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Glycopyrronium bromide

Clinical data
AHFS/Drugs.com	Monograph
MedlinePlus	a602014
Pregnancy category	B
Routes of administration	oral, IV
ATC code	A03AB02 (WHO)
Pharmacokinetic data
Elimination half-life	0.6–1.2 hours
Excretion	85% renal, unknown amount in the bile
Identifiers
IUPAC name 3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidinium
CAS Number	596-51-0
PubChem CID	3494
DrugBank	APRD01000
ChemSpider	11201
UNII	V92SO9WP2I
KEGG	D00540
ChEMBL	ChEMBL1201335
CompTox Dashboard (EPA)	DTXSID6023109
ECHA InfoCard	100.008.990
Chemical and physical data
Formula	C19H28NO3
Molar mass	318.431 g/mol g·mol
3D model (JSmol)	Interactive image
SMILES .O=C(OC1CC(C)(C)C1)C(O)(c2ccccc2)C3CCCC3
InChI InChI=1S/C19H28NO3.BrH/c1-20(2)13-12-17(14-20)23-18(21)19(22,16-10-6-7-11-16)15-8-4-3-5-9-15;/h3-5,8-9,16-17,22H,6-7,10-14H2,1-2H3;1H/q+1;/p-1 Key:VPNYRYCIDCJBOM-UHFFFAOYSA-M
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Glycopyrrolate is a medication of the muscarinic anticholinergic group. It does not cross the blood brain barrier and consequently has no to few central effects. It is a synthetic quaternary amine. It is available in oral and intravenous (i.v.) forms.

With counterion, it is known as glycopyrronium bromide.

Pharmacology

Glycopyrrolate blocks muscarinic receptors, thus inhibiting cholinergic transmission.

Medical uses

In anesthesia, glycopyrrolate injection can be used as a preoperative medication in order to reduce salivary, tracheobronchial, and pharyngeal secretions, as well as decreasing the acidity of gastric secretion. It is also used in conjunction with neostigmine, a neuromuscular blocking reversal agent, to prevent neostigmine's muscarinic effects such as bradycardia.

It is also used to reduce excessive saliva (sialorrhea).

It decreases acid secretion in the stomach and so may be used for treating stomach ulcers, in combination with other medications.

Use in treating asthma and COPD has been described.

It has been used topically and orally to treat hyperhidrosis.

Side effects

Since glycopyrrolate reduces the body's sweating ability, it can even cause fever and heat stroke in hot environments. Dry mouth, difficulty urinating, headaches, diarrhea and constipation are also observed side effects of the medication.

The medication also induces drowsiness or blurred visions, an effect exacerbated by the consumption of alcohol.

References

1. Bajaj V, Langtry JA (2007). "Use of oral glycopyrronium bromide in hyperhidrosis". Br. J. Dermatol. 157 (1): 118–21. doi:10.1111/j.1365-2133.2007.07884.x. PMID 17459043. {{cite journal}}: Unknown parameter |month= ignored (help)
2. Haddad EB, Patel H, Keeling JE, Yacoub MH, Barnes PJ, Belvisi MG (1999). "Pharmacological characterization of the muscarinic receptor antagonist, glycopyrrolate, in human and guinea-pig airways". Br. J. Pharmacol. 127 (2): 413–20. doi:10.1038/sj.bjp.0702573. PMC 1566042. PMID 10385241. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
3. Mier RJ, Bachrach SJ, Lakin RC, Barker T, Childs J, Moran M (2000). "Treatment of sialorrhea with glycopyrrolate: A double-blind, dose-ranging study". Arch Pediatr Adolesc Med. 154 (12): 1214–8. PMID 11115305. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
4. Tscheng DZ (2002). "Sialorrhea - therapeutic drug options". Ann Pharmacother. 36 (11): 1785–90. doi:10.1345/aph.1C019. PMID 12398577. {{cite journal}}: Unknown parameter |month= ignored (help)
5. Olsen AK, Sjøgren P (1999). "Oral glycopyrrolate alleviates drooling in a patient with tongue cancer". J Pain Symptom Manage. 18 (4): 300–2. doi:10.1016/S0885-3924(99)00080-9. PMID 10534970. {{cite journal}}: Unknown parameter |month= ignored (help)
6. Hansel TT, Neighbour H, Erin EM; et al. (2005). "Glycopyrrolate causes prolonged bronchoprotection and bronchodilatation in patients with asthma". Chest. 128 (4): 1974–9. doi:10.1378/chest.128.4.1974. PMID 16236844. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
7. Gilman MJ, Meyer L, Carter J, Slovis C (1990). "Comparison of aerosolized glycopyrrolate and metaproterenol in acute asthma". Chest. 98 (5): 1095–8. doi:10.1378/chest.98.5.1095. PMID 2225951. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
8. Tzelepis G, Komanapolli S, Tyler D, Vega D, Fulambarker A (1996). "Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease". Eur. Respir. J. 9 (1): 100–3. doi:10.1183/09031936.96.09010100. PMID 8834341. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
9. Kim WO, Kil HK, Yoon DM, Cho MJ (2003). "Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate" (). Yonsei Med. J. 44 (4): 579–82. PMID 12950111. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
10. Kim WO, Kil HK, Yoon KB, Yoon DM (2008). "Topical glycopyrrolate for patients with facial hyperhidrosis". Br. J. Dermatol. 158 (5): 1094–7. doi:10.1111/j.1365-2133.2008.08476.x. PMID 18294315. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

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