Action and Spectrum

Actions and Spectrum: 

scopolamine is a medication that belongs to the class of drugs called anticholinergics. It has a broad spectrum of actions and treats various conditions. 

• Motion sickness: scopolamine is a highly effective medication for preventing and treating motion sickness. It works by blocking the action of acetylcholine, a neurotransmitter involved in regulating balance and motion. 
• Nausea and vomiting: scopolamine is used to treat nausea and vomiting caused by various conditions, including motion sickness, chemotherapy, and postoperative nausea and vomiting. 
• Antispasmodic: scopolamine is also used as an antispasmodic medication to treat various conditions, including gastrointestinal spasms, urinary incontinence, and muscle spasms associated with Parkinson’s disease. 
• Anesthesia: scopolamine is sometimes used with other medications to produce anesthesia for surgery. 
• Memory impairment: scopolamine has been shown to cause temporary memory impairment, which has led to its use in research studies exploring the neurobiology of memory. 

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Dry mouth  

Drowsiness  

Dizziness  

Blurred vision  

Frequency not defined 

Disorientation 

Confusion 

Pruritus and edema 

Pupil dilation 

Anticholinergic effects  

Withdrawal symptoms 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

scopolamine has several contraindications and cautions that must be considered before prescribing or using the medication. These include: 

• Hypersensitivity: scopolamine is contraindicated in patients with a known hypersensitivity to the medication or to any of its components. 
• Narrow-angle glaucoma: scopolamine is contraindicated in patients with narrow-angle glaucoma, a type of glaucoma in which the drainage angle between the iris and the cornea is narrow, which can cause a sudden increase in intraocular pressure. 
• Gastrointestinal obstruction: scopolamine is contraindicated in patients with gastrointestinal obstruction, a condition in which the normal movement of food through the digestive tract is blocked. 
• Myasthenia gravis: scopolamine should be used with caution in patients with myasthenia gravis, a neuromuscular disorder that causes muscle weakness and fatigue. 
• Urinary retention: scopolamine should be used cautiously in patients with urinary retention, a condition in which the bladder cannot empty. 
• Elderly patients: scopolamine should be used cautiously in elderly patients, as they may be more sensitive to the medication and experience more side effects, such as confusion and memory impairment. 
• Pregnancy and breastfeeding: scopolamine should be used with caution in pregnant and breastfeeding women, as the medication may cross the placenta and enter breast milk. 

Pregnancy / Lactation

Pregnancy consideration:  

scopolamine should not be used in pregnant females if they are suffering from preeclampsia  

Breastfeeding warnings: no scientific data available for the effect of scopolamine on lactating females  

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: There is no affirmation of risk to the fetus found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a product in humans; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh risks over benefits. The drug is not for pregnant women. 
• Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

scopolamine is an anticholinergic medication that blocks the action of acetylcholine, a neurotransmitter that is involved in the regulation of various physiological processes in the body. Scopolamine acts on muscarinic receptors, which are found in various organs, including the brain, eyes, heart, lungs, gastrointestinal tract, and bladder. 

• Central nervous system: scopolamine acts on muscarinic receptors in the brain, where it has several effects, including sedation, amnesia, and anxiolysis. It can also cause temporary memory impairment, which has led to its use in research studies exploring the neurobiology of memory. 
• Gastrointestinal tract: scopolamine acts on muscarinic receptors in the gastrointestinal tract, where it has antispasmodic effects, reducing the frequency and intensity of gastrointestinal contractions. This action can be useful in the treatment of gastrointestinal spasms and in the prevention of nausea and vomiting associated with various conditions. 
• Eyes: scopolamine acts on muscarinic receptors in the eyes, where it has several effects, including dilation of the pupils (mydriasis) and paralysis of the ciliary muscle, which causes accommodation to be impaired. These effects can be useful in ophthalmic examinations and procedures. 
• Cardiovascular system: scopolamine acts on muscarinic receptors in the cardiovascular system, where it can cause tachycardia (increased heart rate) and mild vasodilation. 
• Respiratory system: scopolamine acts on muscarinic receptors in the respiratory system, where it can cause bronchodilation and a reduction in bronchial secretions. 

Pharmacodynamics: 

scopolamine is an anticholinergic drug that acts by inhibiting the binding of acetylcholine to muscarinic receptors in the body. This results in various pharmacodynamic effects, including: 

• Central nervous system effects: scopolamine is known to produce sedation, amnesia, and anxiolysis by blocking muscarinic receptors in the brain. It also affects the reticular activating system in the brainstem, leading to a decrease in wakefulness and an increase in sleep. 
• Gastrointestinal effects: scopolamine inhibits the muscarinic receptors in the gastrointestinal tract, leading to a decrease in gastric and intestinal motility, and a reduction in gastrointestinal secretions. This results in an antispasmodic effect that can be useful in the treatment of gastrointestinal spasms. 
• Ophthalmic effects: scopolamine blocks muscarinic receptors in the eye, leading to dilation of the pupil (mydriasis) and a reduction in the ability of the eye to focus on near objects (cycloplegia). This is useful in ophthalmic procedures and examinations. 
• Cardiovascular effects: scopolamine can cause mild vasodilation and tachycardia (increased heart rate) due to its effect on muscarinic receptors in the cardiovascular system. 
• Respiratory effects: scopolamine can cause bronchodilation and a reduction in bronchial secretions by blocking muscarinic receptors in the respiratory system. 

Pharmacokinetics: 

Absorption 

Onset of action for intramuscular administration is 0.5-1 hr and for intravenous infusion is 10 min 

Duration of action for intramuscular administration is 4-6 hours and for intravenous administration is 2 hours 

Peak plasma concentration is achieved in 24 hours (transdermal) 

Distribution 

The volume of distribution of intravenous scopolamine is 141.3 ± 1.6 L. 

Metabolism 

The drug is metabolized in the liver by conjugation 

Elimination and Excretion 

The half-life is 9.5 hours 

The drug is primarily excreted in urine, 90% in the form of metabolites 

Adminstartion

Administration: 

scopolamine can be administered through various routes depending on the indication and the desired effect. These routes include: 

• Oral: scopolamine is available in tablet and liquid form for oral administration. When taken orally, the medication is absorbed from the gastrointestinal tract and enters the bloodstream. 
• Transdermal: scopolamine is available in a transdermal patch that can be applied to the skin behind the ear. The medication is slowly released through the skin and enters the bloodstream, providing a prolonged effect. 
• Intravenous: scopolamine can be administered intravenously for rapid onset of action in emergency situations or in surgical procedures. 
• Intramuscular or subcutaneous: scopolamine can be administered via injection into a muscle or under the skin for rapid onset of action. 

The route of administration and the dose of scopolamine depend on the indication and the patient’s age and medical condition. scopolamine should be used with caution in elderly patients, as they may be more sensitive to the medication and may experience more side effects.

Patients should be advised to avoid activities that require mental alertness, such as driving or operating heavy machinery, after taking scopolamine. It is important to follow the instructions of a healthcare provider when taking scopolamine to avoid any adverse effects. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: scopolamine 

Pronounced: sco-pol-am-ine 

Why do we use scopolamine? 

scopolamine is a medication that belongs to a class of drugs called anticholinergics. It primarily treats motion sickness, nausea, vomiting, and dizziness associated with inner ear problems. 

scopolamine is also used in some medical procedures, such as surgeries, to prevent excessive salivation and respiratory secretions. In addition, it can be used as a pre-anesthetic medication to reduce anxiety and induce sedation before surgery. 

Furthermore, scopolamine has been used recreationally as a “date rape drug” because it can cause sedation, confusion, and memory loss when mixed with alcohol or other drugs. However, this use is illegal and highly dangerous. 

It is important to note that scopolamine can have serious side effects and should only be used under the guidance of a healthcare professional.