Cardiac warning for anticholinergic injection

Hyoscine butylbromide injection, an anticholinergic used to relieve acute muscle spasm, can have adverse effects including tachycardia, hypotension, and anaphylaxis. These effects can be more serious in patients with underlying cardiac disease, such as heart failure, coronary heart disease, arrhythmia and hypertension.

The MHRA has received 9 reports of patients who died after receiving hyoscine butylbromide injection, in most cases from cardiac arrest.

In light of these reports, caution is required when giving hyoscine butylbromide injection to patients with pre-existing heart conditions. Patients should be monitored, and resuscitation equipment (and appropriately trained personnel) must be readily available.

Hyoscine butylbromide injection is contraindicated in patients with tachycardia.