D-Hyoscine is a preparation of hyoscine butylBromide. It exerts a spasmolytic action on the smooth muscle of the gastrointestinal, biliary and genito-urinary tracts. As a quarternary ammonium derivative, hyoscine butylD-Hyoscinee is less lipid soluble and it is less likely cross the blood-brain barrier. Therefore, anticholinergic side effects in the central nervous system are reduced. Peripheral anticholinergic effects result from a ganglion-blocking action within the visceral wall as well as from antimuscarinic activity.

For symptomatic relief of smooth muscle spasm like
1. Gastro-intestinal or genito-urinary tract spasm
2. Adjunctive therapy of peptic ulcer diseases
3. Symptomatic relief of irritable bowel syndrome
4. Prevention and treatment of spasmodic dysmenorrhoea

Adult: 20 mg 4 times daily
Irritable bowel syndrome: 10 mg 3 times daily, increased if required up to 20 mg 4 times daily
Child (6-12 years): 10 mg 3 times daily
Children under 6 years: Not recommended
Children under 2 years of age: Not recommended

It is contra-indicated in angle-closure glaucoma, myasthenia gravis, megacolon, paralytic ileus, pyloric stenosis, prostatic enlargement.

Although hyoscine butylBromide has been in wide general use for many years, there is no definite evidence of hazard during human pregnancy. Animal studies have shown no hazard. Nevertheless, medicines should not be used in pregnancy, especially in the first trimester, unless the expected benefit is thought to outweigh any possible risk to the foetus. Safety during lactation has not yet been established.

Side effects of antimuscarinics include constipation, transient bradycardia (followed by tachycardia, palpitations and arrhythmias), reduced bronchial secretions, urinary urgency and retention, dilatation of the pupils with loss of accommodation, photophobia, dry mouth, flushing and dryness of the skin. Side effects that occur occasionally include confusion (particularly in the elderly), nausea, vomiting and giddiness. Because of possible visual accommodation disturbances, patients should not drive or operate machinery if affected.

The antimuscarinic effect of tricyclic antidepressants, antihistamines, quinidine, amantadine, phenothiazines, butyrophenones and disopyramide may be intensified by hyoscine butylD-Hyoscinee. Concomitant treatment with dopamine antagonists such as metoclopramide may result in diminution of the effects of both drugs on the gastrointestinal tract. The tachycardic effects of beta-adrenergic agents may be enhanced by hyoscine butylD-Hyoscinee.

Due to the risk of anticholinergic complications, caution should be used in patients susceptible to intestinal or urinary outlet obstructions and in those inclined to tachycardia. Because of the possibility that anticholinergics may reduce sweating, it should be administered with caution to patients with pyrexia and in situations where the ambient temperature is high. Antimuscarinics should be used with caution in Down's syndrome, in children and in the elderly; they should also be used with caution in reflux oesophagitis, diarrhoea, ulcerative colitis, acute myocardial infarction, hypertension, conditions characterised by tachycardia (including hyperthyroidism, cardiac insufficiency, cardiac surgery), pregnancy and breast -feeding.

Store in a cool, dry place, away from light. Keep out of reach of children.

D-Hyoscine 10 mg tablet: Box containing 10 strips of 10 tablets each. Each film-coated tablet contains hyoscine butylD-Hyoscinee BP 10 mg.