Publications

Published: 8 June 2018

Hyoscine Butylbromide Injection and Cardiovascular Adverse Reactions

Prescriber Update 39(2): 22
June 2018

Key Messages

  • Hyoscine butylbromide injection can lead to cardiovascular adverse reactions, such as hypotension and tachycardia.
  • These adverse reactions may be more serious in patients with underlying cardiac disease.
  • Monitor patients with underlying cardiac conditions who receive hyoscine butylbromide injection.


Hyoscine butylbromide is an antimuscarinic medicine indicated for muscle spasm of the gastrointestinal tract1,2 .

Hyoscine butylbromide injection can cause serious adverse effects, such as tachycardia hypotension, and anaphylaxis. The risk associated with these adverse effects is greater in patients with underlying cardiac disease.

There have been reports, internationally, of patients who have died after receiving intravenous or intramuscular injection of hyoscine butylbromide3 . In most of these cases, the fatal adverse event was acute myocardial infarction or cardiac arrest.

In New Zealand, the Centre for Adverse Reaction Monitoring (CARM) received nine reports of suspected cardiovascular adverse reactions to hyoscine butylbromide injection between 1 January 2013 and 31 December 2017. Tachycardia was reported in six of these cases. In one of these reports, the patient was taking cardiovascular medicines indicative of underlying cardiovascular disease.

Use hyoscine butylbromide with caution in patients with underlying cardiovascular disease. These patients require close monitoring in an environment where resuscitation equipment and staff trained to use it are readily available2 .

Parenteral administration of hyoscine butylbromide is contraindicated in patients with tachycardia2.

Please continue to report any adverse reactions to hyoscine butylbromide to CARM (http://nzphvc.otago.ac.nz/report/).

References
  1. New Zealand Formulary. 2018. New Zealand Formulary v70: Hyoscine butylbromide 1 April 2018. URL: http://nzf.org.nz/nzf_713 (accessed 16 April 2018).
  2. Sanofi-Aventis New Zealand Limited. 2017. Buscopan and Buscopan Forte Data Sheet 9 November 2017. URL: www.medsafe.govt.nz/profs/datasheet/b/Buscopantabinj.pdf (accessed 16 April 2018).
  3. Medicines and Healthcare Products Regulatory Agency. 2017. Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease 20 February 2017. URL: www.gov.uk/drug-safety-update/hyoscine-butylbromide-buscopan-injection-risk-of-serious-adverse-effects-in-patients-with-underlying-cardiac-disease (accessed 16 April 2018).