Glycopyrronium sublingual
| Glycopyrronium sublingual | |
| What is it? | Antichloinergic |
| Mechanism of action | Antimuscarinic |
| Starting dose | 200mcg eight hourly prn sublingual |
| Time to onset of effect | 30–40 min17 |
| Formulation | Oral solution OR Injection |
| Indication | Drooling Noisy rattling breathing Medical management of malignant bowel obstruction Paraneoplastic fevers and sweating |
| Common adverse effects | Constipation; dizziness; drowsiness; dry mouth; dyspepsia; flushing; headache; nausea; palpitations; skin reactions; tachycardia; urinary disorders; vision disorders; vomiting16 |
| Contraindications | Tachycardia >100 Cardiac conduction disorders16 |
| Caution | Elderly Renal impairment—may need to reduce dose |
| Licence | Oral solution ‘off label’ use in adults and ‘off label’ route (however licensed for oral administration in children>3 years to adolescents with neurological disorders) Injection is a licensed product but ‘off label’ route |
| Benefits | Small volume |
| Risks | Risk of glass ampoule when administering |
| Cost | £91 for 150 mL × 200 μg/mL oral solution £76.80 for 60 mL × 400 mcg/mL oral solution £9.95 for 10 × 200 μg/mL ampoules for injection |