This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.

*For information on opioids, please search and refer to the drugs with their given context.

Glycopyrrolate (Glycopyrronium)

Route, Dosage and Frequency

ROUTE

DOSAGE AND FREQUENCY

PO 0.2-0.4mg q4h
SC 0.2-0.4mg p.r.n. to t.d.s.
CSCI 1.2-2.4mg over 24h

Other Information

Indications

Upper airway secretions

Side-Effects

Constipation, Dry mouth, Difficulty with micturition.

Remarks

Anticholinergic but less central and cardiac side-effects than Atropine or Hyoscine. Avoid in bladder outflow obstruction, paralytic ileus and glaucoma. Compatible with most drugs in syringe driver or infusion pump.

Reference 

  • Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.