Hyoscine N-Butylbromide Dosing in a 14-Year-Old
For a 14-year-old patient, administer 10 mg of hyoscine N-butylbromide intravenously or intramuscularly, which can be repeated up to a maximum of 20 mg per dose if needed, based on the adult dosing regimen that applies to adolescents aged 12 years and older.
Age-Appropriate Dosing Framework
- Adolescents aged 12 years and older should receive adult dosing of hyoscine N-butylbromide, which is 10-20 mg intravenously or intramuscularly 1
- The standard adult dose is 20 mg IV, though lower doses (10 mg) are effective for many indications and reduce the risk of anticholinergic side effects 2
- A 14-year-old falls into the adolescent category where adult dosing protocols apply, as pediatric restrictions typically apply only to children under 6-12 years of age 1
Clinical Context and Indication-Specific Considerations
For Gastrointestinal Spasm or Abdominal Pain
- Start with 10 mg IV/IM and assess response before considering a second dose 1
- The drug has demonstrated efficacy comparable to paracetamol in pediatric abdominal cramps in randomized controlled trials 1
- Maximum single dose should not exceed 20 mg 2
For Diagnostic Procedures (Endoscopy, Imaging)
- 20 mg IV is the standard dose for colonoscopy and upper GI procedures to achieve adequate smooth muscle relaxation 3, 2
- Administer at the time of cecal intubation during colonoscopy or at the start of the procedure for upper GI studies 3
- Lower doses (5-10 mg) provide inadequate gastroduodenal distension and are not recommended for diagnostic imaging 2
Safety Profile in Adolescents
- Hyoscine N-butylbromide has an excellent safety record in children and adolescents, with data from thousands of patients showing no significant safety concerns 1
- The most common side effect is transient tachycardia, which typically resolves without intervention 3
- Contraindications include narrow-angle glaucoma, myasthenia gravis, megacolon, and obstructive uropathy (standard anticholinergic precautions) 1
Administration Guidelines
- Intravenous route is preferred for rapid onset (3-5 minutes), while intramuscular administration has onset at 20-30 minutes 4
- Duration of action is approximately 30-60 minutes 4
- Monitor heart rate during and after administration, particularly in patients with cardiac conditions 3
Common Pitfalls to Avoid
- Do not underdose for diagnostic procedures: 5-10 mg doses result in inadequate smooth muscle relaxation and poor examination quality 2
- Avoid in patients with tachyarrhythmias or significant cardiac disease without careful monitoring 4
- Be aware that anticholinergic effects may delay capsule transit in the esophagus if oral medications are given concurrently 5