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