Butylhioscine: Formula, Presentation, Indications, Action Mechanism, Dosage, Side Effects and Warnings

It is a drug derived from quaternary ammonium antimuscarinic.

Obtained from scopolamine, this is a substance found in toxic or poisonous plants, whose everyday use is a paralyzing drug. However, that medicine helps to avoid and prevent pain, thanks to its effect on the relaxation of the internal muscles.

This medicine is used as an antispasmodic for the smooth muscles present in the abdominal organs such as the digestive tract, the urinary tract, and the bile ducts.

Although it is also used to counteract the colic caused by dysmenorrhea.

The commercial name of Butylhioscine is Butylhioscine Bromide, also known as Butyl Copolamine.

This sedative or depressant effect on the nervous system that has this drug confers its usefulness as an antispasmodic and as a local anesthetic and unlike other analgesics.

The action of butylhioscine does not block pain signals in the patient but prevents the onset of spasms and contractions that are the agents that cause pain.

 

Butylscopolamine is anticholinergic antimuscarinic, which is used to treat the discomforts and pains caused by abdominal cramps, menstrual cramps, cramps in the gastrointestinal tract, urinary, uterine, and biliary, and some other types of erratic activity of the digestive system.

It is also used to prevent the bladder’s spasms and facilitate radiological visualization of the gastrointestinal tract.

Chemical formula

  • C21H30BrNO4.

Presentation

  • Solution for injection Bromide of N-butylhioscine 20 mg in 1 ml.
  • Tablets of 10 mg.

Indications

Butylhioscine is indicated in the treatment of spastic pains of the digestive tract, achalasia, sometimes in contrast studies of the digestive tract, gastrointestinal spasms, and cases of dysmenorrhea.

As well as post hysterosalpingography pain, in the occurrence of urinary incontinence, irritable bowel syndrome, gastric and duodenal ulcers, disorders of motility of the gastrointestinal tract, spastic constipation, and dyskinesias of the biliary and urinary tract.

It is also associated with spastic colitis, enteritis, pain from hysterectomy and other uterine interventions, colic of the urethra, renal colic, biliary colic, and contraction pain in pregnant women (only under strict medical supervision). ).

Mechanism of action

Scopolamine butylbromide is an antagonist of muscarinic receptors, which acts by preventing the contraction that stimulates acetylcholine present in the smooth muscle of the gastrointestinal tract.

Scopolamine butylbromide binds to the muscarinic receptor of acetylcholine type M3, located in the smooth muscle of the digestive system, the urinary bladder, and vascular and respiratory tissue in the gastrointestinal tract.

This union prevents the hormone acetylcholine from binding and, in turn, activates the receptors, which results in the contraction of the smooth muscle.

This inhibition of smooth muscle contractions reduces spasms and pain.

This blockade of the muscarinic receptors in the gastrointestinal tract is the basis for recommending its use in treating gastrointestinal tract pain, thus alleviating the pain or cramps generated in these organs.

This drug is widely distributed in the gastrointestinal tissue, liver, and kidney, is metabolized in the liver by enzymatic hydrolysis, and is eliminated by the biliary and urinary tract.

Dose

Injectable solution:

  • The recommended dose in adults is one ampoule of 1 ml 4 to 3 times a day.
  • The recommended dose in children is 1/2 ampoule 0.5 ml three times a day.
  • Moreover, the route of administration is intramuscular and intravenous.

Tablets:

  • In adults and children over 12 years, the recommended dose is 1 to 2 tablets three times a day.
  • In children aged 7 to 11 years, the recommended dose is one tablet three times a day.
  • The tablet should not be broken or chewed, and more than six tablets per day should not exceed the dose.
  • The route of administration is oral.

Side effects

The secondary and adverse reactions that may occur are observed:

  1. Cardiovascular: Butylhioscine can cause hypotension, tachycardia, and, rarely, shocks caused by allergic reactions.
  2. Central nervous system: At this level can cause dizziness, numbness, disorientation, mydriasis, dry mouth, and sleep apnea with unsteady breathing.
  3. Metabolic: Inhibition of salivary secretion and sweating has been known in people receiving Butylhioscine.
  4. Gastrointestinal: Inhibitions of salivation, inhibitions in the production of pancreatic enzymes such as amylase and trypsin, reduction in esophageal transit, and increase in bicarbonate secretion in the digestive system can be shown.
  5. Genitourinary: The administration of Butylhioscine can cause dysuria.
  6. Respiratory: Cases have been reported with shortening Butylhioscine in respiration and nasal flaring.
  7. Skin: Cases of urticaria, rashes and angioneurotic edema, and other data associated with allergies were observed in patients treated with Butylhioscin.
  8. Eyes: Symptoms such as cycloplegia, mydriasis, blurred vision, anisocoria, glaucoma, and ocular pigmentation may occur during the treatment of Butylhioscin.
  9. Other reactions reported: Allergies and unexpected responses unrelated to the dose or pharmacological effect (idiosyncratic reactions).

Warnings and contraindications

It should not be used during the first three months of pregnancy, and its use during the final six months of pregnancy should be widely evaluated.

It is contraindicated during lactation since it is unknown if it is excreted through breast milk.

In geriatric and pediatric patients, particular caution should be exercised in its administration.

Butylhioscin can potentiate the action of drugs with anticholinergic activity, as in tricyclic antidepressants such as quinidine, antihistamines, and disopyramide, or with some beta-blockers or adrenergic antagonist drugs.

Dopaminergic antagonists can be tormented with the effects of Butylhioscine.

It must be administered with caution in patients with pathologies such as paralytic ileus, intestinal atony, ulcerative colitis, xerostomia, fevers, heart disease, gastroesophageal reflux, or prostatic hypertrophy.

It is contraindicated in cases of hypersensitivity to the formula’s components, in cases of hepatic insufficiency, paroxysmal tachycardia, asthma, paralytic ileus, glaucoma, pyloric stenosis, prostatic hypertrophy, achalasia, renal insufficiency, urinary retention and in cases of abnormal dilatation. Of the colon.

Interactions

The concomitant use of quinidine and amantadine may potentiate the anticholinergic effect of butylhioscine.