Glycopyrronium Bromide Injection is an anticholinergic indicated:

• in anesthesia (adult and pediatric patients)
• for reduction of airway or gastric secretions, and volume and acidity of  gastric secretions, and blockade of cardiac inhibitory reflexes during induction of anesthesia and intubation,
• intraoperatively to counteract surgically or drug-induced or vagal reflex-associated arrhythmias, and 
• for protection against peripheral muscarinic effects of cholinergic agents.

Anesthesia

Arrhythmia

Orally Disintegrating Tablets: 1.7 mg of glycopyrrolate

Injection:
Glycopyrrolate Injection may be administered intramuscularly, or intravenously, without dilution, in the following indications:

Adults:

• Preanesthetic Medication: Administered intramuscularly at a dosage of 0.004 mg/kg, approximately 30 to 60 minutes before the expected induction of anesthesia.
• Intraoperative Medication: Administer a single intravenous dose of 0.1 mg, with the option for additional doses, as necessary, at intervals of 2 to 3 minutes.
• Reversal of Neuromuscular Blockade: Use 0.2 mg for every 1 mg of neostigmine or 5 mg of pyridostigmine.
• Peptic Ulcer: Administer 0.1 mg intravenously or intramuscularly at 4-hour intervals, repeated 3 or 4 times daily.

Pediatric patients

• Preanesthetic Medication: Administer 0.004 mg/kg intramuscularly, given 30 to 60 minutes before the expected induction of anesthesia. For patients under 2 years of age, the dosage may be increased to a maximum of 0.009 mg/kg.
• Intraoperative Medication: Administer 0.004 mg/kg intravenously, with a maximum single dose not to exceed 0.1 mg. Repeat as necessary at intervals of 2 to 3 minutes.
• Reversal of Neuromuscular Blockade: Use 0.2 mg for each 1 mg of neostigmine or 5 mg of pyridostigmine.
• Peptic Ulcer: Glycopyrrolate Injection is not recommended for the treatment of peptic ulcer in pediatric patients.
• Caution: Do not use the prefilled syringe to administer a dose less than 0.1 mg (0.5 mL).

Adverse reactions may occur and can vary in frequency. Common to less common adverse reactions may include:

• Dry mouth
• Constipation
• Urinary retention
• Blurred vision
• Tachycardia
• Headache
• Dizziness
• Nausea
• Confusion
• Allergic reactions (rare)

Dry Mouth

Constipation

Urinary retention

Blurred vision

• Anticholinergic Effects: Glycopyrronium bromide may cause anticholinergic effects, leading to dry mouth, blurred vision, urinary retention, and constipation.
• Cardiovascular Effects: Use with caution in patients with cardiovascular diseases, as it may cause tachycardia.
• Renal Impairment: Adjust dosage in patients with renal impairment.
• Hepatic Impairment: Use with caution in patients with hepatic impairment.
• Heat Prostration: Avoid exposure to high temperatures due to the risk of heat prostration.
• Glaucoma: Use cautiously in patients with narrow-angle glaucoma.