GLYCOPYRROLATE

Antimuscarinic medicine

Dosage Forms

Injection

200 micrograms/ml

Uses

  • Premedication before anaesthesia
  • Intra-operative bradycardia
  • Bowel colic
  • Excessive respiratory secretions
  • Reversal of non-depolarising neuromuscular block (with neostigmine)

Dose and Duration

Premedication before anaesthesia
By IM or IV injection,
  • Adult and child over 12 years: 200–400 micrograms or 4–5 micrograms/kg (max 400 micrograms) before induction of anaesthesia
  • Child 1 month–12 years: 4–8 micrograms/kg (max 200 micrograms) before induction of anaesthesia
  • Neonate: 5 micrograms/kg
Bowel colic and excessive respiratory secretions
By SC infusion
  • Adult and child over 12 years: 600–1200 micrograms per 24 hours given every 4 hours as is required (hourly administration may be required in excessive respiratory secretions)
  • Child 1 month–12 years: 12–40 micrograms/kg/24 hours (max 1200 micrograms)
By mouth (injection solution can be used)
  • Child 1 month–18 years: 40–100 micrograms/kg (max 2000 micrograms) 3–4 times daily, adjusted according to response
By SC injection or IM injection or intravenous injection,
  • Child 12–18 years: 200 micrograms every 4 hours when required
  • Child 1 month–12 years: 4–10 micrograms/kg (max 200 micrograms) 4 times a day when required
Intraoperative bradycardia
By IV injection,
  • Adult: 200–400 micrograms or 4–5 micrograms/kg (max 400 micrograms) repeated if necessary
  • Child 1 month–18 years: 4–8 micrograms/kg (max 200 micrograms) repeated if necessary
  • Neonate: 10 micrograms/kg repeated if necessary
Reversal of non-depolarising neuromuscular blocking drugs (with neostigmine)
By IV injection,
  • Adult and child over 12 years: 200 micrograms per 1 mg of neostigmine, or 10–15 micrograms/kg with 0.05 mg/kg of neostigmine
  • Child 1 month–12 years: 10 micrograms/kg (max 500 micrograms) with 0.05 mg/kg of neostigmine
  • Neonate: 10 micrograms/kg

Preparation

  • Injection solution can be used for oral administration

Contraindications

  • Hypersensitivity to glycopyrrolate

Side Effects

  • Dry mouth, inhibition of sweating, constipation
  • Transient bradycardia (followed by tachycardia, palpitation and arrhythmias)
  • Reduced bronchial secretions
  • Urinary urgency and retention, difficulty in micturition
  • Dilatation of pupils, loss of accommodation, photophobia
  • Flushing, dryness of the skin
  • Confusion (particularly in the elderly)

Pregnancy

  • Do not use

Breast-feeding

  • Can be used

⚠️ Caution

  • Use with caution in renal impairment
  • Use with extreme caution in patients with thyrotoxicosis, coronary artery disease, cardiac dysrhythmias, hypertension, congestive heart failure and cardiac insufficiency
  • Observe patients with raised temperature closely since glycopyrrolate inhibits sweating
  • Use with caution in patients with paralytic ileus, prostatic hypertrophy, pyloric stenosis and closed angle glaucoma