Maximum Daily Dose of Kwells (Hyoscine Hydrobromide)
For adults and children 10 years and older, the maximum dose of Kwells is 12 tablets in 24 hours; for children aged 2 to under 12 years, the maximum is 6 tablets in 24 hours. 1
Dosing by Age Group
Adults and Children ≥12 Years
- Standard dose: 1-2 tablets every 4 hours as needed 1
- Maximum daily limit: 12 tablets per 24 hours 1
- Administration: Tablets may be taken sublingually, orally, or chewed 1
Children 2 to <12 Years
- Standard dose: ½ to 1 tablet every 4 hours as needed 1
- Maximum daily limit: 6 tablets per 24 hours 1
- Administration: Same flexible options as adults 1
Important Safety Considerations
Overdose Risk in Young Children
Hyoscine hydrobromide carries serious risks in overdose, particularly in young children. A documented case involved a 4-year-old who ingested 108 μg/kg and developed confusion, ataxia, hallucinations, hypotension, tachycardia, and QTc prolongation on ECG 2. The child experienced persistent visual and auditory hallucinations requiring overnight observation 2.
Common Anticholinergic Effects
- Drowsiness and blurred vision are expected side effects that warrant caution 3
- Dry mouth is frequently reported with hyoscine use 4
- Central nervous system depression is the primary concern in acute overdosage 3
Clinical Pitfalls to Avoid
- Do not exceed the maximum daily dose: Adults taking more than 12 tablets or children taking more than 6 tablets in 24 hours risk anticholinergic syndrome 1, 3
- Consider drug interactions: Patients on other anticholinergic medications (such as loperamide) may experience additive effects and increased toxicity 3
- Verify patient understanding: Unintentional overdoses occur when patients confuse hyoscine with other medications or misunderstand dosing instructions 3
Therapeutic Context
Hyoscine hydrobromide is primarily indicated for motion sickness prophylaxis and treatment 3, 4. The drug demonstrates rapid onset of action, with effects noticeable within 10 minutes when used for conditions like renal or biliary colic 5. However, for motion sickness prevention, the standard oral formulation requires dosing every 4 hours, unlike the transdermal patch which provides 72 hours of coverage 4.