Glycopyrrolate
Administration
- Class: Anticholinergics
- Routes of Administration: Oral, IV, IM
- Dosage Forms: 1-2 mg tablets, 1 mg/5mL oral solution, 0.2 mg/mL injectable solution
- Common Trade Names: Robinul, Cuvposa
Adult Dosing
- PUD, adjunct tx
- PO Dose: 1-2 mg PO bid-tid;
- Start: 1 mg PO tid
- Max: 8 mg/day
- IM/IV Dose: 0.1-0.2 mg IM/IV tid-QID
- Max: 0.8 mg/day
- Space dose 4h apart
- PO Dose: 1-2 mg PO bid-tid;
- Antisialagogue
- PO Dose: 1-2 mg PO bid-tid;
- Max: 8 mg/day
- Parenteral Dose: 0.1-0.2 mg SC/IM/IV q4-8h PRN
- Max: 0.8 mg/day
- PO Dose: 1-2 mg PO bid-tid;
Pediatric Dosing
- Antisialagogue
- PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h PRN
- Max: 1-2 mg/dose, 8mg/day
- Parenteral Dose, 2+ yo: 0.0004-0.01 mg/kg SC/IM/IV q4-8h PRN
- Max: 0.1-0.2 mg/dose, 0.8 mg/day
- PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h PRN
Special Populations
- Pregnancy Rating: B; No known risk of teratogenicity with INJ form at 5x MRHD and with PO form at 320x MRHD
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult: Not defined; consider decreased dose.
- Pediatric: No defined; consider decreased dose.
Hepatic Dosing
- Adult: Not defined.
- Pediatric: Not defined.
Contraindications
- Allergy to class/drug
- Neonates (benzyl alcohol-containing INJ forms)
- Glaucoma, angle-closure
- Obstructive uropathy
- GI Obstruction
- Paralytic ileus
- Toxic megacolon
- Ulcerative colitis, severe
- Intestinal atony in elderly, debilitated pts
- Myasthenia gravis
- Acute hemorrhage with unstable cardiovascular status
- Caution if CAD
- Caution if HTN
- Caution if CHF
- Caution if arrhythmia
- Caution in elderly/debilitated pts
- Caution if renal impairment
- Caution if pulmonary disease
- Caution if hyperthyroidism
- Caution if autonomic neuropathy
- Caution if BPH
- Caution if high environmental temperature
- Caution if febrile
- Caution if ulcerative colitis
- Caution if hiatal hernia with reflux esophagitis
Adverse Reactions
Serious
- Hypersensitivity reaction
- Anaphylaxis
- Intestinal obstruction
- Heat stroke
- Seizure
- Arrhythmia
- Cardiac arrest
- Respiratory arrest
Common
- Xerostomia
- Vomiting
- Constipation
- Flushing
- Headache
- Urinary retention
- Urinary hesitancy
- Blurred vision
- Palpation
- Tachycardia
- Anhidrosis
- Dysgeusia
- Lactation suppression
Pharmacology
- Half-life: 0.83h
- Metabolism: Unknown
- Excretion: Urine 85%, bile
Mechanism of Action
- Antagonizes acetylcholine receptors.