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			{{Short description|Anticholinergic medication}}
	{{Drugbox
			{{for|the medication used to treat nausea|Hyoscine hydrobromide}}
	| verifiedrevid = 444561809
			{{Infobox drug
	| IUPAC_name = -9-butyl-7-(3-hydroxy-<br>1-oxo-2-phenylpropoxy)-9-methyl-3-oxa-<br>9-azonitricyclononane
			| Verifiedfields = changed
	| image = Butylscopolamine skeletal.svg
			| verifiedrevid = 447379730
			| image = Butylscopolamine skeletal with bromide.svg
			| width =
			| alt =
			| caption =
			| JAN = butylscopolamine bromide
	<!--Clinical data-->		<!-- Clinical data -->
	| tradename =		| pronounce =
			| tradename = Buscopan, others
	| pregnancy_AU = B2
	| pregnancy_US = <!-- A / B / C / D / X -->		| Drugs.com =
			| MedlinePlus =
	| pregnancy_category =
			| DailyMedID = n-butylscopolammonium_bromide
	| legal_AU = S2
	| legal_CA = <!-- / Schedule I, II, III, IV, V, VI, VII, VIII -->		| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
			| pregnancy_AU_comment =
	| legal_UK = GSL
			| pregnancy_category =
	| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
			| routes_of_administration = ], ], ]
	| legal_status =
			| class =
	| routes_of_administration = Oral, rectal, ]
			| ATC_prefix = A03
			| ATC_suffix = BB01
			| ATC_supplemental = {{ATC|A03|DB04}}, {{ATCvet|A03|BB01}}
	<!--Pharmacokinetic data-->		<!-- Legal status -->
			| legal_AU = S2
	| bioavailability = <1%
			| legal_AU_comment = <ref>{{cite web |title=Hyoscine Butylbromide (AFT Pharmaceuticals Pty Ltd) |url=https://www.tga.gov.au/resources/prescription-medicines-registrations/hyoscine-butylbromide-aft-pharmaceuticals-pty-ltd |website=] |archive-url=https://web.archive.org/web/20230318045047/https://www.tga.gov.au/resources/prescription-medicines-registrations/hyoscine-butylbromide-aft-pharmaceuticals-pty-ltd |archive-date=2023-03-18 |url-status=live}}</ref>
	| protein_bound = Low
			| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F-->
	| metabolism =
			| legal_BR_comment =
			| legal_CA = OTC (Pharmacist only)
			| legal_CA_comment =
			| legal_DE = <!-- Anlage I, II, III or Unscheduled-->
			| legal_DE_comment =
			| legal_NZ = <!-- Class A, B, C -->
			| legal_NZ_comment =
			| legal_UK = GSL
			| legal_UK_comment =
			| legal_US = Rx-only
			| legal_US_comment = <ref name="Buscopan FDA label">{{cite web | title=Buscopan- n-butylscopolammonium bromide injection | website=DailyMed | date=8 June 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=858926e9-457e-47c2-b7c4-2d1c6bb13ea8 | access-date=16 October 2020}}</ref>
			| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
			| legal_UN_comment =
			| legal_status = OTC
			<!-- Pharmacokinetic data -->
			| bioavailability = <1%
			| protein_bound = Low
			| metabolism =
			| metabolites =
			| onset =
	| elimination_half-life = 5 hours		| elimination_half-life = 5 hours
			| duration_of_action =
	| excretion = ] (50%) and fecal
			| excretion = ] (50%) and fecal<ref name="Tytgat 2007 pp. 1343–1357">{{cite journal | vauthors = Tytgat GN | title = Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain | journal = Drugs | volume = 67 | issue = 9 | pages = 1343–1357 | year = 2007 | pmid = 17547475 | doi = 10.2165/00003495-200767090-00007 | publisher = Springer Science and Business Media LLC | s2cid = 46971321 }}</ref>
	<!--Identifiers-->		<!-- Identifiers -->
			| CAS_number_Ref = {{cascite|correct|??}}
	| CAS_number = 149-64-4
			| CAS_number = 149-64-4
	| ATC_prefix = A03
			| CAS_supplemental =
	| ATC_suffix = BB01
	| PubChem = 160883		| PubChem = 6852391
			| IUPHAR_ligand =
	| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
			| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
	| DrugBank =
			| DrugBank = DBSALT002585
	| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
			| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
	| ChemSpiderID = 16736107
			| ChemSpiderID = 16736107
	| UNII_Ref = {{fdacite|correct|FDA}}
			| UNII_Ref = {{fdacite|correct|FDA}}
	| UNII = 2Z3E1OF81V
			| UNII = 0GH9JX37C8
			| KEGG_Ref =
			| KEGG = D01451
			| ChEBI_Ref =
			| ChEBI = 32123
			| ChEMBL_Ref = {{ebicite|changed|EBI}}
			| ChEMBL = 1256901
			| NIAID_ChemDB =
			| PDB_ligand =
			| synonyms = scopolamine butylbromide
	<!--Chemical data-->		<!-- Chemical and physical data -->
			| IUPAC_name = -9-butyl-7-(3-hydroxy-1-oxo-2-phenylpropoxy)-9-methyl-3-oxa-<br />9-azonitricyclononane
	| C=21 | H=30 | N=1 | O=4 | charge = +
			| C = 21
	| molecular_weight = 360.467 g/mol
			| H = 30
	| smiles = .OC(c1ccccc1)C(=O)O2C34O4(C2)3(C)CCCC
			| Br = 1
	| InChI = 1/C21H30NO4.BrH/c1-3-4-10-22(2)17-11-15(12-18(22)20-19(17)26-20)25-21(24)16(13-23)14-8-6-5-7-9-14;/h5-9,15-20,23H,3-4,10-13H2,1-2H3;1H/q+1;/p-1/t15-,16-,17-,18+,19-,20+,22?;/m1./s1
			| N = 1
	| InChIKey = HOZOZZFCZRXYEK-INRBTMLCBV
			| O = 4
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
			| charge = +
	| StdInChI = 1S/C21H30NO4.BrH/c1-3-4-10-22(2)17-11-15(12-18(22)20-19(17)26-20)25-21(24)16(13-23)14-8-6-5-7-9-14;/h5-9,15-20,23H,3-4,10-13H2,1-2H3;1H/q+1;/p-1/t15-,16-,17-,18+,19-,20+,22?;/m1./s1
			| SMILES = CCCC1(C2CC(CC1C3C2O3)OC(=O)C(CO)C4=CC=CC=C4)C.
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
			| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChIKey = HOZOZZFCZRXYEK-GSWUYBTGSA-M
			| StdInChI = 1S/C21H30NO4.BrH/c1-3-4-10-22(2)17-11-15(12-18(22)20-19(17)26-20)25-21(24)16(13-23)14-8-6-5-7-9-14;/h5-9,15-20,23H,3-4,10-13H2,1-2H3;1H/q+1;/p-1/t15?,16-,17-,18+,19-,20+,22?;/m1./s1
			| StdInChI_comment =
			| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
			| StdInChIKey = HOZOZZFCZRXYEK-HNHWXVNLSA-M
			| density =
			| density_notes =
			| melting_point =
			| melting_high =
			| melting_notes =
			| boiling_point =
			| boiling_notes =
			| solubility =
			| sol_units =
			| specific_rotation =
	}}		}}
	'''Butylscopolamine,''' also known as '''scopolamine butylbromide,''' '''butylhyoscine''' and '''hyoscine butylbromide''', is a peripherally acting ], ]<ref>"". Makoto Murakami, Yoshitaka Tomiyama, Kohichi Hayakawa, Masuo Akahane, Yukiyoshi Ajisawa, Young-Chol Park, Norio Ohnishi, Takahide Sugiyama and Takashi Kurita. ''Journal of Pharmacology and Experimental Therapeutics'' Vol. 292, Issue 1, pp. 67-75, January 2000.</ref> used as an ]-specific ]. It is a ] and a semisynthetic derivative of ]. It is marketed under the trade name '''Buscopan''' by ], Germany, who also offer a combination of butylscopolamine and ], marketed under the name '''Buscopan Plus''' (in some countries, '''Buscopan Compositum''').
			<!-- Definition and medical uses -->
	Butylscopolamine is used to treat pain and discomfort caused by abdominal ], menstrual cramps, or other spasmodic activity in the ]. It is also effective at preventing ]s. It is ''not'' an ] in the normal sense, since it doesn't 'mask' or 'cover over' the pain, but rather works to prevent painful cramps and spasms from occurring in the first place. The attachment of the butyl-bromide moiety effectively prevents the movement of this drug across the ], effectively minimising undesirable ] side-effects associated with scopolamine/hyoscine.
			'''Hyoscine butylbromide''', also known as '''scopolamine butylbromide'''<ref name=Huo2001>{{cite book| vauthors = Juo PS |title=Concise Dictionary of Biomedicine and Molecular Biology.|date=2001|publisher=CRC Press|location=Hoboken|isbn=9781420041309|page=570|edition=2nd|url=https://books.google.com/books?id=Y4DLBQAAQBAJ&pg=PA570|url-status=live|archive-url=https://web.archive.org/web/20151208061939/https://books.google.ca/books?id=Y4DLBQAAQBAJ&pg=PA570|archive-date=2015-12-08}}</ref> and sold under the brandname '''Buscopan''' among others,<ref name = TGA2010Label/> is an ] medication used to treat ], ]s, ], ],<ref>{{Cite web |title=Biliary colic and complications from gallstones - BPJ 61 June 2014 |url=https://bpac.org.nz/bpj/2014/june/gallstones.aspx |access-date=2024-01-22 |website=bpac.org.nz}}</ref> and ].<ref name=TGA2017/><ref name=Ric2015>{{cite book| vauthors = Hamilton R |title=Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition|date=2015|publisher=Jones & Bartlett Learning|isbn=9781284057560|page=270}}</ref> It is also used to improve ] at the ].<ref>{{cite book| vauthors = Paice J |title=Care of the Imminently Dying|date=2015|publisher=Oxford University Press|isbn=9780190244309|page=43|url=https://books.google.com/books?id=QCTYCgAAQBAJ&pg=PT43|url-status=live|archive-url=https://web.archive.org/web/20151208053014/https://books.google.ca/books?id=QCTYCgAAQBAJ&pg=PT43|archive-date=2015-12-08}}</ref> Hyoscine butylbromide can be taken by mouth, ], or ].<ref name=TGA2010Label>{{cite web |title=Buscopan Tablets and Ampoules|date=8 November 2010|access-date=22 October 2013|publisher=Therapeutic Goods Administration, Australia|url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07866-3|url-status=live|archive-url=https://web.archive.org/web/20170330184643/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2010-PI-07866-3|archive-date=30 March 2017}}</ref>
			<!-- Side effects and mechanism -->
	==Usage==
			Side effects may include sleepiness, vision changes, dry mouth, rapid heart rate, triggering of ], and ].<ref name=TGA2017>{{cite web|title=Hyoscine butylbromide SXP|url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2017-PI-02633-1|website=www.ebs.tga.gov.au|access-date=15 March 2018|date=3 July 2017}}</ref> Sleepiness is uncommon.<ref>{{cite book|title=Handbook of Palliative Care|date=2012|publisher=Wiley|location=New York|isbn=9781118426814|page=570|edition=3rd|url=https://books.google.com/books?id=aXP4_H9OX_AC&pg=PT570|url-status=live|archive-url=https://web.archive.org/web/20151208054721/https://books.google.ca/books?id=aXP4_H9OX_AC&pg=PT570|archive-date=2015-12-08}}</ref> It is unclear if it is safe in ].<ref name = TGA2010Label/> It appears safe in breastfeeding.<ref>{{cite web |title=Hyoscine |url=https://www.kemh.health.wa.gov.au/~/media/Files/Hospitals/WNHS/For%20health%20professionals/Clinical%20guidelines/Pharmacy/medications/hyoscine_butylbromide.pdf |website=www.kemh.health.wa.gov.au |access-date=11 September 2019}}</ref> Greater care is recommended in those with heart problems.<ref name=UK2017>{{cite web|title=Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease|url=https://www.gov.uk/drug-safety-update/hyoscine-butylbromide-buscopan-injection-risk-of-serious-adverse-effects-in-patients-with-underlying-cardiac-disease|website=www.gov.uk|access-date=15 March 2018|date=20 February 2017|quote=hyoscine butylbromide injection should be used with caution in patients with cardiac disease}}</ref> It is an ],<ref name = TGA2010Label/> which does not have much effect on the ].<ref name="Oxford University Press">{{cite book| vauthors = Hanks G |title=Oxford textbook of palliative medicine|date=2011|publisher=Oxford University Press|location=Oxford |isbn=9780199693146|page=805|edition=4th|url=https://books.google.com/books?id=Fk9uBAAAQBAJ&pg=PA805|url-status=live|archive-url=https://web.archive.org/web/20151208051001/https://books.google.ca/books?id=Fk9uBAAAQBAJ&pg=PA805|archive-date=2015-12-08}}</ref>
	Butylscopolamine is to treat cramping ] with some success.<ref>{{cite journal |author=Tytgat GN |title=Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain |journal=Drugs |volume=67 |issue=9 |pages=1343–57 |year=2007 |pmid=17547475 |doi= |url=}}</ref>
			<!-- History, society, and culture -->
	==Abuse==
			Hyoscine butylbromide was patented in 1950, and approved for medical use in 1951.<ref>{{cite book | vauthors = Fischer J, Ganellin CR |title= Analogue-based Drug Discovery |date=2006 |publisher=John Wiley & Sons |isbn=9783527607495 |page=446 |url=https://books.google.com/books?id=FjKfqkaKkAAC&pg=PA446 |language=en}}</ref> It is on the ].<ref name="WHO22nd">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 22nd list (2021) | year = 2021 | hdl = 10665/345533 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2021.02 | hdl-access=free }}</ref> It is not available for human use in the United States,<ref>{{cite book | vauthors = Prommer EE, Thompson L, Casciato DA | veditors = Casciato DA, Territo MC |title=Manual of Clinical Oncology |date=2012 |publisher=Wolters Kluwer/Lippincott Williams & Wilkins Health |location=Philadelphia |isbn= 9781451115604 |page=146 |edition=7th | chapter = Supportive Care | chapter-url=https://books.google.com/books?id=4ggoPDgZx2YC&pg=PA146 |url-status=live |archive-url=https://web.archive.org/web/20151208043312/https://books.google.ca/books?id=4ggoPDgZx2YC&pg=PA146|archive-date=2015-12-08}}</ref> and a similar compound ] may be used instead.<ref>{{cite book | vauthors = Satoskar RS, Rege SD, Bhandarkar NN |title=Pharmacology and Pharmacotherapeutics |date=1973 |publisher=Popular Prakashan |isbn=9788179915271 |page=296 |url=https://books.google.com/books?id=7d493VOD4P8C&pg=PA296 |language=en}}</ref> It is manufactured from ] - also known as scopolamine - which occurs naturally in a variety of plants in the nightshade family, ],<ref>{{Cite web |title=Scopolamine {{!}} Anticholinergic, Hyoscine, Motion Sickness {{!}} Britannica |url=https://www.britannica.com/science/scopolamine |access-date=2024-01-22 |website=www.britannica.com |language=en}}</ref> including ] (''Atropa belladonna'').<ref>{{cite book| vauthors = Twycross R |title= Introducing palliative care |date=2003 |publisher=Radcliffe Medical Press |location=Oxford |isbn=9781857759150 |page=172 |edition=4th |url= https://books.google.com/books?id=YmMwVnGTNiYC&pg=PA172 |url-status=live |archive-url= https://web.archive.org/web/20151208071827/https://books.google.ca/books?id=YmMwVnGTNiYC&pg=PA172 |archive-date=2015-12-08}}</ref>
	Butylscopolamine is generally not reported to be euphorogenic or strongly sedative, and has a low incidence of abuse. It should not be used for extended periods.
			It is available in the United States only for the medical treatment of horses.<ref name="Buscopan FDA label" />
	==References==
	<references/>
	==External links==		==Medical uses==
			]
	* from Boehringer Ingelheim
			Hyoscine butylbromide is effective in treating crampy ].<ref>{{cite journal | vauthors = Tytgat GN | title = Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain | journal = Drugs | volume = 67 | issue = 9 | pages = 1343–57 | year = 2007 | pmid = 17547475 | doi = 10.2165/00003495-200767090-00007 | s2cid = 46971321 }}</ref>
	* from Boehringer Ingelheim
			Hyoscine butylbromide is effective in reducing the duration of the first stage of labour, and it is not associated with any obvious adverse outcomes in mother or neonate.<ref>{{cite journal | vauthors = Samuels LA, Christie L, Roberts-Gittens B, Fletcher H, Frederick J | title = The effect of hyoscine butylbromide on the first stage of labour in term pregnancies | journal = BJOG | volume = 114 | issue = 12 | pages = 1542–6 | date = December 2007 | pmid = 17903230 | doi = 10.1111/j.1471-0528.2007.01497.x | s2cid = 71523418 | doi-access = }}</ref>
			It is also used during ], pelvic ], ], and double barium contrasted studies to improve the quality of pictures.<ref>{{cite web | title=Hyoscine butylbromide (Buscopan®) | url=http://www.guysandstthomas.nhs.uk/resources/patient-information/radiology/hyoscine-butylbromide-buscopan.pdf | publisher=] | location=UK | date=July 2014 | access-date=16 June 2016 | url-status=live | archive-url=https://web.archive.org/web/20160808085805/http://www.guysandstthomas.nhs.uk/resources/patient-information/radiology/hyoscine-butylbromide-buscopan.pdf | archive-date=8 August 2016 }}</ref> Hyoscine butylbromide can reduce the peristaltic movement of the intestines and mucosal foldings, thus reducing the movement artifact of the images.<ref name="Tytgat_2008">{{cite journal | vauthors = Tytgat GN | title = Hyoscine butylbromide - a review on its parenteral use in acute abdominal spasm and as an aid in abdominal diagnostic and therapeutic procedures | journal = Current Medical Research and Opinion | volume = 24 | issue = 11 | pages = 3159–3173 | date = November 2008 | pmid = 18851775 | doi = 10.1185/03007990802472700 | s2cid = 73316713 }}</ref>
			==Side effects==
			Since little of the medication crosses the ], this drug has less effect on the ] and therefore causes a reduced occurrence of the centrally-mediated effects (such as ], ] and inhibition of motor functions) which reduce the usefulness of some other anticholinergic drugs.<ref name="Oxford University Press"/>
			Hyoscine butylbromide is still capable of affecting the ], due to the lack of a well-developed blood-brain barrier in the ], which increases the ] effect it produces via local action on the ] of the ].<ref>{{cite journal | vauthors = Glare P, Miller J, Nikolova T, Tickoo R | title = Treating nausea and vomiting in palliative care: a review | journal = Clinical Interventions in Aging | volume = 6 | pages = 243–59 | date = 12 September 2011 | pmid = 21966219 | doi = 10.2147/CIA.S13109 | pmc = 3180521 | doi-access = free }}</ref>
			Other side effects include ] disturbances, ], dry mouth, nausea; urinary retention, reduced blood pressure; ];<ref name="Tytgat_2008" /> Other symptoms are dizziness, flushing and immune system disorders (], potentially fatal); anaphylactic reactions; dyspnoea; skin reactions and other hypersensitivity reactions. Cautions should be taken for those with untreated glaucoma, heart failure, ] with urinary retention as hyoscine may exacerbate these conditions.<ref name="Tytgat_2008" />
			==Pharmacology==
			Hyoscine butylbromide reduces smooth muscle contraction and the production of respiratory secretions. These are normally stimulated by the ], via the ] ]. As an ], hyoscine butylbromide binds to muscarinic acetylcholine receptors, blocking their effect.<ref name=":0">{{Cite web|title=Buscopan 10 mg Tablets - Summary of Product Characteristics (SmPC) - (emc)|url=https://www.medicines.org.uk/emc/product/1775/smpc|access-date=2020-07-22|website=www.medicines.org.uk}}</ref>
			It is a ] and a semisynthetic derivative of ] (scopolamine). The attachment of the butyl-bromide moiety effectively prevents the movement of this drug across the ], effectively minimising undesirable ] side effects associated with scopolamine/hyoscine.<ref name=":0" />
			==Abuse==
			Hyoscine butylbromide is not centrally active and has a low incidence of abuse.<ref name="Oxford University Press"/> In 2015, it was reported that prisoners at ] and other UK prisons were smoking prescribed hyoscine butylbromide, releasing the potent ] ].<ref>{{Cite news|url=http://www.pulsetoday.co.uk/clinical/prescribing/medics-warned-to-review-buscopan-prescriptions-after-prisoners-found-smoking-it/20020097.article|title=Medics warned to review Buscopan prescriptions after prisoners found smoking it|work=Pulse Today|access-date=2018-02-07|language=en|archive-date=2018-02-07|archive-url=https://web.archive.org/web/20180207122645/http://www.pulsetoday.co.uk/clinical/prescribing/medics-warned-to-review-buscopan-prescriptions-after-prisoners-found-smoking-it/20020097.article|url-status=dead}}</ref><ref>{{Cite web|url=http://medicines.necsu.nhs.uk/misuse-of-hyoscine-butylbromide-buscopan/|title=Misuse of hyoscine butylbromide (Buscopan) {{!}}|last=Optimisation|first=NECS Medicines|website=medicines.necsu.nhs.uk|language=en-GB|access-date=2018-02-07|date=2015-07-21}}</ref> There have also been reports of abuse in ] Central Prison in ].<ref>{{cite journal | vauthors = Jalali F, Afshari R, Babaei A | title = Smoking crushed hyoscine/scopolamine tablets as drug abuse | journal = Substance Use & Misuse | volume = 49 | issue = 7 | pages = 793–7 | date = June 2014 | pmid = 24494624 | doi = 10.3109/10826084.2014.880178 | s2cid = 25661684 }}</ref>
			{{Clear}}
			== References ==
			{{reflist}}
	{{Drugs for functional gastrointestinal disorders}}		{{Drugs for functional gastrointestinal disorders}}
			{{Muscarinic acetylcholine receptor modulators}}
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			{{Portal bar|Medicine}}
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