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Components:
Hyoscine Butylbromide
Method of action:
Antiparkinsonian
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Medically reviewed by Fedorchenko Olga Valeryevna, Pharmacy-Provisor. Last updated on 2019.12.06

Name of the medicinal product

Koscopan

Qualitative and quantitative composition

Hyoscine Butylbromide

Therapeutic indications

The information provided in Therapeutic indications of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Buscopan 10 mg Tablets are indicated for the relief of spasm of the genito-urinary tract or gastro- intestinal tract and for the symptomatic relief of Irritable Bowel Syndrome.

Dosage (Posology) and method of administration

The information provided in Dosage (Posology) and method of administration of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Buscopan 10 mg Tablets are for oral administration only.

Buscopan 10 mg Tablets should be swallowed whole with adequate water.

Adults: 2 tablets four times daily. For the symptomatic relief of Irritable Bowel Syndrome, the recommended starting dose is 1 tablet three times daily, this can be increased up to 2 tablets four times daily if necessary.

Children 6 - 12 years: 1 tablet three times daily.

No specific information on the use of this product in the elderly is available. Clinical trials have included patients over 65 years and no adverse reactions specific to this age group have been reported.

Buscopan 10 mg Tablets should not be taken on a continuous daily basis or for extended periods without investigating the cause of abdominal pain.

Contraindications

The information provided in Contraindications of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Buscopan 10 mg Tablets are contraindicated in:

-patients who have demonstrated prior hypersensitivity to hyoscine butylbromide or any other component of the product

-myasthenia gravis

-mechanical stenosis in the gastrointestinal tract

-paralytical or obstructive ileus

-megacolon

-narrow angle glaucoma

Special warnings and precautions for use

The information provided in Special warnings and precautions for use of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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In case severe, unexplained abdominal pain persists or worsens, or occurs together with symptoms like fever, nausea, vomiting, changes in bowel movements, abdominal tenderness, decreased blood pressure, fainting, or blood in stool, medical advice should immediately be sought.

Buscopan 10 mg Tablets should be used with caution in conditions characterised by tachycardia such as thyrotoxicosis, cardiac insufficiency or failure and in cardiac surgery where it may further accelerate the heart rate. Due to the risk of anticholinergic complications, caution should be used in patients susceptible to intestinal or urinary outlet obstructions.

Because of the possibility that anticholinergics may reduce sweating, Buscopan should be administered with caution to patients with pyrexia.

Elevation of intraocular pressure may be produced by the administration of anticholinergic agents such as Buscopan in patients with undiagnosed and therefore untreated narrow angle glaucoma. Therefore, patients should seek urgent ophthalmological advice in case they should develop a painful, red eye with loss of vision whilst or after taking Buscopan.

As the tablet coat contains sucrose (41.2 mg), patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take Buscopan Tablets.

Effects on ability to drive and use machines

The information provided in Effects on ability to drive and use machines of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Effects on ability to drive and use machines in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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No studies on the effects on the ability to drive and use machines have been performed. Because of possible visual accommodation disturbances patients should not drive or operate machinery if affected.

Undesirable effects

The information provided in Undesirable effects of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Undesirable effects in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Many of the listed undesirable effects can be assigned to the anticholinergic properties of BUSCOPAN.

Adverse events have been ranked under headings of frequency using the following convention:

Very common (> 1/10); common (> 1/100, < 1/10); uncommon (> 1/1000, <1/100); rare (> 1/10000, <1/1000); very rare (<1/10000); not known - cannot be estimated from the available data.

Immune system disorders

Uncommon: skin reactions (e.g. urticaria, pruritus)

Not known*: anaphylactic shock , anaphylactic reactions, dyspnoea, rash, erythema, other hypersensitivity

Cardiac disorders

Uncommon: tachycardia

Gastrointestinal disorders:

Uncommon: dry mouth

Skin and subcutaneous tissue disorders

Uncommon: dyshidrosis

Renal and urinary disorders

Rare: urinary retention

* This adverse reaction has been observed in post-marketing experience. With 95% certainty, the frequency category is not greater than uncommon (3/1,368), but might be lower. A precise frequency estimation is not possible as the adverse drug reaction did not occur in a clinical trial database of 1,368 patients.

Reporting of suspected adverse reactions

Reporting suspected adverse reaction after authorisation of the medicinal product is important. It allows continued monitoring of the benefit / risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

Overdose

The information provided in Overdose of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Overdose in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Symptoms:

Serious signs of poisoning following acute overdosage have not been observed in man. In the case of overdosage, anticholinergic effects such as urinary retention, dry mouth, reddening of the skin, tachycardia, inhibition of gastrointestinal motility and transient visual disturbances may occur, and Cheynes-Stokes respiration has been reported.

Therapy:

In the case of oral poisoning, gastric lavage with medicinal charcoal should be followed by magnesium sulfate (15%). Symptoms of Buscopan overdosage respond to parasympathomimetics. For patients with glaucoma, pilocarpine should be given locally. Cardiovascular complications should be treated according to usual therapeutic principles. In case of respiratory paralysis, intubation and artificial respiration should be considered. Catheterisation may be required for urinary retention.

In addition, appropriate supportive measures should be administered as required.

Pharmacodynamic properties

The information provided in Pharmacodynamic properties of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Pharmacodynamic properties in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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ATC code: A03BB01

Buscopan exerts a spasmolytic action on the smooth muscle of the gastrointestinal, biliary and genito-urinary tracts. As a quaternary ammonium derivative, hyoscine butylbromide does not enter the central nervous system. Therefore, anticholinergic side effects at the central nervous system do not occur. Peripheral anticholinergic action results from a ganglion-blocking action within the visceral wall as well as from an anti-muscarinic activity.

Pharmacokinetic properties

The information provided in Pharmacokinetic properties of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Pharmacokinetic properties in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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Absorption

As a quaternary ammonium compound, hyoscine butylbromide is highly polar and hence only partially absorbed following oral (8%) or rectal (3%) administration. After oral administration of single doses of hyoscine butylbromide in the range of 20 to 400 mg, mean peak plasma concentrations between 0.11 ng/mL and 2.04 ng/mL were found at approximately 2 hours. In the same dose range, the observed mean AUC0-tz-values varied from 0.37 to 10.7 ng h/mL. The median absolute bioavailabilities of different dosage forms, i.e. coated tablets, suppositories and oral solution, containing 100 mg of hyoscine butylbromide each were found to be less than 1%.

Distribution

Because of its high affinity for muscarinic receptors and nicotinic receptors, hyoscine butylbromide is mainly distributed on muscle cells of the abdominal and pelvic area as well as in the intramural ganglia of the abdominal organs. Plasma protein binding (albumin) of hyoscine butylbromide is approximately 4.4%. Animal studies demonstrate that hyoscine butylbromide does not pass the blood-brain barrier, but no clinical data to this effect is available. Hyoscine butylbromide (1 mM) has been observed to interact with the choline transport (1.4 nM) in epithelial cells of human placenta in vitro.

Metabolism and elimination

Following oral administration of single doses in the range of 100 to 400 mg, the terminal elimination half-lives ranged from 6.2 to 10.6 hours. The main metabolic pathway is the hydrolytic cleavage of the ester bond. Orally administered hyoscine butylbromide is excreted in the faeces and in the urine. Studies in man show that 2 to 5% of radioactive doses is eliminated renally after oral, and 0.7 to 1.6% after rectal administration. Approximately 90% of recovered radioactivity can be found in the faeces after oral administration. The urinary excretion of hyoscine butylbromide is less than 0.1% of the dose. The mean apparent oral clearances after oral doses of 100 to 400 mg range from 881 to 1420 L/min, whereas the corresponding volumes of distribution for the same range vary from 6.13 to 11.3 x 105 L, probably due to very low systemic availability. The metabolites excreted via the renal route bind poorly to the muscarinic receptors and are therefore not considered to contribute to the effect of the hyoscine butylbromide.

Preclinical safety data

The information provided in Preclinical safety data of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Preclinical safety data in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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In limited reproductive toxicity studies hyoscine butylbromide showed no evidence of teratogenicity in rats at 200 mg/kg in the diet or in rabbits at 200 mg/kg by oral gavage or 50 mg/kg by subcutaneous injection. Fertility in the rat was not impaired at doses of up to 200 mg/kg in the diet.

Incompatibilities

The information provided in Incompatibilities of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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None stated.

Special precautions for disposal and other handling

The information provided in Special precautions for disposal and other handling of Koscopan is based on data of another medicine with exactly the same composition as the Koscopan of the medicine (Hyoscine Butylbromide). Be careful and be sure to specify the information on the section Special precautions for disposal and other handling in the instructions to the drug Koscopan directly from the package or from the pharmacist at the pharmacy.
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None stated.

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