Glycopyrronium bromide
Brand names: Robinul, Sialanar, Cuvposa
Glycopyrronium bromide is an antimuscarinic (anticholinergic) agent used in anaesthesia to dry secretions, prevent bradycardia, and, in combination with anticholinesterases, to counter their muscarinic effects during reversal of neuromuscular blockade.
The product information we hold does not support a dose for this page's specific use, route or population, so none is shown. Follow your local or national guideline, and confirm against the product SmPC.
Clinical monograph
How it works
It competitively blocks muscarinic acetylcholine receptors, reducing salivary and bronchial secretions and increasing heart rate by opposing vagal tone; as a quaternary ammonium compound it does not readily cross the blood-brain barrier.
Prescribing in practice
- Its vagolytic effect produces tachycardia, so use cautiously in patients with cardiovascular disease where an increased heart rate is undesirable.
- Avoid in conditions worsened by antimuscarinic action such as untreated narrow-angle glaucoma, significant bladder outflow obstruction and gastrointestinal obstruction.
- Because it poorly penetrates the central nervous system, it causes less central antimuscarinic effect than tertiary agents such as atropine.
Monitoring
Monitor heart rate and rhythm during administration in the perioperative setting.
Counselling the patient
- Team: expect tachycardia and reduced secretions following administration.
- Patient: a dry mouth and blurred vision may occur transiently.
Evidence & guidelines
Its use as an antisialagogue and as a co-agent with neostigmine to limit muscarinic effects during reversal is well-established anaesthetic practice.
Reference: SPC palliative; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.
