Methscopolamine (Pamine) is an anticholinergic medicine that is used as an adjunctive to other medicines such as proton pump inhibitors (omeprazole, pantoprazole, lansoprazole, and dexlansoprazole) for the treatment of peptic ulcer disease, abdominal cramping, and abdominal pain.

Methscopolamine Uses:

• Peptic ulcer (adjunctive):

  • It is used as adjunctive therapy for the treatment of peptic ulcer disease.
  • Limitations of use:
    • It has not been shown to be effective in the healing of peptic ulcer disease, reducing the rate of recurrence, or preventing complications.

Methscopolamine Dose in Adults:

Methscopolamine (Pamine) Dose in the treatment of Peptic ulcer (adjunctive):

• Initial:
  • 2.5 mg orally 30 minutes before meals and 2.5 to 5 mg at bedtime;
  • An initial dose of 5 mg orally may be administered in patients with severe symptoms who require prompt relief of abdominal cramps and abdominal pain.
  • The dose may be titrated up or reduced based on the patient's clinical response and tolerance. A maximum dose of up to 30 mg per day may be used.

Use in Children:

Not indicated.

Pregnancy Risk Factor C

• No studies have been conducted on animal reproduction.
• It is possible that it crosses the placental barrier because it is a derivative from scopolamine. Scopolamine has been linked to fetal toxicities.

Methscopolamine use while breastfeeding

• It's not known if the drug can be found in breastmilk. Anticholinergic medication may affect milk production.
• If you are a nurse, it is best to use it with caution.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling. It should be used with caution in patients with kidney disease.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling. It should be used with caution in liver disease.

Side effects of Methscopolamine (Pamine):

• Cardiovascular:

  • Palpitation
  • Tachycardia

• Central Nervous System:

  • Headache
  • Insomnia
  • Flushing
  • Nervousness
  • Drowsiness
  • Dizziness
  • Confusion
  • Fever
  • CNS Stimulation May Be Produced With Large Doses

• Dermatologic:

  • Dry Skin
  • Urticaria

• Endocrine & Metabolic:

  • Lactation Suppressed

• Gastrointestinal:

  • Constipation
  • Xerostomia
  • Dry Throat
  • Dysphagia
  • Nausea
  • Vomiting
  • Loss Of Taste

• Genitourinary:

  • Impotence
  • Urinary Hesitancy
  • Urinary Retention

• Neuromuscular & Skeletal:

  • Weakness

• Ocular:

  • Blurred Vision
  • Cycloplegia
  • Ocular Tension Increased
  • Pupil Dilation

• Respiratory:

  • Dry Nose

• Miscellaneous:

  • Allergic Reaction
  • Diaphoresis Decreased
  • Hypersensitivity Reactions
  • Anaphylaxis

Contraindications to Methscopolamine (Pamine):

• Hypersensitivity to methscopolamine or any other component of the formulation;
• Glaucoma
• Obstructive Uropathy, such as bladder neck obstruction caused by prostatic hypertrophy.
• Obstructive disease (as in pyloroduodenal stasis)
• Paralytic ileus
• Debilitated or elderly patients may experience a gastrointestinal atony.
• Unstable cardiovascular health can lead to acute bleeding
• Grave ulcerative colitis
• Toxic megacolon complicates ulcerative colitis
• Myasthenia gravis

Warnings & Precautions

• CNS effects

  • Patients might experience blurred vision and drowsiness that can affect their mental and physical abilities. Patients who are required to be alert for driving or operating heavy machinery should exercise caution.

• Diarrhea

  • Diarrhea may occur in patients with incomplete intestinal obstruction, especially those who have ileostomy and colostomy. In such cases, the treatment should be stopped.

• Heat prostration

  • Heat exhaustion can happen in summer heat. Be careful when exercising with athletes or in hot conditions.

• Cardiovascular disease

  • It should be used with caution in patients with heart disease, hypertension, coronary artery disease, tachycardia, or tachyarrhythmias.

• Hepatic impairment

  • Patients suffering from liver disease should be cautious.

• Hyperthyroidism

  • Hyperthyroid patients should be cautious.

• Neuropathy

  • Patients with autonomic neuropathy should avoid this.

• Prostatic hyperplasia

  • Prostatic hyperplasia patients should be cautious about using it as it can worsen their urinary symptoms.

• Renal impairment

  • Patients with impaired renal function should be cautious when taking the drug.

• Ulcerative colitis

  • Avoid ulcerative colitis.

Methscopolamine: Drug Interaction

Monitoring parameters:

Observe for anticholinergic side effects. A follow-up endoscopy or upper GI contrast radiology may be required to confirm healing.

How to administer Methscopolamine (Pamine)?

• Administer about 30 minutes before meals and at bedtime.

Mechanism of action of Methscopolamine (Pamine):

It is a derivative from scopolamine, a quanary ammonium derivative with anticholinergic characteristics. It decreases the volume and acid content of gastric secretions.

The onset of action:

• About 1 hour

Duration:

• 4 to 6 hours

Absorption:

• Poorly and unreliably absorbed

Bioavailability:

• 10% to 25%

Excretion:

• Bile and urine;
• feces (as unabsorbed drug)

International Brand Names of Methscopolamine:

• Pamine Forte
• Pamine

Methscopolamine Brand Names in Pakistan:

No Brands Available in Pakistan.