Last update: June 12, 2020

Scopolamine

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Scopolamine or Hyoscine is a alcaloid which is naturally found in several plants among Solanacea family.
With a similar chemical structure of Atropine, it shows anti-muscarinic and anti-cholinergic effects (decrease in saliva, bronchial, sweat and gastric secretion, tachycardia, pupil dilation, anti-spasmodic effect on the intestine and urinary tract)
Most frequently used formulations contain buthylbromurate, methybromurate and hydrobromurate. Skin patches contain purified Scopolamine.
Used for prevention of motion-sickness of the traveler and treatment of nausea, post-anesthesia vomiting. Also, as anti-spasmodict and treatment of ophthalmologic disorders.

At latest update, relevant published data on excretion into breast milk were not found.

Less difficulty in breastfeeding has been observed in neonates whose mothers received scopolamine during delivery compared to those who received meperidine (Hemati 2018).

Due to a low oral bioavailability (Putcha 1989), that minimizes the presence into the infant's plasma from mother's milk ingested, thus, the expert consensus is that the risk of use while breastfeeding is minimal (Hale 2019, Briggs 2017, Reece 2017, Chen 2010, Schaefer 2007).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Since at small dosage Scopolamine poisoning with alarming symptoms may occur (irritability, delirium, redness of skin, mouth dryness, constipation, urine retention), we would recommend a cautious and moderate use. Avoid use if the infant is younger than 2 months or premature.

OPHTHALMIC USE:
The small dose and poor plasma absorption of most topical ophthalmological preparations (Lahdes 1990) make it unlikely that significant amounts will transfer into breastmilk.
Topical use in the form of eye drops is compatible with breastfeeding.
Systemic absorption can be minimized by pressing on the tear duct (inner canthus of the eye) with a finger for 1-2 minutes (Bausch 2018).
Drugs with anticholinergic / antimuscarinic effect can inhibit prolactin secretion (Masala 1982), but the stimulation of suckling of the infant is usually sufficient to ensure the production of breast milk (Messinis 1985). No decrease in breast milk production has been reported with regular doses of antimuscarinic eye drops.

Alternatives

We do not have alternatives for Scopolamine.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Scopolamine is also known as


Scopolamine in other languages or writings:

Tradenames

Main tradenames from several countries containing Scopolamine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 8 %
Molecular weight 303 daltons
Protein Binding 4,4 %
VD 1,7 l/Kg
pKa 7,75 -
Tmax 0,5 - 1 hours
T1/2 2,9 - 10 hours

References

  1. Hale TW. Hale's Medications & Mothers' Milk. Springer Publishing Company. 2019
  2. Hemati Z, Abdollahi M, Broumand S, Delaram M, Namnabati M, Kiani D. Association between Newborns' Breastfeeding Behaviors in the First Two Hours After Birth and Drugs Used For Their Mothers in Labor. Iran J Child Neurol. 2018 Spring;12(2):33-40. Abstract
  3. Bausch. Tropicamide. Drug Summary. 2018 Full text (in our servers)
  4. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  5. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  6. AEMPS-Sanofi A. Escopolamina (Buscapina). Ficha técnica. 2017 Full text (in our servers)
  7. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  8. Scopolamine. New Zealand Datasheet. 2010 Full text (in our servers)
  9. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  10. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  11. Ebert U, Siepmann M, Oertel R, Wesnes KA, Kirch W. Pharmacokinetics and pharmacodynamics of scopolamine after subcutaneous administration. J Clin Pharmacol. 1998 Abstract
  12. Lahdes K, Huupponen R, Kaila T, Salminen L, Iisalo E. Systemic absorption of ocular scopolamine in patients. J Ocul Pharmacol. 1990 Abstract
  13. Putcha L, Cintrón NM, Tsui J, Vanderploeg JM, Kramer WG. Pharmacokinetics and oral bioavailability of scopolamine in normal subjects. Pharm Res. 1989 Abstract
  14. Messinis IE, Souvatzoglou A, Fais N, Lolis D. Histamine H1 receptor participation in the control of prolactin secretion in postpartum. J Endocrinol Invest. 1985 Apr;8(2):143-6. Abstract
  15. Masala A, Alagna S, Devilla L, Rovasio PP, Rassa S, Faedda R, Satta A. Muscarinic receptor blockade by pirenzepine: effect on prolactin secretion in man. J Endocrinol Invest. 1982 Jan-Feb;5(1):53-5. Abstract

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