What is the dosage and use of Hyoscyamine for gastrointestinal disorders?

From the Guidelines

Hyoscyamine is recommended for the treatment of gastrointestinal disorders, such as irritable bowel syndrome, at a dosage of 0.125 to 0.25 mg every 4 hours as needed, due to its ability to reduce abdominal pain and improve global relief of IBS symptoms, as suggested by the AGA clinical practice guideline 1. The medication works by relaxing smooth muscles in the digestive tract, reducing cramping, pain, and excessive motility.

• Key benefits of hyoscyamine include:
  • Reduction of abdominal pain associated with IBS
  • Improvement in global relief of IBS symptoms
  • Relief from painful spasms and associated symptoms
• Important considerations for hyoscyamine use:
  • Common side effects: dry mouth, blurred vision, and urinary retention
  • Contraindications: glaucoma, myasthenia gravis, gastrointestinal obstruction, and certain urinary conditions
  • Elderly patients may require lower doses due to increased sensitivity to anticholinergic effects
  • Patients should avoid alcohol while taking hyoscyamine to minimize drowsiness The AGA suggests using antispasmodics, such as hyoscyamine, in patients with IBS, although the certainty in evidence is low due to the serious risk of bias and publication bias 1.
• Extended-release formulations of hyoscyamine are available at 0.375 mg taken twice daily, and the medication should be taken 30-60 minutes before meals for best effect. Overall, hyoscyamine can be a useful treatment option for patients with gastrointestinal disorders, such as IBS, when used appropriately and under medical supervision 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION HYOSYNE ORAL DROPS (Hyoscyamine Sulfate Oral Solution) Dosage may be adjusted according to the conditions and severity of symptoms. Measuredosage very carefully. Adults and pediatric patients 12 years of age and older: 1 to 2 mL every four hours or as needed. Do not exceed 12 mL in 24 hours Pediatric patients 2 to under 12 years of age: 1/4 to 1 mL every four hours or as needed. Do not exceed 6 mL in 24 hours. HYOSYNE ELIXIR (Hyoscyamine Sulfate Elixir)Dosage may be adjusted according to the conditions and severity of symptoms. Measure dosage very carefully. Adults and pediatric patients 12 years of age and older: 1 to 2 teaspoonfuls every four hours or as needed. Do not exceed 12 teaspoonfuls in 24 hours

The dosage of Hyoscyamine for gastrointestinal disorders is as follows:

• Adults and pediatric patients 12 years of age and older:
  • 1 to 2 mL of oral drops every four hours or as needed, not exceeding 12 mL in 24 hours
  • 1 to 2 teaspoonfuls of elixir every four hours or as needed, not exceeding 12 teaspoonfuls in 24 hours
• Pediatric patients 2 to under 12 years of age:
  • 1/4 to 1 mL of oral drops every four hours or as needed, not exceeding 6 mL in 24 hours
  • dosage of elixir is based on body weight, with a maximum of 6 teaspoonfuls in 24 hours 2 The use of Hyoscyamine is for the treatment of gastrointestinal disorders, with dosage adjustments according to the conditions and severity of symptoms.

From the Research

Dosage and Use of Hyoscyamine for Gastrointestinal Disorders

• The dosage of hyoscyamine for gastrointestinal disorders varies depending on the specific condition being treated and the route of administration.
• In a study published in 1993, patients undergoing barium enema examinations were randomly assigned to receive either 0.125 mg or 0.25 mg of oral hyoscyamine sulfate, with results showing that both doses were effective in reducing abdominal discomfort 3.
• Another study published in 1999 found that premedication with 0.5 mg of intravenous hyoscyamine sulfate was beneficial in terms of reducing cecal intubation time, total procedure time, and improving patient comfort during colonoscopy 4.
• Hyoscyamine is used to treat various gastrointestinal disorders, including irritable bowel syndrome (IBS), functional dyspepsia, and abdominal cramping and pain.
• According to a review article published in 2006, hyoscyamine is one of the myorelaxants available in the United States for the treatment of IBS-associated pain, although its efficacy has not been proven 5.
• A more recent review article published in 2021 examined the efficacy and safety of antispasmodics, including hyoscyamine, for the treatment of chronic abdominal pain in patients with disorders of gut-brain interaction, and found that the agents evaluated varied dramatically in efficacy and safety 6.

Efficacy and Safety of Hyoscyamine

• The efficacy and safety of hyoscyamine have been evaluated in several studies, with results showing that it is generally well tolerated and effective in reducing abdominal discomfort and pain.
• However, the high frequency of sinus tachycardia seen with the dose used in one study indicates the need for further study before the drug can be recommended as a routine premedication for colonoscopy 4.
• Hyoscyamine is considered a valuable treatment option for patients with symptoms of abdominal pain or discomfort associated with cramping, with a low incidence of adverse events reported 7.