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During one of my recent online tutorial sessions, a client asked me about the differences between hyoscine hydrobromide and hyoscine butylbromide. These drugs often cause confusion as they sound very similar! So, I thought to include a Blog entry here at www.pharmascholar.co.uk to help others quickly understand the key differences between each medicine to help with university study and / or real-world practice. Importantly, these agents are not to be confused with ‘hyoscyamus 200’. So, here we go…..

Hyoscine hydrobromide and hyoscine butylbromide are both anticholinergic agents that are frequently applied in clinical practice for various reasons. The use of each similar sounding medicine is based upon the key physicochemical differences between each.

Hyoscine hydrobromide has a small molecular structure when compared to the butylbromide salt. As such the former is more readily absorbed into the body resulting in a quicker onset of action. In terms of the delivery route, hyoscine hydrobromide can be administered both orally (e.g. Kwells® and Travel Calm®), by injection (e.g. Hyoscine hydrobromide 400micrograms/1ml ampoules) or transdermally (e.g. Scopoderm® 1.5mg patches). Whereas, hyoscine butylbromide is normally taken orally (e.g. Buscopan® 10mg tablets). For more information on the hyoscine butylbromide structure please contact our Lead Tutor, Dr Davies.

As both drug substances are anticholinergic in nature, they work by blocking the neurotransmitter called acetylcholine which is distributed throughout the brain and body. Importantly, hyoscine hydrobromide is typically applied to manage motion sickness and nausea by blocking the activity of acetylcholine. Here, the drug affects the inner ear and brain to control vomiting and relaxes stomach muscles. However, hyoscine butylbromide is often used to treat vertigo and gastrointestinal issues.

In summary, the choice between each medicine is dependent on the clinical context, desired outcomes and patient-specific needs. For example, hyoscine hydrobromide acts in a rapid manner to manage the clinical issue at hand (i.e. motion sickness).

Pharmacists and prescribers alike need to be aware of these important factors, plus others such as cautions for use and interactions with other medicines, in order to ensure the delivery of safe and effective patient care.

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