Buscopan (Hyoscine Butylbromide) Intramuscular Dosing
The standard intramuscular dose of Buscopan (hyoscine butylbromide) for adults and adolescents aged 12 years or older is 20 mg, which can be repeated as needed. 1, 2
Standard IM Dosing Protocol
- Adults and adolescents ≥12 years: 20 mg IM as a single dose, with the option to repeat based on clinical need 1, 2
- The 20 mg dose has been validated through clinical trials as the optimal dose for achieving therapeutic smooth muscle relaxation 1
- IM administration has an onset time of 20-30 minutes, with a duration of action of approximately 30-60 minutes 3
Route Selection Considerations
- Intravenous administration is preferred when rapid onset is required (onset 3-5 minutes vs. 20-30 minutes for IM) 3
- The IM route is appropriate when IV access is unavailable or when a slightly delayed onset is acceptable 3
- Both routes use the same 20 mg dose for adults 1, 2
Critical Safety Monitoring
- Monitor heart rate during and after administration in patients with any cardiac history, as hyoscine butylbromide can exacerbate tachyarrhythmias 3, 4
- Contraindicated in patients with tachycardia, angina, cardiac failure, and prostatic hypertrophy with urinary retention 4
- Patients with these conditions should only receive Buscopan when benefits clearly outweigh risks, and require continuous cardiac monitoring with resuscitation equipment immediately available 4
Common Pitfalls to Avoid
- Do not reduce the dose below 20 mg - studies demonstrate that lower doses (5 mg, 10 mg) produce suboptimal therapeutic effects 1
- Counsel patients post-administration to seek emergency care if they experience eye pain, redness, decreased vision, nausea, vomiting, or headache, though significant visual impairment is rare 4, 5
- Routine pre-procedure glaucoma screening is not necessary, but post-procedure warning is appropriate 4, 5