2025 Guidelines for the Evaluation and Management of Adults With Congenital Heart Disease
December 19, 2025
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Brand Name :
Robinul, Cuvopsa, Robinul forte, Dartisla ODT, Glycate
Synonyms :
glycopyrrolate
Class :
Anticholinergics, antispasmodics
Brand Name :
Robinul, Cuvopsa, Robinul forte, Dartisla ODT, Glycate
Synonyms :
glycopyrrolate
Class :
Anticholinergics, antispasmodics
Dosage Forms & Strengths
Tablets
1mg- Robinul (generic)
2mg- Robinul forte (generic)
Oral disintegrating tablet
1.7mg- Dartisla ODT
Oral solution
1mg/5ml- CUvposa
Injectable solution
0.2mg/ml
Intravenous (IV)
0.2mg i.v./1 mg neostigmine or 0.2 mg i.v. per 5 mg of pyridostigmine
1
mg
Orally
3 times a day
Maximum dose: 8mg daily
To ensure symptom control throughout the night, some patients will need to take 2 mg before bed
0.1mg i.m or i.v, every four hours three to four times a day as required
Maximum dose: four doses a day
Chronic Obstructive Pulmonary Disease (COPD)
solution
Inhalation
Using the nebulization system, inhale the contents of the vial two times a day
Capsules for inhalation
using an inhaler, inhale the capsule contents twice daily
Preanesthetic
0.004mg/kg i.m. Half an hour to one hour before the expected introduction of anesthesia
Intraoperative
0.1mg intravenous, can repeat every 2-3min
Dosage Forms & Strengths
Tablets
1mg- Robinul (generic)
2mg- Robinul forte (generic)
Oral solution
1mg/5ml- Cuvposa
Injectable solution
0.2mg/ml
Preanesthetic 0.004mg/kg i.m. Half an hour to one hour before the expected introduction of anesthesia 0.009mg/kg may be required for infants of 1 month to 2 years of age Intraoperative 0.004mg intravenous, can repeat every 2-3min
For children aged 3 to 16 years:
1
mg/5ml
Initial dose: 0.002mg/kg, orally three times a day, atleast an hour before meals
0.2mg/neostigmine or per each 5mg of pyridostigmine
Refer to adult dosing
may have an increased anticholinergic effect when combined with glycopyrrolate
may have an increased anticholinergic effect when combined with glycopyrrolate
may have an increased anticholinergic effect when combined with glycopyrrolate
may have an increased anticholinergic effect when combined with glycopyrrolate
may have an increased anticholinergic effect when combined with glycopyrrolate
glycopyrrolate: they may increase the bradycardic effect of Bradycardia-Causing Agents
glycopyrrolate: they may increase the bradycardic effect of Bradycardia-Causing Agents
glycopyrrolate: they may increase the bradycardic effect of Bradycardia-Causing Agents
glycopyrrolate: they may increase the bradycardic effect of Bradycardia-Causing Agents
glycopyrrolate: they may increase the bradycardic effect of Bradycardia-Causing Agents
glycopyrrolate: they may increase the CNS depressant effect of CNS Depressants
glycopyrrolate: they may increase the CNS depressant effect of CNS Depressants
glycopyrrolate: they may increase the CNS depressant effect of CNS Depressants
glycopyrrolate: they may increase the CNS depressant effect of CNS Depressants
glycopyrrolate: they may increase the CNS depressant effect of CNS Depressants
glycopyrrolate: they may enhance the serum concentration of CYP2D6 Inhibitors
glycopyrrolate: they may enhance the serum concentration of CYP2D6 Inhibitors
glycopyrrolate: they may enhance the serum concentration of CYP2D6 Inhibitors
glycopyrrolate: they may enhance the serum concentration of CYP2D6 Inhibitors
glycopyrrolate: they may enhance the serum concentration of CYP2D6 Inhibitors
anticholinergic agents increase the anticholinergic effect of glycopyrrolate
anticholinergic agents increase the anticholinergic effect of glycopyrrolate
hydrocodone/chlorpheniramine/pseudoephedrine
may increase the CNS depressant activity of CNS depressants
may increase the anti-cholinergic effect
may increase the anti-cholinergic effect of anti-cholinergic agents
may increase the anticholinergic of anticholinergic agents
may increase the anticholinergic effect of anticholinergic agents
may increase the anticholinergic effect of anticholinergic agents
may increase the anticholinergic effect of Anticholinergic Agent
may increase the anticholinergic effect of Anticholinergic Agents
acetaminophen/doxylamine/dextromethorphan
may increase the anticholinergic effect of Anticholinergic Agents
it increases the concentration of metformin in the serum
may increase the anticholinergic effect of Anticholinergic Agents
may enhance the anticholinergic effect of Anticholinergic agents
Actions and spectrum:
The muscarinic antagonist glycopyrrolate has the most excellent affinity for M1 receptors, subsequent to M3/M2/M4 and M5.
Frequency not defined
Flushing
Palpitation
Cyclopedia
Dry skin
Dry mouth
Blurred vision
Photophobia
Urinary retention
Black Box Warning
Not listed
Contraindication/Caution:
Contraindication:
Hypersensitivity
Glaucoma
Pyloroduodenalstenosis
Achalasia
Intestinal atony
Myasthenia gravis
Caution:
Liver failure
Reflux esophagitis
Hyperthyroidism
Autonomic neuropathy
Ulcerative colitis
Pregnancy consideration:
USFDA pregnancy category: Not assigned
Lactation:
The excretion of glycopyrrolate into human milk is unknown.
Pregnancy category:
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus `in either the first or second trimester.
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology:
Pharmacodynamics:
Among the long-acting muscarinic antagonists that are most frequently prescribed is glycopyrrolate, a quaternary ammonium compound. Glycopyrrolate exhibited a prolonged duration of action due to its gradual dissociation from muscarinic receptors. Its therapeutic index is broader than that of other anticholinergic drugs, like tiotropium.
Pharmacokinetics:
Absorption
Glycopyrrolate undergoes rapid absorption through the intravenous route
It is absorbed incompletely in the gastrointestinal tract
Distribution
The volume of distribution:
Adults: 0.2 to 0.62 l/kg
Children: 1.3- 1.8l/kg
Metabolism
Undergoes metabolism mainly in the liver
Elimination and excretion
85% of the drug administered through the intravenous route is eliminated in the urine
Half-life:
33-53 hours
Administration:
Take the drug as prescribed by the physician
Patient information leaflet
Generic Name: glycopyrrolate
Why do we use glycopyrrolate?
An anticholinergic drug, glycopyrrolate, is used to treat COPD, severe drooling, ulcers, and COPD when combined with other drugs and anesthesia.
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