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From Hyoscine

Care should be taken when moving from another type of anticholinergic drug due to the potential for increased risk of anticholinergic adverse effects.1 There is no available data to support transferring patients from a non-glycopyrronium bromide anticholinergic (e.g. hyoscine/scopolamine or atropine) to Sialanar®.1,2

A washout period from the first drug should be considered. Sialanar® should be prescribed following the dose titration table, starting from dose level 1 to balance efficacy and side effects.2

The half-life of free scopolamine is approx. 10 hours so the drug should be cleared within about 72 hours. However, the ultimate decision as to when to start the second drug and the appropriate starting dose should lie with the treating clinician.

From generic glycopyrronium bromide oral solutions:

Oral preparations of glycopyrronium bromide are not interchangeable on a microgram-for-microgram basis due to differences in bioavailability. Care should be taken if switching between oral preparations and dosing adjusted accordingly.3

Please follow the links below to find documents providing guidance on the equivalent doses of Sialanar® (2mg/5ml glycopyrronium bromide) oral solutionand different generic glycopyrronium bromide oral solutions4-7

 

Safety

Head to this section for guidance on side effects and titration.

Clinical Evidence

Glycopyrronium has demonstrated lower rates of problematic side effects8 and treatment cessation8,9 vs. hyoscine.

References

  1. Sialanar® SmPC (January 2023) https://www.medicines.org.uk/emc/product/2301  – accessed August  2023 
  2. Scopoderm (hyoscine) SmPC (September 2024).https://www.medicines.org.uk/emc/product/13379/smpc - accessed August 2025
  3. BNFC Glycopyrronium Bromide https://bnfc.nice.org.uk/drugs/glycopyrronium-bromide/ - accessed August 2023
  4. Glycopyrronium Bromide 1 mg/5 ml Oral Solution (Colonis Pharma) SmPC (July  2024) https://www.medicines.org.uk/emc/product/7344/smpc – Accessed September 2025
  5. Glycopyrronium Bromide 1 mg/5 ml Oral Solution (Rosemont Pharmaceuticals Limited) SmPC (January 2022) https://www.medicines.org.uk/emc/product/13136/smpc – Accessed September 2025
  6. Glycopyrronium Bromide 1 mg/5 ml Oral Solution (Strandhaven Limited t/a Somex Pharma UK Limited) SmPC (October 2022) https://www.medicines.org.uk/emc/product/14104/smpc – Accessed September 2025
  7. Glycopyrronium Bromide 2 mg/5 ml Oral Solution (Colonis Pharma) SmPC (February 2025). https://www.medicines.org.uk/emc/product/100528/smpc#gref – accessed September 2025. 
  8. Parr J.R, Todhunter E, Pennington L, et al. Drooling Reduction Intervention randomized trial (DRI): comparing the efficacy and acceptability of hyoscine patches and glycopyrronium liquid on drooling in children with neurodisability. Arch Dis Child 2017; 1-6. Doi:10. 1136/ archdischild-2017-313763.
  9. Reid S.M, et al. Anticholinergic medications for reducing drooling in children with developmental disability. Developmental Medicine & Child Neurology 2019; 63(3): 346-353

UK-SIA-25-0065 | October 2025

Adverse Event Reporting Information

UK: Adverse events should be reported. Reporting forms and information can be found at: www.mhra.gov.uk/yellowcard

Republic of Ireland: Adverse events should be reported. Reporting forms and information can be found at: www.hpra.ie.

Adverse events should also be reported to Proveca Limited. Phone: +44 333 200 1866 E-Mail: medinfo@proveca.com

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