How does this medication work? What will it do for me?

Glycopyrrolate belongs to the class of medications called anticholinergics. It is used to reduce severe, long-term drooling for people aged 3 to 18 years of age, who have medical conditions that are linked to problem drooling, such as cerebral palsy. It works by reducing salivation.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Each 5 mL of clear, cherry-flavoured oral solution contains 1 mg of glycopyrrolate. Nonmedicinal ingredients: citric acid, glycerin, methylparaben, natural and artificial cherry flavour, propylene glycol, propylparaben, purified water, saccharin sodium, sodium citrate, and sorbitol solution.

How should I use this medication?

The dose of glycopyrrolate is based on your child's body weight. The usual starting dose is calculated as 0.02 milligrams per kilogram of body weight, taken by mouth, 3 times a day. Glycopyrrolate should be given at least 1 hour before or 2 hours after meals.

The dose may be increased gradually, every 5 to 7 days, depending on side effects and effectiveness. Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If your child misses a dose, and it is less than two hours since the missed dose, give it as soon as possible unless a meal has been taken within the past 2 hours or will be taken within the next hour, and continue with your child's regular schedule. If it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not give your child a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. Discard this medication 60 days after opening the bottle.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to glycopyrrolate or any ingredients of the medication
  • are taking potassium chloride tablets or capsules
  • have glaucoma
  • have a blockage in the urinary tract
  • have a blockage in the digestive tract
  • have uncontrolled heart disease or high blood pressure
  • have severe inflammation of the colon (ulcerative colitis)
  • have toxic inflammation of the colon (toxic colitis)
  • have myasthenia gravis

Do not give this medication to children less than 3 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • diarrhea
  • dry mouth
  • flushing of the face or skin
  • headache
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • changes in body temperature or feeling very hot and unable to cool down, less alert or passing out, fast and weak pulse, shallow breathing, fever (usually after exercise, dehydration, or being in a warm place)
  • difficulty starting urination
  • problem urinating
  • rapid heartbeat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are any nutrients depleted by this medication?

Some medications can affect vitamin and nutrient levels in the body. Below is a list of nutrient depletions associated with this medication. Talk to your doctor or pharmacist about whether taking a supplement is recommended or if you have any questions or concerns.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Body temperature: This medication can disrupt the body's ability to control body temperature. People who exercise vigorously, who are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., benztropine, oxybutynin) are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool down while taking this medication.

Digestive problems: Glycopyrrolate slows down the movement of material through the intestines, making symptoms of certain digestive problems worse. If you have ulcerative colitis or hiatal hernia, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of an intestinal blockage, such as severe stomach pain, loss of appetite, felling of being full, stomach swelling or constipation, nausea or vomiting, contact your doctor as soon as possible.

Drowsiness/reduced alertness: Glycopyrrolate may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.

Heart problems: Glycopyrrolate may worsen symptoms of heart disease. If you have heart disease such as angina, congestive heart failure, arrhythmia, or high blood pressure, discuss with your doctor how this medication may affect the medical condition, how the medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Contact your doctor as soon as possible if you develop symptoms of heart problems such as shortness of breath, chest pain, rapid heartbeat, or swollen ankles.

Kidney function: The kidneys are largely responsible for removing this medication from your body. Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Seizures: This medication can reduce seizure control. Seizures may be more likely to occur with the use of this medication. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Urinary problems: This medication should not be used by people with urinary problems. If you have difficulty passing urine or pain when urinating, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: The safety and effectiveness of using this medication during pregnancy have not been studied. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if glycopyrrolate passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 3 years of age.

What other drugs could interact with this medication?

There may be an interaction between glycopyrrolate and any of the following:

  • aclidinium
  • amantadine
  • antihistamines (e.g., azelastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, rupatadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • atenolol
  • atropine
  • benztropine
  • botulinum toxin
  • buprenorphine
  • butorphanol
  • cannabis
  • clidinium
  • darifenacin
  • digoxin
  • dimenhydrinate
  • disopyramide
  • domperidone
  • donepezil
  • ethopropazine
  • fesoterodine
  • galantamine
  • glucagon
  • ipratropium
  • ketotifen
  • levodopa
  • metformin
  • methadone
  • metoclopramide
  • mirabegron
  • moclobemide
  • muscle relaxants (e.g., cyclobenzaprine, orphenadrine)
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone, tapentadol, tramadol)
  • neostigmine
  • nitroglycerin
  • olopatadine
  • oxybutynin
  • potassium supplements (e.g., potassium chloride, potassium citrate)
  • propiverine
  • prucalopride
  • pyridostigmine
  • rivastigmine
  • scopolamine
  • solifenacin
  • thiazide diuretics (water pills; hydrochlorothiazide, indapamide)
  • tiotropium
  • tolterodine
  • topiramate
  • tranylcypromine
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, doxepin, trimipramine)
  • trihexyphenidyl
  • trospium
  • umeclidinium

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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