Indications
Glycopyrrolate (also called glycopyrronium) is an anticholinergic medicine. As an injection it is used around surgery to reduce saliva and airway secretions, to protect the heart from slowing during anaesthesia, and together with Neostigmine to reverse muscle relaxants at the end of an operation. As tablets it may be used to reduce severe drooling and, less often today, as an add-on treatment for peptic ulcer.
How It Works
It blocks acetylcholine, a chemical messenger that switches on glands and some smooth muscles. This reduces the production of saliva, sweat and stomach acid and prevents the heart rate from dropping too low. Because it hardly enters the brain, it causes fewer confusion problems than similar medicines such as Atropine.
Dosage and Administration
The injection is given into a vein or muscle by a doctor or anaesthetist, with the dose worked out for each patient. Tablets are taken as prescribed, usually on an empty stomach, about one hour before or two hours after meals. Do not change the dose yourself.
Interactions
- Other anticholinergic medicines, some antihistamines, tricyclic antidepressants and antipsychotics can add to dry mouth, constipation and urinary retention.
- It may change how some tablets are absorbed, such as Potassium Chloride tablets, which can irritate the gut more when gut movement slows.
- Tell your doctor about all medicines you take before surgery.
Contraindications
- Allergy to Glycopyrrolate.
- Narrow angle glaucoma.
- Blockage of the bowel or bladder outlet, severe ulcerative colitis or toxic megacolon.
- Myasthenia gravis (unless used with Neostigmine under specialist care).
Side Effects
Common effects include dry mouth, constipation, difficulty passing urine, blurred vision, reduced sweating, flushing and a faster heartbeat. Some people feel headache or drowsiness.
Get urgent medical help if you have a very fast or irregular heartbeat, cannot pass urine, have severe eye pain with blurred vision, signs of overheating, or swelling of the face, lips or throat or trouble breathing.
Pregnancy and Lactation
It is used during caesarean section and other surgery when the doctor considers it needed. For regular tablet use in pregnancy or breastfeeding, ask your doctor first, as information is limited and it may reduce milk flow.
Precautions and Warnings
- Use with care in heart disease, fast heart rhythm, high blood pressure, enlarged prostate, overactive thyroid, reflux and kidney disease.
- It reduces sweating, so avoid overheating in hot weather or during exercise.
- Blurred vision may affect driving.
Overdose
Too much can cause a very dry mouth, hot dry skin, fast heartbeat, high temperature, inability to pass urine and, rarely, restlessness. Seek emergency medical care straight away.
Therapeutic Class
Anticholinergic (antimuscarinic) agent.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.