Isonil

• Peptic Ulcer Disease: Adjunctive treatment to reduce gastric motility and acid secretion.
• Irritable Bowel Syndrome (IBS): Relief of intestinal spasms and cramping.
• Functional Bowel Disorders: Management of spastic colon symptoms.
• Other Gastrointestinal Spasms: Including colic and smooth muscle spasms in the gastrointestinal tract.
• Adjunct in Biliary or Renal Colic: To relieve smooth muscle spasm.
• Off-label uses: May be used in other conditions involving smooth muscle spasm as determined by physician.

• Adults:
• Oral: Typically 10–20 mg 3 to 4 times daily before meals and at bedtime.
• Injectable (if available): Dose individualized; usually administered intramuscularly or intravenously under supervision.
• Elderly: Start with lower doses and monitor for anticholinergic side effects.
• Pediatrics: Use with caution; dosing based on clinical judgment and body weight.
• Renal/Hepatic Impairment: Use cautiously; dose adjustments may be necessary due to reduced clearance and increased side effect risk.
• Administration: Oral tablets should be taken with water. Injectable forms administered by healthcare professionals.

Oxyphenonium bromide is an anticholinergic agent that competitively blocks muscarinic acetylcholine receptors in smooth muscle and secretory glands. By inhibiting parasympathetic stimulation, it reduces gastrointestinal motility and smooth muscle spasms, decreases gastric acid secretion, and reduces secretions, thereby relieving symptoms related to spasmodic gastrointestinal conditions.

• Absorption: Well absorbed orally with onset of action within 30–60 minutes.
• Distribution: Widely distributed; crosses blood-brain barrier to some extent.
• Metabolism: Partially metabolized in the liver.
• Elimination: Primarily renal excretion of unchanged drug and metabolites.
• Half-life: Approximately 4–6 hours.
• Onset: 30–60 minutes (oral); faster onset with parenteral use.

• Pregnancy: FDA Category C. Animal studies have shown adverse effects; use only if benefits justify potential risks.
• Lactation: Unknown if excreted in human milk; caution advised when administered to nursing mothers.

• Anticholinergic agent
• Antispasmodic

• Known hypersensitivity to oxyphenonium bromide or other anticholinergics
• Narrow-angle glaucoma
• Myasthenia gravis
• Megacolon or paralytic ileus
• Urinary retention
• Severe ulcerative colitis
• Toxic megacolon

• Use cautiously in patients with:
• Prostatic hypertrophy with urinary retention
• Cardiovascular disease (may cause tachycardia)
• Glaucoma (risk of increased intraocular pressure)
• Hepatic or renal impairment
• Monitor for anticholinergic toxicity, especially in elderly patients.
• Avoid abrupt discontinuation in chronic use.

• Common: Dry mouth, blurred vision, constipation, urinary retention, dizziness, tachycardia
• Less common: Headache, flushing, nervousness, confusion (especially elderly)
• Serious (rare): Acute glaucoma attack, paralytic ileus, severe urinary retention, hallucinations

• Additive anticholinergic effects with other anticholinergic drugs (e.g., antihistamines, tricyclic antidepressants)
• May reduce efficacy of cholinergic agents (e.g., bethanechol)
• Possible interaction with drugs that affect gastric motility
• Caution when combined with other CNS-active agents

• No major recent changes in approved indications or warnings.
• Continued emphasis on careful use in elderly due to increased risk of cognitive impairment and anticholinergic burden.

• Store at 20°C to 25°C (68°F to 77°F)
• Protect from moisture and light
• Keep container tightly closed
• Keep out of reach of children