Egazil

Uses

Egazil is an anticholinergic indicated to treat functional gastrointestinal disorders, biliary and renal colic, and acute rhinitis.

As a drug that is not FDA approved, hyscyamine has no official indications. Intravenous hysocyamine has been used to reduce gastric motility, reduce pancreatic pain and secretions, to facilitate imaging of the gastrointestinal tract, treat anticholinesterase toxicity, treat certain cases of partial heart block, improve visualization of the kidneys, and for symptomatic relief of biliary and renal colic. Intravenous hyoscyamine is also used pre-operatively to reduce secretions of the mouth and respiratory tract to facilitate intubation. Oral hyoscyamine is used to treat functional intestinal disorders, for symptomatic relief of biliary and renal colic, and symptomatic relief of acute rhinitis.

Egazil is also used to associated treatment for these conditions: Biliary Colic, Colic, Cystitis, Diverticulitis, Heart Block, Irritable Bowel Syndrome (IBS), Neurogenic Bladder Dysfunction, Neurogenic Bowel Dysfunction, Pancreatitis, Parkinsonism, Peptic Ulcer, Poisoning caused by anticholinesterases, Pylorospasm, Renal Colic, Spastic bladder, Tracheo-bronchial secretion excess, Acute Enterocolitis, Acute Rhinitis, Gastric secretions, Mild Dysentery, Pharyngeal secretions, Salivary secretions, Spastic colitis

How Egazil works

Egazil competitively and non-selectively antagonises muscarinic receptors in the smooth muscle, cardiac muscle, sino-atrial node, atrioventricular node, exocrine nodes, gastrointestinal tract, and respiratory tract. Antagonism of muscarinic M1, M4, and M5 receptors in the central nervous system lead to cognitive impairment; antagonism of M2 in the sinoatrial and atrioventricular nodes leads to bradycardia and lowers contractility; and antagonism of M3 in smooth muscle results in reduced peristalsis, bladder contraction, salivary secretions, gastric secretions, bronchial secretions, sweating, increased bronchodilation, mydriasis, and cycloplegia.

Toxicity

Patients experiencing an overdose may present with headache, nausea, vomiting, dizziness, dry mouth, difficulty in swallowing, dilated pupils, blurred vision, urinary retention, hot dry and flushed skin, tachycardia, hypertension, hypotension, respiratory depression, CNS stimulation, fever, ataxia, excitation, lethargy, stupor, coma, and paralysis. Patients should be treated with symptomatic and supportive therapy which may include emesis, gastric lavage, activated charcoal, artificial respiration, or intravenous physostigmine. Dialysis is expected to remove hyoscyamine sulfate from circulation.

Food Interaction

• Take before a meal. Take 30-60 minutes before a meal.
• Take separate from antacids. Take oral hyoscyamine before meals and antacids after meals.

Egazil Alcohol interaction

[Moderate] GENERALLY AVOID:

Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous.

In addition, the potential for abuse may be increased with the combination.

The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system.

No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load.

However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

Alcohol should generally be avoided during therapy with anticholinergic agents.

Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

Egazil Hypertension interaction

[Minor] Cardiovascular effects of anticholinergics may exacerbate hypertension.

Therapy with anticholinergic agents should be administered cautiously in patients with hypertension.

Egazil Drug Interaction

Moderate: diphenhydramine, cyclobenzaprine, acetaminophen / hydrocodoneMinor: acetaminophenUnknown: duloxetine, omega-3 polyunsaturated fatty acids, fluticasone nasal, pregabalin, polyethylene glycol 3350, esomeprazole, albuterol, pantoprazole, montelukast, levothyroxine, cyanocobalamin, ascorbic acid, cholecalciferol, alprazolam, ondansetron, cetirizine

Egazil Disease Interaction

Major: autonomic neuropathy, GI obstruction, glaucoma, obstructive uropathy, reactive airway diseases, myasthenia gravis, infectious diarrheaModerate: cardiac disease, tachycardia, coronary artery disease, gastric ulcer, gastroesophageal reflux, ulcerative colitis, liver disease, renal failureMinor: hypertension, hyperthyroidism, diarrhea, fever

Elimination Route

Egazil is completely absorbed by sublingual and oral routes, though exact data regarding the C_max, T_max, and AUC are not readily available.

Half Life

The half life of hyoscyamine is 3.5 hours.

Elimination Route

The majority of hyoscyamine is eliminated in the urine as the unmetabolized parent compound.

Innovators Monograph

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