Glycopyrrolate

Glycopyrrolate is used in combination with other medications to treat ulcers in adults and children 12 years of age and older. Glycopyrrolate (Cuvposa) is used to reduce saliva and drooling in children between 3 and16 years of age that have certain medical conditions that cause drooling. Glycopyrrolate is in a class of medications called anticholinergics. It decreases stomach acid and saliva production by blocking the activity of a certain natural substance in the body.

Glycopyrrolate comes as a tablet and solution (liquid) to take by mouth. For the treatment of ulcers, the tablet is usually taken 2 or 3 times a day. To reduce saliva and drooling in children with certain medical conditions, the solution is usually taken 3 times a day. Take the solution on an empty stomach (at least 1 hour before or 2 hours after a meal). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take glycopyrrolate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start your child on a low dose of the solution and gradually increase the dose over a 4-week period.

If you are giving the solution to a child, do not use a household spoon to measure the dose. Use an oral syringe that is made especially for measuring liquid medication.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking glycopyrrolate,

• tell your doctor and pharmacist if you are allergic to glycopyrrolate, any other medications, or any of the ingredients in glycopyrrolate tablets or solution. Ask your pharmacist for a list of the ingredients..
• tell your doctor if you are taking extended-release (long-acting) potassium chloride tablets or capsules. Your doctor may tell you not to take glycopyrrolate if you are taking this medication.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amantadine (Symmetrel); atenolol (Tenormin, in Tenoretic); digoxin (Lanoxin); levodopa (in Rytary, in Sinemet, in Stavelo); ipratropium (Atrovent); mediations for anxiety, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, seizures, ulcers, or urinary problems; sedatives; tranquilizers; and tricyclic antidepressants such as amitriptyline, amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with glycopyrrolate, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had glaucoma; difficulty urinating; a blockage or narrowing of your stomach or intestines, paralytic ileus (condition in which digested food does not move through the intestines) toxic megacolon (a serious or life-threatening widening of the intestine), or myasthenia gravis (a disorder of the nervous system that causes muscle weakness). Your doctor may tell you not to take glycopyrrolate.
• tell your doctor if you have or have ever had enlargement of the prostate, ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum), overactive thyroid, high blood pressure, heart failure, irregular or rapid heartbeats, coronary artery disease, hiatal hernia with reflux, disorders of the nervous system, or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking glycopyrrolate, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking glycopyrrolate.
• you should know that glycopyrrolate may make you drowsy or cause blurred vision. Do not drive a car or operate machinery until you know how this medication affects you.
• you should know that glycopyrrolate reduces the body's ability to cool off by sweating. Avoid being in hot or very warm temperatures. If you experience any of the following symptoms, call your doctor immediately: lack of sweating in hot weather; hot, red skin; decreased alertness; loss of consciousness; fast, weak pulse; fast, shallow breathing; or fever.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Glycopyrrolate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dry mouth
• blurred vision
• vision problems
• loss of taste
• headache
• nervousness
• confusion
• drowsiness
• weakness
• dizziness
• difficulty falling asleep or staying asleep
• upset stomach
• nausea
• vomiting
• constipation
• bloated feeling
• nasal congestion

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• diarrhea
• rash
• hives
• difficulty breathing or swallowing
• difficulty urinating or unable to urinate

Glycopyrrolate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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