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Palliative cancer care - nausea & vomiting - Management
What issues do I need to be aware of before prescribing hyoscine butylbromide?
- Hyoscine butylbromide must not be confused with hyoscine hydrobromide, which is used in lower doses.
- Hyoscine butylbromide is poorly absorbed orally. For the management of nausea and vomiting it should be given as a subcutaneous bolus dose or by continuous subcutaneous infusion.
- Unlike hyoscine hydrobromide, hyoscine butylbromide does not cross the blood–brain barrier and therefore does not cause drowsiness or have a central anti-emetic action.
- Antimuscarinics should be avoided in people with paralytic ileus or symptomatic acid reflux, as they relax the lower oesophageal sphincter.
- Antimuscarinics may precipitate glaucoma in people at risk, particularly the elderly.
[Twycross and Wilcock, 2001]
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