Scopolamine

Scopolamine is a prescription drug used in adults for prevention of nausea and vomiting.

• Scopolamine is available under the following different brand names: Transderm Scop, Scopace, and Maldemar.

Transdermal patch

• 1 mg/75 hour

Dosage Considerations – Should be Given as Follows:

• May cause withdrawal symptoms if used longer than 3 days

Nausea and Vomiting Treatment

• 0.3-0.65 mg intravenously/intramuscular/subcutaneous; repeat every 6-8 hours if necessary

Motion Sickness

Prophylaxis

• Apply 1 patch behind the ear at least 4-12 hours before (preferably 12 hours) before an anticipated exposure to motion, then every 3 days as needed

Nausea and vomiting associated with anesthesia

• Apply 1 patch behind the ear on the night before the scheduled surgery, then leave on for 24 hours after surgery
• Cesarean section: Apply 1 patch behind the ear 1 hour before surgery (to minimize newborn exposure, apply no sooner); remove 24 hours after surgery

Chemotherapy-induced nausea and vomiting (off label)

• Apply 1 patch every 72 hours

Pediatric

• Safety and efficacy not established

Side effects of scopolamine include:

• dry mouth
• sleepiness
• urinary retention
• agitation
• dilated pupils
• sore throat
• drowsiness
• dizziness
• blurred vision
• disorientation
• confusion
• itching and swelling at the application site
• anticholinergic effects (dry mouth, blurred vision, constipation, dizziness, difficulty urinating)
• withdrawal symptoms (dizziness, nausea, and vomiting) if used over 3 days

Postmarketing side effects include:

• acute psychosis with hallucinations, disorientation, and paranoia
• headache
• amnesia
• coordination abnormalities
• speech disorder
• disturbance in attention
• restlessness
• application site burning
• dry eyes
• itchy eyes
• angle-closure glaucoma
• lazy eye
• eyelid irritation
• rash
• skin irritation
• reddening of the skin
• pain or difficulty urinating
• spinning sensation (vertigo)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Scopolamine has no known severe interactions with other drugs.
• Serious interactions of scopolamine include:
  • pramlintide
• Scopolamine has moderate interactions with 108 different drugs.
• Mild interactions of scopolamine include:
  • dimenhydrinate
  • donepezil
  • galantamine
  • levodopa
  • tacrine

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains scopolamine. Do not take Transderm Scop, Scopace, or Maldemar if you are allergic to scopolamine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity to scopolamine, belladonna alkaloids, or any component in the formulation
• Closed-angle glaucoma

Effects of Drug Abuse

• May cause withdrawal symptoms if used longer than 3 days

Short-Term Effects

• May cause central nervous system depression; caution when operating heavy machinery or tasks which require mental alertness
• See "What Are Side Effects Associated with Using Scopolamine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Scopolamine?"

Cautions

• Use caution in patients with open-angle glaucoma, benign prostatic hyperplasia, history of seizures or psychosis, ulcerative colitis, high blood pressure (hypertension), hyperthyroidism, Down syndrome, toxin-mediated diarrhea, coronary artery disease, fast heart rate (tachyarrhythmia), brain damage, or spastic paralysis in children, cardiac conduction disorder, and chronic heart failure
• Children and elderly persons are particularly susceptible to side effects of belladonna alkaloids
• Severe allergic reaction (anaphylaxis), including episodes of shock, reported, following parenteral administration; monitor for signs and symptoms of hypersensitivity reactions
• Lower doses may increase vagal tone and cause paradoxical slow heart rate (bradycardia)
• May cause central nervous system depression; caution when operating heavy machinery or tasks which require mental alertness
• Patients may experience idiosyncratic toxic psychosis, agitation, delusions, confusion, hallucinations, paranoid behavior, and rambling speech
• Discontinue if the patient experiences unusual visual disturbances or pain within the eye
• In patients with Parkinson's disease, or abrupt discontinuation of large doses may result in adverse effects, including headache, nausea, vomiting, and dizziness; withdrawal symptoms may also appear more than 24 hours after removing the transdermal patch
• The drug interferes with gastric secretion test

Pregnancy and Lactation

• Use scopolamine during pregnancy with caution if benefits outweigh risks
• Animal studies show risk and human studies are not available, or neither animal nor human studies were done
• Scopolamine is distributed into breast milk; use caution if breastfeeding