What is glycopyrrolate, and how does it work (mechanism of action)?
Glycopyrrolate is a synthetic anti-cholinergic
medication. Glycopyrrolate works by blocking acetylcholine activity on smooth
muscles and other tissues. Acetylcholine is neurotransmitter, a chemical that
nerves use for communicating. Blocking of acetylcholine leads to decrease in
volume and acidity of stomach secretions and decrease in pharyngeal, tracheal,
and bronchial secretions. It also reverses symptoms of excessive bronchial
secretions, bronchospasm, low heart rate, and intestinal hypermotility caused by
medications that increase the action of acetylcholine. The FDA approved
glycopyrrolate in August 1961.
What brand names are available for glycopyrrolate?
Robinul, Robinul Forte, Cuvposa, Glycate
Is glycopyrrolate available as a generic drug?
Yes
Do I need a prescription for glycopyrrolate?
Yes
What are the side effects of glycopyrrolate?
Common side effects of glycopyrrolate are:
- dry mouth,
- urinary retention,
- blurred vision,
- dilated pupils,
- increased heart rate,
- sweating,
- weakness,
- dizziness,
- dry skin,
- constipation,
- urinary retention, and
- mental confusion.
What is the dosage for glycopyrrolate?
Adults
- Preanesthetic medication: Inject 0.004 mg/kg intramuscularly or intravenously
30 to 60 minutes prior to surgery. - Intraoperative medication: Inject 0.1 mg as a single dose intravenously every
2 to 3 minutes as needed. - Reversal of neuromuscular blockade: Inject 0.2 mg for each 1 mg of
neostigmine or 5 mg of pyridostigmine given. - Peptic ulcer: Inject 0.1 mg intramuscularly or intravenously at 4-hour
intervals, up to 3 to 4 times daily. May increase to 0.2 mg if needed.
Children
- Preanesthetic medication (children over 2 years of age): Inject 0.004 mg/kg
intramuscularly, given 30 to 60 minutes prior to anesthesia, narcotic, or
sedative. - Preanesthetic medication (Infants of 1 month to 2 years of age): Inject up to
0.009 mg/kg. - Intraoperative medication: Inject 0.004 mg/kg as single dose intravenously
every 2 to 3 minutes as needed. Do not exceed 0.1 mg in a single dose. - Reversal of neuromuscular blockade: Inject 0.2 mg for each 1 mg of
neostigmine or 5 mg of pyridostigmine given.
Glycopyrrolate Injection is not recommended for the treatment of peptic ulcer
in pediatric patients.
Which drugs or supplements interact with glycopyrrolate?
Glycopyrrolate should not be used with anti-cholinergic
drugs such as phenothiazines, Parkinson’s drugs, or
tricyclic antidepressants
because it can significantly increase anticholinergic side effects like
mydriasis (pupil dilation),
high blood pressure (hypertension), flushing, fever, and increased heart
rate.
Glycopyrrolate should be used with caution with potassium chloride because
concomitant use can decrease bowel movement and can cause irritation or lesions
in the stomach and intestine.
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Is glycopyrrolate safe to take if I’m pregnant or breastfeeding?
There are no adequate studies done on glycopyrrolate to determine
safe and effective use in
pregnant women. It has been shown that small amounts
of glycopyrrolate will pass the placental barrier.
It is not known whether glycopyrrolate enters
breast milk;
therefore, it is best to be cautious before using it in nursing mothers. Anticholinergics may cause suppression of lactation.
What else should I know about glycopyrrolate?
What preparations of glycopyrrolate are available?
Glycopyrrolate injection is available in 0.2 mg/ml strength in
1 ml and 2 ml single-use vials. It is also available in 5 ml and 20 ml multi-use
vials. All vials contain benzyl alcohol 0.9% as preservative.
How should I keep glycopyrrolate stored?
Store Glycopyrrolate injection at room temperature between 20 C and
25 C (68 F and 77 F).