From the FDA Drug Label
Hyoscyamine sulfate is indicated along with morphine or other narcotics in symptomatic relief of biliary and renal colic The medication hyoscyamine can be used to treat sphincter of Oddi dysfunction, as it is indicated for symptomatic relief of biliary colic 1.
- Key points:
- Hyoscyamine is used as adjunctive therapy
- It is used in combination with morphine or other narcotics
- The goal is symptomatic relief of biliary colic, which is related to sphincter of Oddi dysfunction.
From the Research
Sphincter of Oddi dysfunction is typically treated with medications that relax the sphincter muscle and reduce spasms, with nifedipine being a commonly prescribed calcium channel blocker at doses of 10-20 mg taken 30-60 minutes before meals. The primary medications used are smooth muscle relaxants, particularly anticholinergics and calcium channel blockers.
- Nifedipine, a calcium channel blocker, helps relax the sphincter by blocking calcium influx into smooth muscle cells 2.
- Hyoscyamine (Levsin), an anticholinergic, may be used at 0.125-0.25 mg doses taken 30 minutes before meals to reduce spasms by blocking acetylcholine's effect on the sphincter.
- For pain management, antispasmodics like dicyclomine (Bentyl) at 10-20 mg three to four times daily can be effective.
- Some patients benefit from tricyclic antidepressants like amitriptyline at low doses (10-25 mg at bedtime), which can help with visceral hypersensitivity. Treatment typically continues for several weeks to months, with dosage adjustments based on symptom response.
- These medications work by decreasing the tone and contractility of the sphincter of Oddi, thereby improving bile and pancreatic juice flow and reducing pain 3. If medications fail to provide relief, endoscopic sphincterotomy may be considered as a next step in management.
- However, the use of non-invasive investigations and medical therapy should be prioritized, especially for Type II and III Sphincter of Oddi dysfunction, due to the risks associated with endoscopic sphincterotomy 3.