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
  • 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

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

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

Common

Pharmacology

  • Half-life: 0.83h
  • Metabolism: Unknown
  • Excretion: Urine 85%, bile

Mechanism of Action

  • Antagonizes acetylcholine receptors.

Comments

See Also

References