II. Indications

  1. Motion Sickness (Scopolamine Patch)
  2. Nausea Vomiting (including postoperative prophylaxis)
  3. Vertigo
  4. Mydriatic (Isopto Hyoscine)
  5. Hypersalivation (excessive Drooling)

III. Mechanism

  1. Tropane alkaloid derived from Hyoscyamus niger and Atropa belladonna, plants in the nightshade family (Solanaceae)
  2. Chemical structure is similar to Acetylcholine and blocks Acetylcholine activity at Muscarinic Receptors
    1. Postganglionic Cholinergic nerves
    2. Smooth Muscle receptors
  3. Effects
    1. Ocular (Mydriasis, cycloplegia)
    2. Decreases Saliva secretion
    3. Decreases gastric acid secretion
    4. Decreases gastrointestinal motility
    5. Antiemetic properties

IV. Dosing: Adults (and children over age 12 years old)

  1. Motion Sickness
    1. Apply Scopolamine patch patch (disc) behind ear starting 4 hours before travel, and may replace every 72 hours
  2. Prevention of post-operative Nausea or Vomiting
    1. Apply Scopolamine patch patch (disc) behind ear starting 4 hours before surgery, and remove 24 hours after surgery

V. Dosing: Child (off-label)

  1. Perioperative nausea Vomiting (or prevention)
    1. Scopolamine 6 mcg/kg/dose IM/IV/SQ up to 0.3 mg/dose (may be repeated in 6 to 8 hours)

VI. Safety

  1. Pregnancy Category C
  2. Safe in Lactation

VII. Adverse Effects

IX. References

  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 46-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Related Studies

Cost: Medications

scopolamine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SCOPOLAMINE 1 MG/3 DAY PATCH Generic $8.83 each

Ontology: Scopolamine (C0036442)

Definition (NCI) A tropane alkaloid derived from plants of the nightshade family (Solanaceae), specifically Hyoscyamus niger and Atropa belladonna, with anticholinergic, antiemetic and antivertigo properties. Structurally similar to acetylcholine, scopolamine antagonizes acetylcholine activity mediated by muscarinic receptors located on structures innervated by postganglionic cholinergic nerves as well as on smooth muscles that respond to acetylcholine but lack cholinergic innervation. The agent is used to cause mydriasis, cycloplegia, to control the secretion of saliva and gastric acid, to slow gut motility, and prevent vomiting.
Definition (CSP) anticholinergic alkaloid.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D012601
SnomedCT 72870001, 387639006, 387409009, 48899009
LNC LP15008-3, MTHU001494
English Benzeneacetic acid, alpha-(hydroxymethyl)-, 9-methyl-3-oxa-9-azatricyclo(3.3.1.02,4)non-7-yl ester, (7(S)-(1alpha,2beta,4beta,5alpha,7beta))-, Benzeneacetic Acid, alpha-(hydroxymethyl)-,(1alpha,2beta,4beta,5alpha,7beta)-9-methyl-3-oxa-9-azatricyclo(3.3.1.02,4)non-7-yl ester,(alphaS)-, 1alphaH,5alphaH-Tropan-3alpha-ol, 6beta,7beta-epoxy-,(-)-tropate(ester), Epoxytropine Tropate, 6,7-Epoxytropine Tropate, 6beta,7beta-Epoxy-3alpha-tropanyl S-(-)-tropate, Scopolamine, hyoscine, Hyoscine product, scopolamine preparations, scopolamine preparations (medication), scopolamine, Hyoscine, SCOPOLAMINE, Hyoscine (product), Scopolamine (product), Scopolamine (substance)
French Hyoscine, Scopolamine
Portuguese Escopolamina, Hioscina
Spanish Escopolamina, Hioscina, hioscina (producto), hioscina, escopolamina (producto), escopolamina (sustancia), escopolamina
German Scopolamin, Hyoscin