Recommended Dosing of Buscopan (Hyoscine butylbromide) for Abdominal Cramps and Spasms
For adults and children 12 years and older, the recommended dose of Buscopan (Hyoscine butylbromide) is 1-2 tablets (10-20 mg) every four hours as needed, not exceeding 12 tablets (120 mg) in 24 hours. 1
Dosage Guidelines
- For adults and pediatric patients 12 years and older: 1-2 tablets (10-20 mg) every four hours as needed, with a maximum of 12 tablets in 24 hours 1
- For pediatric patients 2 to under 12 years of age: ½ to 1 tablet (5-10 mg) every four hours as needed, with a maximum of 6 tablets in 24 hours 1
- Tablets may be taken sublingually, orally, or chewed 1
Mechanism of Action
- Buscopan (Hyoscine butylbromide) is an antispasmodic drug with high affinity for muscarinic receptors located on smooth muscle cells of the gastrointestinal tract 2
- Its anticholinergic action exerts a smooth-muscle relaxing/spasmolytic effect, which is the basis for its use in treating abdominal pain secondary to cramping 2
- Buscopan also binds to nicotinic receptors, inducing a ganglion-blocking effect that may contribute to its spasmolytic activity 3
Pharmacokinetics
- Hyoscine butylbromide has low systemic availability after oral administration, with plasma concentrations generally below the limit of quantitation 2
- The bioavailability is generally <1% as estimated from renal excretion 2
- Despite low systemic availability, its high tissue affinity for muscarinic receptors allows it to remain available at the site of action in the intestine and exert a local spasmolytic effect 2
Clinical Efficacy
- Buscopan has been shown to be effective in treating abdominal pain caused by cramping in multiple placebo-controlled studies 2
- It produces a significant reduction in pain scores among patients with irritable bowel syndrome with predominant diarrhea (IBS-D) 4
- Research suggests that the clinical benefits of Buscopan may relate more to effects on visceral sensation than motility 4
- In a randomized controlled trial, parenteral Buscopan 20 mg was not inferior to anisodamine in pain relief for patients with acute gastric or intestinal spasm-like pain 5
Safety Profile
- Buscopan is generally well tolerated due to its minimal absorption and inability to penetrate the blood-brain barrier 2
- Common side effects include dry mouth, thirst, and visual disturbances 5, 6
- No significant increases in the incidence of anticholinergic-related adverse effects have been observed in clinical trials 2
Clinical Considerations
- Antispasmodics like Buscopan are among the most frequently used over-the-counter treatments for irritable bowel syndrome (IBS) 6
- The British Society of Gastroenterology guidelines note that certain antispasmodics may be effective for global symptoms and abdominal pain in IBS, though the quality of evidence is very low 6
- When using antispasmodics for IBS, patients should be warned about potential side effects such as dry mouth, visual disturbance, and dizziness 6