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Palliative cancer care - pain - Management
What issues should I consider before prescribing hyoscine butylbromide?
- Hyoscine butylbromide should not be administered to people with myasthenia gravis, megacolon, narrow-angle glaucoma, tachycardia, prostatic enlargement with urinary retention, mechanical stenoses in the region of the gastrointestinal tract, or paralytic ileus, as hyoscine may further worsen these conditions.
- Hyoscine butylbromide has a rapid onset of action and starts to take effect within 15 minutes of subcutaneous administration. It has a duration of action of up to 1 hour.
- Common adverse effects of antimuscarinic drugs that may occur with increasing dose include dry mouth, constipation, urinary retention, and blurred vision. CKS found no evidence on the extent to which these occur in people in the terminal phase of illness.
- Hyoscine butylbromide does not readily cross the blood–brain barrier and therefore does not produce central nervous system adverse effects.
[Twycross and Wilcock, 2007; ABPI Medicines Compendium, 2008b]
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