From the Guidelines
Buscopan (hyoscine butylbromide) is a recommended antispasmodic medication for relieving abdominal pain and cramping in patients with irritable bowel syndrome (IBS), as it has been shown to reduce global symptoms and abdominal pain in clinical trials. The medication works by blocking the action of acetylcholine on muscarinic receptors in the smooth muscle of the gut, thereby reducing muscle contractions and relieving pain 1. According to the AGA clinical practice guideline on the pharmacological management of IBS, antispasmodics, including hyoscine butylbromide, are suggested for use in patients with IBS, although the certainty in evidence is low due to the risk of bias and publication bias 1.
Key Points
- Buscopan is commonly prescribed for conditions such as IBS, menstrual cramps, and intestinal colic
- The typical adult dose is 10-20 mg taken up to four times daily, preferably 30 minutes before meals
- Common side effects may include dry mouth, blurred vision, and constipation
- Buscopan should be used with caution in patients with glaucoma, prostatic hypertrophy, or urinary retention due to its anticholinergic properties
Evidence Summary
A Cochrane Review included 22 RCTs evaluating 2983 patients with IBS, and found that antispasmodics, including hyoscine butylbromide, were associated with a significantly greater proportion of patients having adequate global relief of IBS symptoms (RR, 0.67; 95% CI, 0.55–0.80) and improvement in abdominal pain (RR, 0.74; 95% CI, 0.59–0.93) compared to placebo 1. However, the overall certainty in evidence was low due to the serious risk of bias and publication bias. The British Society of Gastroenterology guidelines also support the use of antispasmodics, including hyoscine butylbromide, in the management of IBS, citing a meta-analysis of 26 RCTs that found antispasmodics to be effective in reducing global symptoms and abdominal pain 1.
From the Research
Role of Buscopan (Hyoscine butylbromide)
- Buscopan is an antimuscarinic agent used to induce smooth muscle relaxation and reduce spasmodic activity of the gastrointestinal (GI) tract during endoscopic procedures 2.
- It is commonly used as an anticholinergic antispasmodic for the treatment of abdominal cramping or visceral pain associated with cramps 3.
- Buscopan has been shown to be effective in treating acute renal colic, with 72.7% of patients showing significant improvement after 1 hour 4.
- It is also used as an aid in abdominal diagnostic and therapeutic procedures, such as radiological imaging and endoscopy, to reduce motion artefacts and improve diagnostic image quality 5.
Clinical Applications
- Buscopan is used to treat biliary and renal colic, and acute spasm in the genito-urinary tract 5.
- It is also used to support diagnostic and therapeutic abdominal procedures, such as double-contrast barium and computed tomographic colonography studies, and magnetic resonance imaging 5.
- Buscopan has been shown to shorten total labour duration, relieve pain, and reduce GI secretions in terminal cancer patients with inoperable bowel obstruction 5.
Safety Profile
- Parenteral administration of Buscopan is associated with mild and self-limiting adverse events, typical for anticholinergic drugs 5.
- Buscopan should be used with caution in patients with cardiac comorbidities, as it is contraindicated in patients with tachycardia, angina, and cardiac failure 2.
- It should also be used cautiously in patients with prostatic hypertrophy with urinary retention, and only when the potential benefits of its use outweigh the potential risks in a particular case 2.