Scopolamine Transdermal Patch

WHY is this medicine prescribed?

Scopolamine is used to prevent nausea and vomiting caused by motion sickness or medications used during surgery. Scopolamine is in a class of medications called antimuscarinics. It works by blocking the effects of a certain natural substance (acetylcholine) on the central nervous system.

Are there OTHER USES for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Scopolamine comes as a patch to be placed on the hairless skin behind your ear. When used to help prevent nausea and vomiting caused by motion sickness, apply the patch at least 4 hours before its effects will be needed and leave in place for up to 3 days. If treatment is needed for longer than 3 days to help prevent nausea and vomiting caused by motion sickness, remove the current patch and apply a new patch behind the other ear. When used to prevent nausea and vomiting from medications used with surgery, apply the patch as directed by your doctor and leave it in place for 24 hours after your surgery. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use the scopolamine patch exactly as directed.

To apply the patch, follow these instructions:

1. After washing the area behind the ear, wipe the area with a clean, dry tissue to ensure that the area is dry. Avoid placing on areas of your skin that have cuts, pain, or tenderness.
2. Remove the patch from its protective pouch. Peel off the clear plastic protective strip and discard it. Don't touch the exposed adhesive layer with your fingers.
3. Place the adhesive side against the skin.
4. After you have placed the patch behind your ear, wash your hands thoroughly with soap and water.

Do not cut the patch.

Limit contact with water while swimming and bathing because it may cause the patch may fall off. If the scopolamine patch falls off, discard the patch, and apply a new one on the hairless area behind the other ear.

When the scopolamine patch is no longer needed, remove the patch and fold it in half with the sticky side together and dispose of it. Wash your hands and the area behind your ear thoroughly with soap and water to remove any traces of scopolamine from the area. If a new patch needs to be applied, place a fresh patch on the hairless area behind your other ear.

If you have used scopolamine patches for several days or longer, you may experience withdrawal symptoms that could start 24 hours or more after removing the scopolamine patch such as difficulty with balance, dizziness, nausea, vomiting, stomach cramps, sweating, headache, confusion, muscle weakness, slow heart rate or low blood pressure. Call your doctor right away if your symptoms become severe.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before using scopolamine patches,

• tell your doctor and pharmacist if you are allergic to scopolamine, other belladonna alkaloids, any other medications, or any of the ingredients in scopolamine patches. Ask your doctor or pharmacist, check the package label, or check the Medication Guide for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines such as meclizine (Antivert, Bonine, others); medications for anxiety, irritable bowel disease, motion sickness, pain, Parkinson's disease, seizures or urinary problems; muscle relaxants; sedatives; sleeping pills; tranquilizers; or tricyclic antidepressants such as desipramine (Norpramin), clomipramine (Anafranil), imipramine (Tofranil), and trimipramine (Surmontil) Many other medications may also interact with scopolamine patch, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

• tell your doctor if you have angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Your doctor will probably tell you not to use scopolamine patch.

• tell your doctor if you have or have ever had open-angle glaucoma (increase in internal eye pressure that damages the optic nerve); seizures; psychotic disorders (conditions that cause difficulty telling the difference between things or ideas that are real and things or ideas that are not real); stomach or intestinal obstruction; difficulty urinating; preeclampsia (condition during pregnancy with increased blood pressure, high protein levels in the urine, or organ problems); or heart, liver, or kidney disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using scopolamine patches, call your doctor immediately.

• you should know that scopolamine patch may make you drowsy. Do not drive a car or operate machinery until you know how scopolamine patches will affect you. If you participate in water sports, use caution because this medication can have disorienting effects.

• talk to your doctor about the safe use of alcoholic beverages while using this medication. Alcohol can make the side effects caused by scopolamine patches worse.

• talk to your doctor about the risks and benefits of using scopolamine if you are 65 years of age or older. Older adults should not usually use scopolamine because it is not as safe or effective as other medications that can be used to treat the same condition.

What should I do IF I FORGET to take a dose?

Apply the missed patch as soon as you remember it. Do not apply more than one patch at a time.

What SIDE EFFECTS can this medicine cause?

Scopolamine patches may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• disorientation
• dry mouth
• drowsiness
• dilated pupils
• dizziness
• sweating
• sore throat

Some side effects can be serious. If you experience any of the following symptoms, remove the patch and call your doctor immediately:

• rash
• redness
• eye pain, redness, or discomfort; blurred vision; seeing halos or colored images
• agitation
• seeing things or hearing voices that do not exist (hallucinating)
• confusion
• believing things that are not true
• not trusting others or feeling that others want to hurt you
• difficulty speaking
• seizure
• painful or difficulty urinating
• stomach pain, nausea, or vomiting

Scopolamine patches may cause other side effects. Call your doctor if you have any unusual problems while you are using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Store patches in an upright position; do not bend or roll them.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose or if someone swallows a scopolamine patch, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include the following:

• dry skin
• dry mouth
• difficulty urinating
• fast or irregular heartbeat
• tiredness
• drowsiness
• confusion
• agitation
• seeing things or hearing voices that do not exist (hallucinating)
• seizure
• vision changes
• coma

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are using scopolamine patch.

Remove the scopolamine patch before having a magnetic resonance imaging scan (MRI).

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.