Antispasmodic (Anticholinergic) Pregnancy: Limited data in pregnant women; as a precautionary measure not recommended during pregnancy. Insufficient information on excretion in human milk and a risk to the breastfed child cannot be excluded; use during breastfeeding is not recommended.

Hyoscine Butylbromide

Brand names: Buscopan

Hyoscine butylbromide is an antimuscarinic antispasmodic used for abdominal or genitourinary smooth-muscle spasm (e.g. in irritable bowel syndrome or colic) and for secretions in palliative care.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 20 mg (2 x 10 mg tablets)

Route: Oral

Frequency: Four times daily

SPC for the 10 mg coated tablet. Adults: 2 tablets (20 mg) four times daily. For symptomatic relief of Irritable Bowel Syndrome, the recommended starting dose is 1 tablet (10 mg) three times daily, which can be increased up to 2 tablets four times daily if necessary. Swallow whole with adequate water. Should not be taken on a continuous daily basis or for extended periods without investigating the cause of abdominal pain. Children 6-12 years: 1 tablet (10 mg) three times daily. No specific dosage information in the elderly; no age-specific adverse reactions reported in patients over 65 in clinical trials.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Prior hypersensitivity to hyoscine butylbromide or any component of the product
Myasthenia gravis
Mechanical stenosis in the gastrointestinal tract
Paralytic or obstructive ileus
Megacolon
Narrow angle glaucoma

Side effects

Tachycardia (uncommon)
Dry mouth (uncommon)
Skin reactions e.g. urticaria, pruritus; abnormal sweating (uncommon)
Urinary retention (rare)
Anaphylactic shock, anaphylactic reactions, dyspnoea, other hypersensitivity (not known)

Interactions

Tri- and tetracyclic antidepressants, antihistamines, quinidine, amantadine, antipsychotics (e.g. butyrophenones, phenothiazines), disopyramide and other anticholinergics (e.g. tiotropium, ipratropium, atropine-like compounds): anticholinergic effect may be intensified
Dopamine antagonists such as metoclopramide: concomitant use may diminish the effects of both drugs on the gastrointestinal tract
Beta-adrenergic agents: their tachycardic effects may be enhanced

Clinical monograph

How it works

It blocks muscarinic receptors on smooth muscle, relaxing spasm; it crosses the blood-brain barrier poorly, so central effects are limited.

Prescribing in practice

Given intravenously it can cause serious tachycardia and hypotension — use caution and have monitoring in patients with cardiac disease (MHRA).
Antimuscarinic cautions apply — avoid in narrow-angle glaucoma, significant bladder-outflow obstruction and gastrointestinal obstruction.
Oral absorption is low, so the oral form mainly acts locally in the gut.

Monitoring

For intravenous use, monitor heart rate and blood pressure, especially in cardiac disease.

Counselling the patient

It can cause dry mouth and blurred vision.
Report difficulty passing urine or eye pain.

Evidence & guidelines

An antispasmodic for smooth-muscle colic and for secretions in palliative care, with an MHRA caution about intravenous use in cardiac disease.

Reference: NICE CG61 IBS; SPC Buscopan; NICE Palliative Care Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Drugs

Dicycloverine Hydrochloride (Dicyclomine) · Antispasmodic (Anticholinergic)

Pathways