Scopoderm (hyoscine) Patches

Scopoderm patches contain the active ingredient hyoscine hydrobromide, which is a type of medicine called an antimuscarinic (or anticholinergic). Hyoscine hydrobromide is sometimes known as scopolamine. It is used to prevent travel sickness.

Garvan

Pharmacist - M.B.A. (Public Health) D.I.C.

Scopoderm (hyoscine) Patches

What is it used for? Preventing travel…

Garvan J. Lynch
MBA (Public Health)

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What is it used for?

  • Preventing travel sickness in adults and children aged 10 years and over.

How does it work?

  • Scopoderm patches contain the active ingredient hyoscine hydrobromide, which is a type of medicine called an antimuscarinic (or anticholinergic). Hyoscine hydrobromide is sometimes known as scopolamine. It is used to prevent travel sickness.
  • Travel sickness is believed to be a result of the brain receiving conflicting information about what the body senses is happening and what the eyes see is happening.
  • In the inner ear are three fluid-filled canals called the vestibular system. These detect changes in the body's position. Motion sickness is thought to occur when the vestibular system sends messages to the brain telling it that the body is being moved around, while the eyes send messages that the body is stationary.
  • Hyoscine hydrobromide is thought to prevent motion sickness by stopping the messages sent from the vestibular system from reaching an area of the brain called the vomiting centre. This area of the brain co-ordinates the vomiting reflex. Hyoscine blocks receptors called muscarinic (or cholinergic) receptors that are found in the vomiting centre. This prevents the vomiting centre from sending nerve messages to the stomach that would normally cause vomiting.
  • Scopoderm patches need to be applied a few hours before travel to be most effective, as once feeling sick or vomiting has started it is more difficult to control. The medicine passes from the patch through the skin and into the bloodstream.

How do I use it?

  • Follow the printed instructions provided with this medicine. 
  • One Scopoderm patch should be applied to a clean, dry, hairless area of skin behind the ear five to six hours before travel, or the night before the journey. Don't apply the patch to broken or irritated skin.
  • One patch can prevent travel sickness for up to 72 hours. If only needed for a shorter time, the patch should be removed at the end of the journey. If longer protection is needed, the patch should be removed after 72 hours and a new patch applied behind the other ear. Do not apply more than one patch at the same time.
  • You should wash your hands after handling the patch. You should also wash the area where the patch was stuck after removing it. This is to avoid accidentally transferring any of the medicine into the eyes, which can cause blurred vision and dilated pupils.
  • You should try to keep the patch as dry as possible. However, short contact with water, eg in a shower or swimming, should not affect it. If a patch accidentally falls off it should be replaced with a new one.

Key points

  • This medicine may cause drowsiness, dizziness, confusion and blurred vision. These side effects may affect your ability to drive or perform other activities that require concentration. You should not drive or operate machinary if you experience these symptoms. Do not drink alcohol, as it can worsen these side effects.
  • You may find that if you experience any side effects, including drowsiness, that they may last for 24 hours or longer after you have removed the patch.
  • Avoid touching the patch once you have stuck it on the skin. Pressing on the patch may possibly cause the medicine to ooze out at the edge.
  • This patch should be removed before medical scans such as MRI scans because it contains aluminium.

Not to be used in

  • Children under 10 years of age.
  • People with glaucoma or a history of this.
  • People with symptoms that could indicate raised pressure in the eye or glaucoma, for example blurred vision, pain in the eye or seeing haloes around lights. If you have these symptoms you should have an eye examination before using these patches.
  • This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

Use with caution in

  • Elderly people. 
  • Kidney disease.
  • Liver disease.
  • People who have difficulty passing urine, for example men with an enlarged prostate gland (prostatic hypertrophy).
  • People with any blockage or obstruction in the stomach or intestines.
  • People with a narrowing of the outlet of the stomach that makes it difficult for food to pass into the intestines (pyloric stenosis).
  • Epilepsy.

Pregnancy and breastfeeding

  • The safety of this medicine for use during pregnancy has not been established. It should only be used during pregnancy, particularly in the first trimester, if the expected benefit to the mother outweighs any potential risk to the developing baby. Seek medical advice from your doctor before using this medicine if you are or think you could be pregnant.
  • This medicine may pass into breast milk, but only in small amounts that are unlikely to be harmful to a nursing infant. Seek medical advice from your doctor before using this medicine if you are breastfeeding.

Side effects

  • Dry mouth.
  • Sleepiness.
  • Dizziness.
  • Blurred vision or difficulty focusing.
  • Dilated pupils (sometimes in just one eye).
  • Irritation of skin at patch application site.
  • Irritation of the eyelids.
  • Confusion.
  • Feeling disorientated.
  • Hallucinations.
  • Restlessness.


The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

There may be an increased risk of drowsiness if this medicine is used in combination with any of the following:

  • alcohol
  • antipsychotic medicines, eg chlorpromazine, haloperidol
  • barbiturates, eg phenobarbital
  • benzodiazepines, eg diazepam, temazepam
  • sedating antihistamines, eg chlorphenamine, brompheniramine, hydroxyzine
  • sleeping tablets, eg zopiclone
  • strong opioid painkillers, eg morphine, codeine, dihydrocodeine
  • tricyclic antidepressants, eg amitriptyline.

There may be an increased risk of antimuscarinic side effects, such as dry mouth, blurred vision or difficulty passing urine, if this medicine is used in combination with other medicines that have antimuscarinic effects, such as the following:

  • amantadine
  • antiarrhythmic medicines for irregular heartbeats, eg disopyramide, propafenone, quinidine
  • antihistamines, eg promethazine, brompheniramine, chlorphenamine, diphenhydramine, triprolidine (some of these are often found in over-the-counter cough and cold remedies)
  • antimuscarinic medicines for Parkinson's symptoms, eg procyclidine, orphenadrine, trihexiphenidyl
  • antimuscarinic medicines for urinary incontinence, eg oxybutynin, trospium, tolterodine
  • antipsychotics, eg chlorpromazine, clozapine, thioridazine
  • antisickness medicines, eg meclozine, cyclizine
  • antispasmodics, eg atropine, propantheline, hyoscine butylbromide
  • MAOI antidepressants, eg phenelzine
  • muscle relaxants, eg baclofen
  • tricyclic antidepressants, eg amitriptyline, clomipramine.

If you experience a dry mouth as a side effect of this medicine you may find that medicines that are designed to dissolve and be absorbed from under the tongue, eg sublingual glyceryl trinitrate (GTN) tablets, become less effective. This is because the tablets do not dissolve properly in a dry mouth. To resolve this, drink a mouthful of water before taking sublingual tablets.

This medicine may oppose the effect of domperidone or metoclopramide. This is because metoclopramide and domperidone increase the motility of the gut, whereas hyoscine may reduce it.

References:

https://www.medicines.org.uk/emc/product/3276/smpc

https://www.doctorfox.co.uk/travel-sickness/scopoderm.html

https://www.netdoctor.co.uk/medicines/digestion/a7507/scopoderm-patches-hyoscine-hydrobromide/

https://medlineplus.gov/druginfo/meds/a682509.html

https://www.healthnavigator.org.nz/medicines/h/hyoscine-patch/

 

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