Glycopyrronium bromide is a quarternary ammonium antimuscarinic. It blocks acetylcholine at parasympathomimetic sites and induces smooth muscle relaxation. It also reduces gastric acid secretions and controls pharyngeal, tracheal and bronchial secretions. It antagonises muscarinic symptoms such as bronchorrhoea, bronchospasm, bradycardia and intestinal hypermotility induced by anticholinesterases.
Supotaria 0.2 mg Injection
For IM/IV administration-
Adults: 0.2 mg to 0.4 mg intravenously or intramuscularly before the induction of anesthesia. Alternatively, a dose of 0.004 to 0.005 mg/kg.
Children (1 month to 12 years of age): 0.004 to 0.008 mg/kg up. Larger doses may result in profound and prolonged antisialogogue effect which may be unpleasant for the patient.
Adults: A single dose of 0.2 to 0.4 mg (or 0.004 to 0.005 mg/kg) by intravenous injection should be used.
Children: (1 month to 12 years of age) – A single dose of 0.004 to 0.008 mg/kg by intravenous injection should be used. This dose may be repeated if necessary.
Reversal of Neuromuscular Blockade:
Adults: 0.2 mg intravenously per 1 mg neostigmine or the equivalent dose of pyridostigmine.
Children (1 month to 12 years of age) – 0.01 mg/kg intravenously with 0.05 mg/kg neostigmine or the equivalent dose of pyridostigmine. Supotaria may be administered simultaneously from the same syringe with the anticholinesterase; greater cardiovascular stability results from this method of administration.
For oral administration-
Initiate dosing at 0.02 mg/kg orally three times daily and titrate in increments of 0.02 mg/kg every 5-7 days based on therapeutic response and adverse reactions. The maximum recommended dosage is 0.1 mg/kg three times daily not to exceed 1.5-3 mg per dose based upon weight.
During the four-week titration period, dosing can be increased with the recommended dose titration schedule while ensuring that the anticholinergic adverse events are tolerable. Prior to each increase in dose, review the tolerability of the current dose level with the patient’s caregiver.
Glycopyrrolate should be dosed at least one hour before or two hours after meals. The presence of high fat food reduces the oral bioavailability of Glycopyrrolate if taken shortly after a meal