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Side effects of buscopan

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Buscopan hyoscine butylbromide side effects

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https://www.nhs.uk/medicines/buscopan-hyoscine-butylbromide/…

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Here is a thorough breakdown of Buscopan (hyoscine butylbromide) side effects:

Buscopan (Hyoscine Butylbromide) - Side Effects

Buscopan blocks muscarinic acetylcholine receptors on smooth muscle of the GI tract. Because it is poorly absorbed orally and does not readily cross the blood-brain barrier, central anticholinergic effects are rare - this distinguishes it from hyoscine hydrobromide (scopolamine), which is centrally acting. Its side effects are mainly peripheral anticholinergic.

Common Side Effects (>1 in 100 people)

These are classic peripheral anticholinergic effects:
Side EffectNotes
Dry mouthMost frequently reported
ConstipationReduced GI motility
Blurred visionDue to pupil dilation and loss of accommodation; do not drive until resolved
TachycardiaEspecially with IV/IM injection

Serious Side Effects (Rare)

  • Acute angle-closure glaucoma - presents as a painful red eye with sudden loss of vision; stop Buscopan immediately and seek emergency care
  • Urinary retention - particularly in men with benign prostatic hypertrophy
  • Anaphylaxis - sudden swelling of lips/tongue/throat, difficulty breathing, collapse

Injection-Specific (IV/IM) - MHRA Safety Warning

The MHRA (UK medicines regulator) issued a Drug Safety Update in 2017 after 8 patient deaths linked to IV/IM Buscopan. Key risks with injectable form:
  • Tachycardia - can precipitate myocardial infarction
  • Hypotension
  • Cardiac arrest / acute MI - reported in patients with pre-existing cardiac disease (heart failure, coronary artery disease, arrhythmias, hypertension)
  • Fatal anaphylaxis - more likely to be fatal in patients with underlying coronary heart disease
Injection is contraindicated in patients with tachycardia and must be used with extreme caution in those with cardiac disease. Resuscitation equipment must be available.

Anticholinergic Effects Summary

Since Buscopan does NOT significantly cross the blood-brain barrier (unlike scopolamine/hyoscine hydrobromide), cognitive effects, confusion, and hallucinations are rare - the Maudsley Prescribing Guidelines confirm this distinction (The Maudsley Prescribing Guidelines in Psychiatry, 15th ed.).
Peripheral anticholinergic effects to watch for:
  • Reduced sweating / dry skin
  • Flushing
  • Difficulty urinating
  • Dilated pupils (mydriasis)

Contraindications (conditions where these side effects become dangerous)

  • Myasthenia gravis
  • Tachyarrhythmias
  • Narrow-angle glaucoma
  • Pyloric stenosis / paralytic ileus
  • Benign prostatic hypertrophy
  • Underlying cardiac disease (for injections)
Most people taking oral Buscopan for IBS or abdominal spasm experience only mild or no side effects. The more serious risks are concentrated with the injectable form, especially in patients with cardiovascular disease.
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