider Therapy Modification
CNS Depressants: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor
Cyclizine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Dantrolene: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Daridorexant: May increase CNS depressant effects of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification
Darifenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Darifenacin. Risk C: Monitor
DexmedeTOMIDine: CNS Depressants may increase CNS depressant effects of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider Therapy Modification
Dicyclomine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dicyclomine. Risk C: Monitor
Difelikefalin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Difenoxin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Dihydralazine: CNS Depressants may increase hypotensive effects of Dihydralazine. Risk C: Monitor
Dimethindene (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dimethindene (Systemic). Risk C: Monitor
Dimethindene (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Dothiepin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Doxylamine: CNS Depressants may increase CNS depressant effects of Doxylamine. Risk C: Monitor
DroNABinol: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of DroNABinol. Risk X: Avoid
DroPERidol: May increase CNS depressant effects of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider Therapy Modification
Eluxadoline: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Eluxadoline. Risk X: Avoid
Emedastine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk C: Monitor
Entacapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Esketamine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Fesoterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Fesoterodine. Risk C: Monitor
Flunarizine: CNS Depressants may increase CNS depressant effects of Flunarizine. Risk X: Avoid
Flunitrazepam: CNS Depressants may increase CNS depressant effects of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider Therapy Modification
FluPHENAZine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Gastrointestinal Agents (Prokinetic): Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Gastrointestinal Agents (Prokinetic). Risk C: Monitor
Gepotidacin: May decrease anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Glucagon: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor
Glycopyrrolate (Oral Inhalation): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Oral Inhalation). Risk X: Avoid
Glycopyrrolate (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Systemic). Risk C: Monitor
Glycopyrronium (Topical): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid
HydrOXYzine: May increase CNS depressant effects of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider Therapy Modification
Ipratropium (Nasal): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Ipratropium (Oral Inhalation): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid
Itopride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Itopride. Risk C: Monitor
Ixabepilone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Kava Kava: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Ketotifen (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Kratom: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Lemborexant: May increase CNS depressant effects of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider Therapy Modification
Levocetirizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Levosulpiride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Levosulpiride. Risk X: Avoid
Lisuride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Lofepramine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Lofexidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Loxapine: CNS Depressants may increase CNS depressant effects of Loxapine. Management: Consider reducing the dose of CNS depressants administered concomitantly with loxapine due to an increased risk of respiratory depression, sedation, hypotension, and syncope. Risk D: Consider Therapy Modification
Magnesium Sulfate: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Maprotiline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Maprotiline. Risk C: Monitor
Melitracen [INT]: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Melperone: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Mequitazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Metergoline: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Methotrimeprazine: CNS Depressants may increase CNS depressant effects of Methotrimeprazine. Methotrimeprazine may increase CNS depressant effects of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider Therapy Modification
Methoxyflurane: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Methscopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methscopolamine. Risk C: Monitor
Metoclopramide: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
MetyroSINE: CNS Depressants may increase sedative effects of MetyroSINE. Risk C: Monitor
Minocycline (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Mirabegron: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Mirabegron. Risk C: Monitor
Moxonidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Nabilone: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Nalfurafine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Nitroglycerin: Agents with Clinically Relevant Anticholinergic Effects may decrease absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor
Noscapine: CNS Depressants may increase adverse/toxic effects of Noscapine. Risk X: Avoid
OLANZapine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OLANZapine. Risk C: Monitor
Olopatadine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Opicapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Opioid Agonists: CNS Depressants may increase CNS depressant effects of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification
Opipramol: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Opipramol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Orphenadrine: CNS Depressants may increase CNS depressant effects of Orphenadrine. Risk X: Avoid
Oxatomide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid
Oxomemazine: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid
Oxybate Salt Products: CNS Depressants may increase CNS depressant effects of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider Therapy Modification
OxyBUTYnin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OxyBUTYnin. Risk C: Monitor
OxyCODONE: CNS Depressants may increase CNS depressant effects of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification
Paliperidone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Paraldehyde: CNS Depressants may increase CNS depressant effects of Paraldehyde. Risk X: Avoid
Perampanel: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Perazine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Periciazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Perphenazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Perphenazine. Risk C: Monitor
Pipamperone: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor
Piribedil: CNS Depressants may increase CNS depressant effects of Piribedil. Risk C: Monitor
Pizotifen: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Potassium Chloride: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid
Potassium Citrate: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid
Pramipexole: CNS Depressants may increase sedative effects of Pramipexole. Risk C: Monitor
Pramlintide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. These effects are specific to the GI tract. Risk X: Avoid
Procarbazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Promethazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Promethazine. Risk C: Monitor
Propantheline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Propantheline. Risk C: Monitor
Propiverine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
QuiNIDine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor
Ramosetron: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Ramosetron. Risk C: Monitor
Revefenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Revefenacin. Risk X: Avoid
Rilmenidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Rivastigmine: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Rivastigmine. Rivastigmine may decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider Therapy Modification
Ropeginterferon Alfa-2b: CNS Depressants may increase adverse/toxic effects of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider Therapy Modification
ROPINIRole: CNS Depressants may increase sedative effects of ROPINIRole. Risk C: Monitor
Rotigotine: CNS Depressants may increase sedative effects of Rotigotine. Risk C: Monitor
Secretin: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider Therapy Modification
Sofpironium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Sofpironium. Risk X: Avoid
Suvorexant: CNS Depressants may increase CNS depressant effects of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification
Thalidomide: CNS Depressants may increase CNS depressant effects of Thalidomide. Risk X: Avoid
Thiazide and Thiazide-Like Diuretics: Agents with Clinically Relevant Anticholinergic Effects may increase serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor
Thiothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Thiothixene. Risk C: Monitor
Tiapride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Tiapride. Risk C: Monitor
Tiotropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tiotropium. Risk X: Avoid
Tolterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tolterodine. Risk C: Monitor
Topiramate: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Topiramate. Risk C: Monitor
Trimeprazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Trimethobenzamide: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trimethobenzamide. Risk C: Monitor
Trospium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trospium. Risk C: Monitor
Umeclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid
Valerian: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor
Zolpidem: CNS Depressants may increase CNS depressant effects of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider Therapy Modification
Zuclopenthixol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Zuclopenthixol. Risk C: Monitor
Zuranolone: May increase CNS depressant effects of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider Therapy Modification
Scopolamine crosses the placenta.
When the transdermal patch is used to prevent nausea and vomiting associated with surgery, dose adjustments are required prior to cesarean delivery. Avoid use of transdermal patches in pregnant patients with severe preeclampsia; eclamptic seizures have been reported after IV and IM use.
Body temperature, heart rate, urinary output, intraocular pressure; drowsiness, dizziness, or disorientation; new or worsening psychiatric symptoms.
Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands and the CNS; increases cardiac output, dries secretions, antagonizes histamine and serotonin; at usual recommended doses, causes blockade of muscarinic receptors at the cardiac SA-node and is parasympatholytic (ie, blocks vagal activity increasing heart rate)
Onset of action:
Butylbromide: Injection: ≤15 minutes.
Hydrobromide: Injection: ~15 minutes (Renner 2005).
Scopolamine base: Transdermal: 6 to 8 hours.
Duration:
Hydrobromide: Injection: ~4 hours.
Scopolamine base: Transdermal: 72 hours.
Absorption:
Butylbromide: Oral: Quaternary salts are poorly absorbed (local concentrations in the GI tract following oral dosing may be high).
Hydrobromide: IM, SubQ: Rapid.
Distribution: Vd: Butylbromide: 128 L.
Protein binding: Butylbromide: ~4% (albumin).
Metabolism: Hepatic.
Bioavailability: Butylbromide: Oral: 8%.
Half-life elimination:
Butylbromide: Terminal: IV: ~5 hours; Oral: ~6 to 11 hours.
Hydrobromide: Injection: ~1 to 3.5 hours (Renner 2005).
Scopolamine base: Transdermal: 9.5 hours.
Time to peak:
Butylbromide: Oral: ~2 hours.
Hydrobromide: IM: ~20 minutes; IV: ~5 minutes; SubQ: ~15 minutes (Renner 2005).
Scopolamine base: Transdermal: 24 hours.
Excretion:
Butylbromide: IV: Urine (42% to 61% [half as parent drug]), feces (28% to 37%).
Hydrobromide: Injection: Urine (variable; as parent drug and metabolites) (Renner 2005).
Scopolamine base: Transdermal: Urine (<10%, as parent drug and metabolites).
