Glycopyrrolate 0.2mg/ml Inj, 2ml

Glycopyrrolate is a synthetic quaternary ammonium anticholinergic agent. It competitively blocks the action of acetylcholine at muscarinic receptors located on exocrine glands, smooth muscles, and the heart. This blockade leads to a reduction in salivary, tracheobronchial, and pharyngeal secretions, as well as a decrease in the volume and acidity of gastric secretions. It also produces vagal blockade, resulting in increased heart rate and bronchodilation. Due to its quaternary ammonium structure, it is highly ionized and does not readily cross the blood-brain barrier, minimizing central nervous system effects.

Serious Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Inability to sweat during physical activity or in warm temperatures
Difficulty urinating
Chest pain or pressure, rapid heartbeat, or irregular heartbeat
Rapid breathing
Fever
Enlarged pupils
Changes in vision, eye pain, or severe eye irritation
Confusion
Diarrhea or constipation
Bloating
Abdominal swelling
Stomach pain
Erectile dysfunction
Muscle weakness

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor:

Dry mouth
Upset stomach or vomiting
Nasal congestion
Dizziness, drowsiness, fatigue, or weakness
Blurred vision
Flushing
Changes in taste
Headache
Feeling nervous or restless
* Sleep disturbances

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions and circumstances to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reactions you experienced, including the symptoms that occurred.
Certain health problems, including:
+ Heart issues related to bleeding
+ Glaucoma
+ Gastrointestinal (GI) problems, such as:
- Bowel blockage
- Slow-moving GI tract
- Colitis
- Bleeding ulcer
+ Myasthenia gravis
+ Difficulty urinating
A history of an enlarged colon
Current use of potassium tablets
Use of medications that can slow the movement of the GI tract or increase the risk of bowel blockage. There are many medications that can cause this effect, so consult your doctor or pharmacist if you are unsure.
Use of anticholinergic medications, such as ipratropium or oxybutynin. If you are unsure whether any of your medications belong to this class, ask your doctor.

This list is not exhaustive, and it is crucial to disclose all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems to your doctor and pharmacist. They will help you determine whether it is safe to take this medication with your existing treatments and health conditions. Never start, stop, or adjust the dose of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, be cautious and avoid driving or performing tasks that require alertness and clear vision until you understand how it affects you.

Before consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may cause drowsiness, consult with your doctor to discuss potential interactions.

If you experience constipation, consult your doctor, as there may be ways to mitigate this side effect.

Be aware that this medication can increase the risk of heat stroke, especially in hot weather or during physical activity. Take necessary precautions to stay cool and hydrated.

Unless your doctor advises you to limit fluid intake, drink plenty of non-caffeinated liquids to stay hydrated after taking this medication.

You may be sensitive to bright lights while taking this medication. Wearing sunglasses can help alleviate this issue.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

For pediatric patients, use this medication with caution, as the risk of certain side effects may be higher in children.

Some formulations of this medication may contain benzyl alcohol. If possible, avoid using products with benzyl alcohol in newborns or infants, as high doses of benzyl alcohol can cause serious side effects, particularly when combined with other medications containing benzyl alcohol. Consult your doctor to determine if the product contains benzyl alcohol.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor to discuss the potential benefits and risks to you and your baby.

• Potassium chloride (oral solid dosage forms): Increased risk of GI lesions due to delayed GI motility.
• Other anticholinergics (e.g., atropine, scopolamine, tricyclic antidepressants, phenothiazines, quinidine, disopyramide, antihistamines): Additive anticholinergic effects (dry mouth, urinary retention, blurred vision, constipation, tachycardia).

• Cholinesterase inhibitors (e.g., donepezil, rivastigmine, galantamine): Glycopyrrolate may antagonize the therapeutic effects of cholinesterase inhibitors.
• Antacids: May interfere with absorption of oral glycopyrrolate (not relevant for injectable form, but good to note for general drug class).
• Opioid analgesics: Increased risk of severe constipation and/or paralytic ileus.
• Digoxin: May increase digoxin levels due to delayed gastric emptying (for oral forms).

• Dry mouth
• Blurred vision
• Urinary retention
• Constipation
• Tachycardia
• Palpitations
• Dizziness
• Headache
• Nervousness
• Flushing
• Fever (especially in children)

Category B. Animal studies have not shown harm, but human studies are limited. Use only if clearly needed.

Excreted in breast milk in small amounts. Potential for anticholinergic effects in the infant (e.g., dry mouth, constipation, urinary retention, decreased milk production). Use with caution, monitor infant for adverse effects.

Infants and young children, especially those with spastic paralysis or brain damage, may be more sensitive to the effects of anticholinergics and are more prone to developing fever due to suppression of sweat glands. Use with caution and monitor closely for signs of anticholinergic toxicity or hyperthermia.

Elderly patients may be more susceptible to anticholinergic side effects, particularly urinary retention, constipation, and confusion (though CNS effects are less common with glycopyrrolate due to poor BBB penetration). Use with caution and consider lower initial doses.

• Glycopyrrolate is preferred over atropine for reversal of neuromuscular blockade due to less tachycardia and less CNS effects.
• Its quaternary ammonium structure limits CNS penetration, making it less likely to cause central anticholinergic side effects (e.g., delirium, sedation) compared to tertiary amines like atropine or scopolamine.
• Primarily eliminated unchanged by the kidneys; dose adjustment is crucial in renal impairment.
• Effective antisialagogue, often used pre-operatively to reduce oral and respiratory secretions and prevent aspiration.
• Can cause significant dry mouth, which can be distressing for patients.

• Atropine (for antisialagogue or bradycardia, but with more CNS effects and tachycardia)
• Scopolamine (for antisialagogue, but with significant CNS effects)
• Hyoscyamine (for GI spasm, but less commonly used as injectable antisialagogue)

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed to do so by a healthcare professional, do not flush medications down the toilet or drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the amount, and the time of ingestion.