Akineton

1 What is Akineton?

Brand: Akineton, Artane, Bentyl, Cantil, Cogentin, Colidrops Pediatric, Cystospaz, Detrol, Ditropan, Ed-Spaz, Enablex, hyoMax, HyoMax-DT, HyoMax-FT, HyoMax-SR, Hyosyne, IB-Stat, Levsinex, Neosol, Norflex, Nulev, Oscimin, Oscimin-SR, Oxytrol, Pamine, Pro-Banthine, Pro-Hyo, Robinul, Sanctura, Scopodex, Spacol TS, Spasdel, Symax, Symax Duotab, Symmetrel, Toviaz, Transderm Scop, Urispas, Vesicare

Generic: Anticholinergics and antispasmodics

Akineton is an anticholinergic. Anticholinergics and antispasmodics are a group of medications that include natural alkaloids (atropine, belladonna, hyoscyamine and scopolamine) and related products.

These medications are used to relieve cramps or spasms in the stomach, intestines, and bladder. Some are used with antacids or other medications to treat peptic ulcers. Others are used to prevent nausea, vomiting and motion sickness.

These medications are also used in certain surgical and emergency procedures. Some are given by injection before anaesthesia to help you relax and decrease secretions such as saliva before surgery.

During anaesthesia and surgery, atropine, glycopyrrolate, hyoscyamine and scopolamine are used to help keep your heartbeat normal. Scopolamine is also used to prevent nausea and vomiting after surgery and anaesthesia.

Atropine is also given to help relax the stomach and intestines for certain types of procedures.

Anticholinergics are used to treat poisoning caused by medications such as Neostigmine and Physostigmine, certain types of mushrooms and nerve gases or organic phosphorous pesticides.

These medications can be used for painful menstruation, runny nose and to prevent urination while sleeping.

Once a medication has been approved for marketing for a certain use, experience may show that it is also helpful for other medical problems.

These uses may not be listed in product labelling. However, these medications are also used in certain patients with the following medical conditions:

These medications are available only through your doctor’s prescription.

This product is available in the following forms:

  • Tablet
  • Extended release capsule
  • Elixir
  • Capsule
  • Suppository
  • Solution
  • Liquid filled capsule
  • Syrup
  • Extended release tablet
  • Gel/Jelly
  • Extended release patch
  • Spray
  • Liquid
  • Disintegrated tablet
  • Chewable tablet

2 What To Know Before Using

As with all medicines, the risks of using Akineton must be compared to how much this medication will help you. This is a decision that you and your doctor will make together.

For this medication, there are many things that need to be considered:

  • Allergies: Inform your doctor if you have ever had an allergic reaction to Doxorubicin or to any other medications. It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
  • Pediatric: Children are normally more sensitive to the use of anticholinergics. Unusual excitement, nervousness, restlessness or irritability and unusual warmth, dryness and flushing of the skin are more likely to occur in this age group. When these medications are given to children in hot weather, a rapid increase in body temperature may occur..This medication may be more likely to cause severe side effects in infants and children, especially those with spastic paralysis or brain damage. Shortness of breath or difficulty breathing has occurred in children taking Dicyclomine.
  • Geriatric: The elderly are more sensitive to the effects of anticholinergics than younger adults. Confusion or memory loss, constipation, difficult urination, drowsiness, dryness of the mouth, nose, throat or skin or irritability are more likely to occur in this age group. Eye pain may occur, which may be a sign of glaucoma.
  • Pregnancy: If you are pregnant or may become pregnant, be sure to tell your doctor if your medication contains any of the following:
    • Atropine - Has not been shown to cause birth defects or other problems in animals. However, when injected into women during pregnancy, this medication increased the heartbeat of the fetus.
    • Belladonna - Has not been studied in pregnant women or animals.
    • Clidinium - Has not been studied in pregnant women. However, this medication has not been shown to cause birth defects or other problems in animals.
    • Dicyclomine - Has been associated with a few cases of human birth defects. However, this medication has not been confirmed as the cause.
    • Glycopyrrolate - Has not been studied in pregnant women. However, this medication has not been shown to cause birth defects in animals but did decrease the chance of becoming pregnant and the newborn’s chance of surviving after weaning.
    • Hyoscyamine - Has not been shown to cause birth defects or other problems in animals. However, when injected into women during pregnancy, this medication increased the heartbeat of the fetus.
    • Mepenzolate - Has not been studied in pregnant women. However, this medication has not been shown to cause birth defects or other problems in animals.
    • Propantheline - Has not been studied in pregnant women or animals.
    • Scopolamine - Has not been studied in pregnant women or animals.
  • Breastfeeding: Although these medications may pass into breast milk, they have not been reported to cause problems in nursing babies. The flow of breast milk may be reduced in some patients. The use of dicyclomine is contraindicated and should not be used in nursing mothers because it has been reported to cause breathing problems in infants.
  • Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur.In these cases, your doctor may want to change your dose or take other precautions. When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below.The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following is not recommended.Your doctor may decide not to treat you with this medication, or change some of the other medications you take:
    • Ambenonium
    • Amifampridine
    • Bepridil
    • Cisapride
    • Dronedarone
    • Fluconazole
    • Itraconazole
    • Ketoconazole
    • Mesoridazine
    • Metoclopramide
    • Nelfinavir
    • Pimozide
    • Piperaquine
    • Posaconazole
    • Potassium
    • Potassium Chloride
    • Saquinavir
    • Sparfloxacin
    • Terfenadine
    • Thioridazine
    • ZiprasidoneUsing this medication with any of the following medication is not recommended, but may be unavoidable in some cases. Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:
    • Alfentanil
    • Alfuzosin
    • Amiodarone
    • Amitriptyline
    • Amoxapine
    • Anagrelide
    • Anileridine
    • Apomorphine
    • Aripiprazole
    • Arsenic Trioxide
    • Asenapine
    • Astemizole
    • Azithromycin
    • Bromazepam
    • Buprenorphine
    • Bupropion
    • Buserelin
    • Ceritinib
    • Chloroquine
    • Chlorpromazine
    • Ciprofloxacin
    • Citalopram
    • Clarithromycin
    • Clomipramine
    • Clozapine
    • Codeine
    • Crizotinib
    • Dabrafenib
    • Dasatinib
    • Degarelix
    • Delamanid
    • Desipramine
    • Deslorelin
    • Digoxin
    • Disopyramide
    • Dofetilide
    • Dolasetron
    • Domperidone
    • Donepezil
    • Droperidol
    • Erythromycin
    • Escitalopram
    • Fentanyl
    • Fingolimod
    • Flecainide
    • Flibanserin
    • Fluoxetine
    • Gatifloxacin
    • Gemifloxacin
    • Gonadorelin
    • Goserelin
    • Granisetron
    • Halofantrine
    • Haloperidol
    • Histrelin
    • Hydrocodone
    • Hydromorphone
    • Hydroxychloroquine
    • Ibutilide
    • Idelalisib
    • Iloperidone
    • Imipramine
    • Ivabradine
    • Ketoconazole
    • Lapatinib
    • Leuprolide
    • Levofloxacin
    • Levorphanol
    • Lopinavir
    • Lumacaftor
    • Lumefantrine
    • Mefloquine
    • Memantine
    • Meperidine
    • Methadone
    • Metronidazole
    • Mifepristone
    • Morphine
    • Morphine Sulfate Liposome
    • Moxifloxacin
    • Nafarelin
    • Nilotinib
    • Norfloxacin
    • Nortriptyline
    • Octreotide
    • Ofloxacin
    • Ondansetron
    • Oxycodone
    • Oxymorphone
    • Paliperidone
    • Panobinostat
    • Pasireotide
    • Pazopanib
    • Perflutren Lipid Microsphere
    • Piperaquine
    • Procainamide
    • Prochlorperazine
    • Promethazine
    • Propafenone
    • Propoxyphene
    • Protriptyline
    • Quetiapine
    • Quinidine
    • Quinine
    • Ranolazine
    • Remifentanil
    • Salmeterol
    • Sevoflurane
    • Sodium Oxybate
    • Sodium Phosphate
    • Sodium Phosphate, Dibasic
    • Sodium Phosphate, Monobasic
    • Sorafenib
    • Sotalol
    • Sufentanil
    • Sunitinib
    • Suvorexant
    • Tacrolimus
    • Tapentadol
    • Telavancin
    • Tetrabenazine
    • Thioridazine
    • Trazodone
    • Trifluoperazine
    • Trimipramine
    • Triptorelin
    • Vandetanib
    • Vardenafil
    • Vemurafenib
    • Vinflunine
    • Voriconazole
  • Other Interactions: Certain medications should not be used while eating, or while eating certain foods in the case of negative interactions. Using alcohol or tobacco with certain medications may also cause negative interactions. Talk with your doctor about the use of your medication with food, alcohol or tobacco.
  • Other Medical Problems: Pre-existing medical problems may affect the use of this medication. Be sure to tell your doctor if you have any other medical problems, especially:
    • Bleeding problems (severe).
    • Heart failure.
    • Hyperthyroidism (overactive thyroid).
    • Tachycardia (fast heart rate) - These medications may increase the heart rate and make these conditions worse.
    • Brain damage (in children) - This condition may increase the unwanted nervous system effects of these medications.
    • Colitis (severe).
    • Dry mouth (severe and continuous).
    • Enlarged prostate.
    • Fever.
    • Glaucoma.
    • Heart Disease.
    • Hernia (hiatal).
    • High blood pressure (hypertension).
    • Intestinal blockage or severe constipation.
    • Lung disease.
    • Myasthenia gravis.
    • Urinary tract blockage or difficult urination - These medications may make these conditions worse.
    • Down’s Syndrome - These medications may cause an increase in pupil size and heart rate for patients with these conditions.
    • Liver disease - This condition may cause higher blood levels of these medications, which could increase side effects.
    • Spastic paralysis (in children) - This condition may increase the effects of these medications.

3 Proper Usage

Only take Akineton as directed by your doctor. Do not take more, less or for a longer or shorter period of time than your doctor tells you.

To use by mouth:

  • Take the medication 30-60 minutes before meals unless told otherwise by your doctor.
  • Do not take the medication within 2-3 hours of taking an antacid or medication for diarrhea. Taking the medication too close together with antacids or anti-diarrhea medication may prevent them from work properly.

To use by injectable (dicyclomine):

  • The injectable form should be given into a muscle (intramuscular). Do not give it in a vein (intravenous).
  • The injectable form should only be used for 1-2 days. Your doctor may give you an oral medication that works the same way.

To use by rectal suppository (scopolamine):

  • If the suppository is too soft to insert, chill it in the refrigerator for 30 minutes or run cold water over it before removing the foil wrapper.
  • To insert the suppository: Remove the foil wrapper and moisten the suppository with cold water. Lie down on your side and use your finger to push the suppository well up into the rectum.

To use transdermal patch (scopolamine):

  • This medication comes with a patient information brochure. It is very important that you read this information before using this medication.
  • Wash and dry your hands before and after handling the patch.
  • Apply the patch to the hairless area of skin behind your ear. Do not place it over any cuts or irritations.

Dosing

Different patients will be given a different dose of this medication based on the strength of the medication.

The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.

The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.

Anisotropine (tablets):

For duodenal or stomach ulcers:

  • Adults and teenagers - 50mg 3 times a day. Your doctor may adjust the dose if needed.
  • Children - Dose must be determined by your doctor.

Atropine:

  • TabletsFor duodenal or stomach ulcers, intestinal problems or urinary problems:
    • Adults and teenagers - 300-1200mcg (micrograms) ever 4-6 hours.
    • Children - Dose is based on body weight. The normal dose is 10mcg per kilogram of body weight every 4-6 hours. However, the dose will not be more than 400mcg every 4-6 hours.
  • Injectable
    For duodenal or stomach ulcers or intestine problems:
    • Adults and teenagers - 400-600mcg injected into a muscle (intramuscular), vein (intravenous) or under the skin (subcutaneous) every 4-6 hours.
    • Children - Dose is based on body weight. The normal dose is 10mcg per kilogram of body weight every 4-6 hours. However, the dose will not be more than 400mcg every 4-6 hours.For heart problems:
    • Adults and teenagers - 400-1000mcg injected into a vein (intravenous) every 1-2 hours as needed. The total dose will not be more than 2mg.
    • Children - The dose is based on body weight. The normal dose is 10-30mcg per kilogram of body weight injected into a vein (intravenous).

Belladonna (oral solution):

For duodenal or stomach ulcers or intestine problems:

  • Adults and teenagers - 180-300mcg 3-4 times a day. The dose should be taken 30-60 minutes before meals and at bedtime. Your doctor may change your dose if needed.
  • Children - The dose is based on body weight. The normal dose is 9mcg per kilogram of body weight 3-4 times a day.

Clidinium (capsules):

For duodenal or stomach ulcers:

  • Adults and teenagers - 2.5-5mg 3-4 times a day. The dose should be taken before meals and at bedtime. Your doctor may change your dose if needed.
  • Children - Dose must be determined by your doctor.

Dicyclomine:

  • Oral (Capsules, syrup, and tablets)
    For intestine problems:
    • Adults and teenagers - 30mg 4 times a day. Your doctor may adjust your dose if needed. The dose is not usually more than 160mg per day.
    • Children and infants older than 6 months of age - Use are not recommended.
    • Infants younger than six months of age - Avoid use, use is contraindicated.
  • Injectable (intramuscular only)
    For intestine problems:
    • Adults and teenagers - 10-20mg injected into a muscle (intramuscular) 4 times per day.
    • Children and infants older than 6 months of age - Use are not recommended.
    • Infants younger than six months of age - Avoid use, use is contraindicated.

Glycopyrrolate:

  • Tablets
    For duodenal or stomach ulcers:
    • Adults and teenagers - Start with 1-2mg 2-3 times a day. Some people may also take 2mg at bedtime. Your doctor may change your dose if needed. Your dose will not be more than 8mg per day.
    • Children - Dose must be determined by your doctor.
  • Injectable
    For duodenal or stomach ulcers:
    • Adults and teenagers - 100-200mcg injected into a muscle (intramuscular) or vein (intravenous). The dose may be repeated every 4 hours up to 4 times a day.
    • Children - Dose must be determined by your doctor.

Homatropine (oral dosage):

For duodenal or stomach ulcers:

  • Adults and teenagers - 5-10mg 3-4 times a day. Your doctor may change the dose if needed.
  • Children - Dose must be determined by your doctor.

Hyoscyamine:

  • Oral forms (capsules, elixir, oral solution, tablets)
    Duodenal or stomach ulcers, intestine problems or urinary problems:
    • Adults and teenagers - 125-500mcg 4-6 times a day. Some people may take 375mcg twice a day. The tablets should be taken 30-60 minutes before meals. Your doctor may change the dose if needed.
    • Children - Dose is based on body weight. The normal dose is 12.5-187mcg every 4 hours as needed.
  • Injectable
    Duodenal or stomach ulcers or intestine problems:
    • Adults and teenagers - 250-500mcg injected into a muscle (intramuscular), vein (intravenous) or under the skin (subcutaneous) every 4-6 hours.
    • Children - Dose must be determined by your doctor.

Mepenzolate (tablets):

For duodenal or stomach ulcers or intestine problems:

  • Adults and teenagers - 25-50mg 4 times a day, with meals and at bedtime. Your doctor may change the dose if needed.
  • Children - Dose must be determined by your doctor.

Methantheline (tablets):

For intestine and stomach ulcers, intestine problems or urinary problems:

  • Adult and teenagers - 50-100mg every 6 hours. Your doctor may change your dose if needed.
  • Children 1 year of age and older - 12.5-50mg 4 times a day. Your doctor may change the dose if needed.
  • Children 1 month to 1 year of age - 12,5mg 4 times a day. Your doctor may change the dose if needed.
  • Children up to 1 month of age - 12.5mg twice a day. Your doctor may change the dose if needed.

Methscopolamine (tablets):

For duodenal or stomach ulcers or intestine problems:

  • Adults and teenagers - 2.5-5mg 4 times a day, 30 minutes before meals and at bedtime. Your doctor may change the dose if needed.
  • Children - Dose is based on body weight. The normal dose is 200mcg per kilogram of body weight 4 times a day. The dose should be taken before meals and at bedtime.

Pirenzepine (tablets):

For duodenal or stomach ulcers or intestine problems:

  • Adults and teenagers - 50mg twice a day, at morning and at bedtime. Your doctor may change the dose if needed.
  • Children - Dose must be determined by your doctor.

Propantheline (tablets):

For duodenal or stomach ulcers:

  • Adults and teenagers - 7.5-15mg 3 times a day, 30 minutes before meals and 30mg at bedtime. Your doctor may change the dose if needed.
  • Children - Dose is based on body weight. The normal dose is 375mcg per kilogram of body weight 4 times a day. Your doctor may change the dose if needed.

Scopolamine

  • Tablets
    For urinary problems, intestine problems or painful menstruation:
    • Adults and teenagers - 10-20mg 3-4 times a day. Your doctor may change the dose if needed.
    • Children - Dose must be determined by your doctor.
  • Injectable
    Urinary problems or intestine problems:
    • Adults and teenagers - 10-20mg 3-4 times a day. Your doctor may change the dose if needed.
    • Children - Dose must be determined by your doctor.
  • Suppository
    For urinary problems, intestine problems or painful menstruation:
    • Adults and teenagers - Insert one 10mg suppository rectally 4-5 times a day.Your doctor may change the dose if needed.
    • Children - Dose must be determined by your doctor.
  • Transdermal Patch
    For motion sickness:
    • Adults and teenagers - Apply 1 patch behind the ear at least 4 hours before the anti-nausea effect is needed.
    • Children - Use is not recommended.For nausea and vomiting after surgery:
    • Adults and teenagers - Apply 1 patch behind the ear the evening before surgery to prevent nausea and vomiting after surgery.
    • Children - Use is not recommended.

Missed Dose

If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and resume your normal dosing schedule. Do not double dose.

Storage

Store this medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.

Keep out of the reach of children. Do not keep expired medication or medication you no longer need. Ask your doctor how to dispose of any medication you do not use.

4 Precautions To Take

If you think you may have taken an overdose of Akineton, get emergency help immediately. Taking an overdose of any belladonna alkaloids or taking scopolamine with alcohol or other CNS depressants may lead to unconsciousness and possibly death.

Some signs of overdose are clumsiness or unsteadiness, dizziness, severe fatigue, fever, hallucinations (seeing, hearing or feeling things that aren’t there), confusion, shortness of breath or difficulty breathing, slurred speech, unusual excitement, nervousness, restlessness or irritability, fast heartbeat (tachycardia), and unusual warmth, dryness or flushing of the skin.

These medications may make you sweat less, causing your body temperature to increase. Be very careful to not become overheated during exercise or hot weather while taking this medication, as overheating can result in heat stroke. Hot baths or saunas may make you dizzy or faint while taking this medication.

Ask your doctor before you stop using this medication. Your doctor may want you to gradually reduce the amount you use before stopping completely. Stopping this medication suddenly may cause withdrawal effects such as vomiting, sweating, and dizziness.

These medications may cause some people to have blurred vision. Make sure your vision is clear before you drive or do anything else that could be dangerous if you can’t see properly. This medication may also cause your eyes to become more light-sensitive than normal. Wearing sunglasses may help lessen the discomfort from bright light.

These medications may cause some people to become dizzy or drowsy, especially in high doses. Make sure you know how you react to these medications before driving, using machinery or doing anything else that could be dangerous if you are dizzy or not alert.

Dizziness, lightheadedness or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help lessen this problem.

These medications may cause dryness in the mouth, nose and throat. For temporary relief of mouth dryness, use sugarless gum or candy, melt ice in your mouth or use a saliva substitute.

If your mouth continues to feel dry for more than 2 weeks, check with your doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungal infections.

For patients taking scopolamine: This medication will add to the effects of alcohol and other CNS depressants (medications that slow the nervous system, commonly causing drowsiness).

Examples of CNS depressants are antihistamines, sedatives, tranquilizers or sleeping medication, prescription pain medication or narcotics, barbiturates, medication for seizures, muscles relaxants or anesthetics.

Ask your doctor before taking any of the above while using this medication.

5 Potential Side Effects

Akineton may produce unwanted effects along with the intended effects. Although not all of these side-effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if you experience any of the following side-effects:

Rare

  • Confusion (especially in the elderly)
  • Dizziness, lightheadedness that continues or fainting
  • Eye pain
  • Skin rash or hives

Some side effects that may occur do not normally need medical attention. These may leave as your body becomes accustomed to treatment. Ask your doctor about ways to prevent or reduce some of these side effects.

Talk to your doctor if any of the following side effects continue or are bothersome, or if you have questions:

More Common

  • Constipation
  • Decreased sweating
  • Dryness of the mouth, nose, throat or skin

Less common or Rare

  • Bloated feeling
  • Blurred vision
  • Difficult urination
  • Difficulty swallowing
  • Drowsiness
  • False sense of well-being
  • Headache
  • Increased sensitivity to light
  • Loss of memory
  • Nausea or vomiting
  • Redness or other signs of irritation at injection site
  • Trouble sleeping (insomnia)
  • Unusual fatigue or weakness

For patients using scopolamine:

After you stop using this medication, your body may need time to adjust. The length of time this takes depends on the amount of medication you were using and how long you used it. During this time period, inform your doctor if you have any troubling side effects.

Some patients may experience other side effects that are not listed. Check with your doctor if you notice any other side effects.

Ask your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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