Glycopyrrolate

Generic Name

glycopyrrolate (gli co PIE ro late)

 

Trade Name

Robinul

 

What is glycopyrrolate?

This drug acts on the muscle in the wall of the gut and also the urinary bladder. It relaxes the muscle and prevents spasms from occurring. It also can slightly reduce the production of stomach acid.

 

What is it used for?

The main role of this drug is to prevent painful spasm of the gut and urinary bladder. The following conditions may be helped: diarrhea, irritable or spastic bowel, diverticulosis, colic and bladder spasm. It is seldom used in treating peptic ulcers since there are much better drugs now available to reduce stomach acid and heal ulcers.

 

How do I take it?

Follow your physician’s instructions carefully. Take glycopyrrolate 30 to 60 minutes before eating for best results. If you also take an antacid, take the antacid after the meal. Taking an antacid at the same time as glycopyrrolate can interfere with the absorption of this drug. Store at room temperature in a tightly sealed container. Keep all medications away from children. Never share your medications with anyone else.

 

What do I do for a missed dose?

If you miss a dose of this medicine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on this medication.

 

Are there interactions with food or beverages?

There are no known food interactions with glycopyrrolate. This drug can cause constipation which can be prevented by using foods rich in fiber and bran. Alcohol should be used with caution or avoided completely because the combination may cause excessive sedation.

 

Are there interactions with other drugs?

An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. Because this is a synthetic drug and falls into a class called quaternary ammonium compounds, it differs in some ways from the other anticholinergics such as hyoscyamine (Levsin) and dicyclomine (Bentyl). The manufacturer notes that there are no known drug interactions but it may be wise to note the interactions with other drugs in this class.

Interactions with this drug may occur with the following:

  • monoamine oxidase (MAO) inhibitors (Nardil, Parnate)
  • sedatives (Ambien, Dalmane, Restoril)
  • antidepressants (Haldol, Elavil)
  • antacids
  • antihistamines (Benadryl)
  • cimetidine (Tagamet)
  • prednisone
  • digoxin (Lanoxin)
  • metoclopramide (Reglan)
  • thiazide diuretics (Dyazide, hydrochlorothiazide)
  • amantadine (Symmetrel)
  • cardiac rhythm regulators (Pronestyl, quinidine)

 

Is there a problem if I have another disorder or disease?

At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease.

With this drug, the following disorders may be a problem:

  • glaucoma
  • prostate enlargement – BPH
  • hypertension (high blood pressure)
  • congestive heart failure
  • severe ulcerative colitis where bowel movements have stopped

 

What about allergies?

People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives and itching. Of course, a personshould not take glycopyrrolate if there has been a previous reaction to this or other antispasmodic drugs.

 

What if I’m pregnant, considering pregnancy or breast-feeding?

Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Glycopyrrolate is ranked B. Always consult your physician before taking any drug during or when planning pregnancy.

 

What are the effects on sexual function?

Glycopyrrolate can cause impotence. In nursing mothers it can cause suppression of breast milk.

 

Are there other precautions?

  • Glycopyrrolate may make you dizzy, drowsy or blur your vision. Do not drive or operate hazardous machinery while taking this medication until the effects of the drug have been determined.
  • This medication may decrease your ability to perspire. Do not become overheated in extremely hot weather or during exercise or other activities, as heat stroke may occur.
  • Some mental changes have occasionally been reported in individuals who are sensitive to this group of drugs. Symptoms include confusion, short-term memory loss, hallucinations or agitation. These symptoms usually resolve within 12 to 48 hours after discontinuation of the drug.

 

How long is it safe to take glycopyrrolate?

The side effects are usually the limiting factor in the length of use of glycopyrrolate. As long as the side effects are tolerable or there is no change in the intensity of the side effects, the drug can be used long-term with physician supervision.

 

How about side effects?

Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.

For glycopyrrolate, the following are the observed side effects:

Minor:

  • headache
  • drowsiness
  • dizziness
  • confusion
  • blurred vision
  • rapid heartbeat
  • dry mouth
  • nausea
  • vomiting
  • rash
  • constipation

Major:

  • difficult urination
  • difficulty in focusing your eyes
  • severe diarrhea

 

A physician’s comment…

This drug relieves symptoms. It does not cure an underlying disorder. It can be used long-term if there are no side effects. Some people have problems with constipation while taking this drug. The addition of fiber to the diet is helpful.