II. Indications

  1. Bladder Spasm
  2. Irritable Bowel Syndrome
  3. Decrease gastrointestinal hypermotility
  4. Decrease gastric secretions

IV. Mechanism

  1. Hyoscyamine is an L-isomer of the belladonna alkaloid, Atropine
  2. Similar to Atropine, Hyoscyamine is an Anticholinergic Agent
    1. Non-selective, competitive Muscarinic Antagonist
  3. Inhibits at various sites
    1. Inhibits Bladder smooth Muscle Contraction
    2. Slows gastrointestinal motility and digestive enzyme secretion
    3. Decreases secretion of Saliva, sweat and Bronchial mucus

V. Medications

  1. Hyoscyamine 0.125 ODT (Anaspaz)
  2. Hyoscyamine 0.125 tablets (Levsin)
  3. Hyoscyamine 0.125 SL (Levsin-SL)
  4. Hyoscyamine 0.125 chewable
  5. Hyoscyamine 0.125/5ml elixir
  6. Hyoscyamine 0.125/ml drops
  7. Hyoscyamine 0.375 Extended Release (Levbid)

VI. Dosing: Adult (or age >12 years)

  1. Regular release
    1. Take 125 to 250 mcg (0.125 to 0.25 mg) orally (or sublingual) every 4 hours as needed
  2. Extended release (ER)
    1. Take 375 to 750 mcg (0.375 to 0.75 mg) orally every 12 hours
  3. Maximum
    1. Limit to 1500 mcg (1.5 mg) per day

VII. Dosing: Child

  1. Note that dosing is in mcg (not mg)
  2. Age <2 years: Dose up to every 4 hours as needed (maximum of 6 doses daily)
    1. Weight 2.3 kg: Give 12.5 mcg (or 3 drops of 0.125 mg/ml)
    2. Weight 3.4 kg: Give 16.7 mcg (or 4 drops of 0.125 mg/ml)
    3. Weight 5 kg: Give 20.8 mcg (or 5 drops of 0.125 mg/ml)
    4. Weight 7 kg: Give 25 mcg (or 6 drops of 0.125 mg/ml)
    5. Weight 10 kg: Give 32 mcg (or 8 drops of 0.125 mg/ml)
    6. Weight 15 kg: Give 46 mcg (or 11 drops of 0.125 mg/ml)
  3. Age 2 to 12 years: Dose up to every 4 hours as needed (maximum 750 mcg/day)
    1. Weight 20 kg: Give 62.5 mcg orally every 4 hours as needed
    2. Weight 40 kg: Give 93.8 mcg orally every 4 hours as needed
    3. Weight 50 kg: Give 125 mcg orally every 4 hours as needed
  4. Age >12 years
    1. Use adult dosing

IX. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

XI. References

  1. (2020) Med Lett Drugs Ther 62(1594): 41-58
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

hyoscyamine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
HYOSCYAMINE 0.125 MG ODT Generic $0.14 each
HYOSCYAMINE 0.125 MG TAB SL Generic $0.12 each
HYOSCYAMINE SULF 0.125 MG TAB Generic $0.14 each

Ontology: Hyoscyamine (C0596004)

Definition (MSH) The 3(S)-endo isomer of atropine.
Definition (NCI) A belladonna alkaloid derivative and the levorotatory form of racemic atropine isolated from the plants Hyoscyamus niger or Atropa belladonna, which exhibits anticholinergic activity. Hyoscyamine functions as a non-selective, competitive antagonist of muscarinic receptors, thereby inhibiting the parasympathetic activities of acetylcholine on the salivary, bronchial, and sweat glands, as well as the eye, heart, bladder, and gastrointestinal tract. These inhibitory effects cause a decrease in saliva, bronchial mucus, gastric juices, and sweat. Furthermore, its inhibitory action on smooth muscle prevents bladder contraction and decreases gastrointestinal motility.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D064692
SnomedCT 372757002, 40851005, 48899009
LNC LP15172-7, MTHU002561
English hyoscyamine, Duboisine, urological antispasmodics hyoscyamine, hyoscyamine (medication), l-hyoscyamine, (-)-Atropine, Benzeneacetic acid, alpha-(hydroxymethyl)-, 8-methyl-8-azabicyclo(3.2.1)oct-3-yl ester, (3(S)-endo)-, (S)-Atropine, HYOSCYAMINE, Atropine, 3(S)-endo-Isomer, Duboisine (substance), Hyoscyamine [Chemical/Ingredient], L-hyoscyamine, Hyoscyamine (product), Hyoscyamine (substance), Hyoscyamine
Spanish duboisina, duboisina (sustancia), L-hiosciamina, hiosciamina (producto), hiosciamina (sustancia), hiosciamina
Czech levo-atropin, levotočivý izomer atropinu, hyoscyamin
French Hyoscyamine
German Hyoscyamin
Italian Iosciamina
Russian ЦИТОСПАЗ, ГИОСЦИАМИН, АТРОПИНА СУЛЬФАТ, 3(S)-ЭНДО-ИЗОМЕР, ГИОСЦИАМИНА СУЛЬФАТ, ANASPAZ, GIOSTSIAMIN, ATROPINA SUL'FAT, 3(S)-ENDO-IZOMER, GIOSTSIAMINA SUL'FAT, АНАСПАЗ, TSITOSPAZ