Glycopyrrolate

Pronunciation: gly-koh-PIRR-oh-late.

Generic name
glycopyrrolate (glycopyrronium bromide)
Drug class
Antimuscarinic (anticholinergic)
Form
Tablet, oral solution, or injectable solution
Route
Oral (tablet or solution) or injection (intravenous/intramuscular)
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Robinul (injection); generic glycopyrronium bromide injection (6) · Full directory

What glycopyrrolate (glycopyrronium bromide) is and how it works

Glycopyrrolate is a prescription-only anticholinergic medicine that reduces certain body secretions, such as saliva. It is used to manage severe drooling in children with neurological conditions, and, as an injection, to reduce secretions and protect the heart rhythm during anaesthesia and surgery. (2) (3)

Take or receive glycopyrrolate exactly as your prescriber directs. For drooling, the dose is built up gradually and is based on body weight in children -- it is not a fixed dose for everyone. The injectable form is given by a healthcare professional as part of anaesthesia care.

Mechanism of action: how glycopyrrolate (glycopyrronium bromide) works

Glycopyrrolate is a synthetic quaternary ammonium antimuscarinic compound. Its charged quaternary structure limits its ability to cross lipid membranes such as the blood-brain barrier, in contrast to tertiary amine anticholinergics like atropine, which may result in fewer central nervous system effects at equivalent peripheral antimuscarinic doses. (2) (1)

What glycopyrrolate (glycopyrronium bromide) is used for

Severe drooling (chronic sialorrhoea) in children with neurological conditions

Used to reduce chronic severe drooling in children (from around age 3) with neurological conditions such as cerebral palsy, epilepsy, or other neurodegenerative conditions affecting saliva control. (2) (4)

Anaesthesia premedication and intraoperative use

Given by injection before or during anaesthesia and surgery to reduce saliva, airway, and stomach secretions, to reduce stomach acidity, and to help prevent slow heart rate (bradycardia) linked to certain anaesthetic drugs or surgical reflexes; also used to counteract the effects of medicines like neostigmine that are given to reverse muscle-relaxant drugs after surgery. (1) (7)

Before taking glycopyrrolate (glycopyrronium bromide)

Do not take / not appropriate for

  • Do not use glycopyrrolate if you have glaucoma, or a tendency toward narrow-angle (angle-closure) glaucoma. (all countries) (1) (3)
  • Do not use glycopyrrolate if you have myasthenia gravis. (all countries) (1) (3)
  • Do not use glycopyrrolate if you have a bowel blockage, paralytic ileus, severe ulcerative colitis, or toxic megacolon. (all countries) (1) (3)
  • Do not use glycopyrrolate if you have unstable heart or circulation problems during acute bleeding, or urinary retention/significant prostate enlargement. (all countries) (1) (3)

Tell your clinician about

  • Any history of glaucoma, myasthenia gravis, bowel problems, or heart rhythm problems.
  • Kidney or liver disease -- doses may need adjusting.
  • Any autonomic nervous system disorder, hyperthyroidism, or hiatal hernia with reflux.
  • All other medicines you take, especially other anticholinergic medicines, potassium chloride tablets, digoxin, or amantadine.
  • Pregnancy, plans for pregnancy, or breastfeeding.
  • Whether you will be exposed to hot environments or vigorous exercise, since glycopyrrolate reduces sweating.
(1) (2) (3)

How to take glycopyrrolate (glycopyrronium bromide)

  • For drooling, oral glycopyrrolate is usually taken at least 1 hour before or 2 hours after meals, since fatty food can reduce absorption.
  • The injectable form is given by a healthcare professional, typically before or during anaesthesia.
  • Any change in dose for the oral drooling treatment should be made gradually by your prescriber, based on response and side effects.
(2) (7)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

For the oral drooling treatment, if a dose is missed, take it as soon as remembered unless it is close to the next dose, in which case skip the missed dose -- do not double up. Contact your prescriber or pharmacist if you are unsure. The injectable form is administered by a healthcare professional, so a missed dose does not apply in the same way.

Overdose

Seek urgent medical attention if too much glycopyrrolate is taken, or if there are signs such as a very fast heartbeat, severe flushing, high fever, marked drowsiness, difficulty urinating, or confusion. (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Dry mouth.

What to notice: Dry mouth.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (3)

Constipation.

What to notice: Constipation.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (3)

Flushing and nasal congestion.

What to notice: Flushing and nasal congestion.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (3)

Blurred vision.

What to notice: Blurred vision.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Urinary retention or difficulty passing urine.

What to notice: Urinary retention or difficulty passing urine.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (1)

Irritability or drowsiness (more common in children).

What to notice: Irritability or drowsiness (more common in children).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (3)

Serious warnings

Overheating (heat prostration) from reduced sweating — high caution

Symptoms: Fever, hot/flushed skin, dizziness, or confusion in hot weather or during exercise -- glycopyrrolate reduces the body's ability to sweat and cool down.

Action: Avoid excessive heat exposure and vigorous exercise where possible, and seek medical attention promptly for fever or signs of heatstroke; discuss activity and environment planning with your prescriber. (2) (1)

Signs of intestinal pseudo-obstruction or severe constipation — high caution

Symptoms: Abdominal swelling or distension, pain, nausea, or vomiting, which can appear within about 4-5 days of starting or increasing the dose.

Action: Contact your prescriber promptly if these symptoms occur -- this may require dose adjustment under medical supervision. (2)

Signs of significant urinary retention — high caution

Symptoms: Inability to pass urine, or a swollen, painful lower abdomen.

Action: Seek prompt medical attention -- this may require dose review or other treatment. (2)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (2)

Interactions

  • Other anticholinergic medicines can add to glycopyrrolate's effects (dry mouth, constipation, urinary retention, confusion) -- tell your prescriber about all medicines you take. (3)
  • Solid oral potassium chloride tablets should not be combined with glycopyrrolate, since reduced gut motility can increase the risk of the tablets irritating or damaging the gut lining. (2) (3)
  • Digoxin tablets, amantadine, atenolol, and metformin may have altered blood levels when combined with glycopyrrolate -- your prescriber may adjust doses or monitor more closely. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Data in pregnancy are limited. Some glycopyrrolate products (such as those labelled specifically for paediatric drooling) are contraindicated in pregnancy; for other uses, glycopyrrolate should only be used if your prescriber judges it clearly necessary. (1) (2) (3) (4) (5) (6) (7)

Breastfeeding

There is limited data on whether glycopyrrolate passes into breast milk in clinically significant amounts. Discuss the benefits and risks with your prescriber. (1) (2) (3) (4) (5) (6) (7)

Children

Approved for severe drooling from around age 3, with weight-based dosing and gradual titration; more anticholinergic side effects such as irritability have been reported in children than adults. (1) (2) (3) (4) (5) (6) (7)

Elderly

Older adults may be more sensitive to anticholinergic side effects (confusion, urinary retention, constipation, heat intolerance); some drooling-specific products are not recommended in people 65 and older due to limited data. (1) (2) (3) (4) (5) (6) (7)

Hepatic_impairment

Not specifically addressed in detail in the sources reviewed; use with caution and clinician guidance. (1) (2) (3) (4) (5) (6) (7)

Renal_impairment

Dose reduction is recommended in mild-to-moderate kidney impairment, and glycopyrrolate is contraindicated in severe kidney impairment for at least one paediatric-labelled oral product -- your prescriber will adjust the dose based on kidney function. (1) (2) (3) (4) (5) (6) (7)

Source_ids

US-DAILYMED-GLYCOPYRROLATE-ORAL-2026,UK-EMC-GLYCOPYRRONIUM-SIALORRHEA-2026 (1) (2) (3) (4) (5) (6) (7)

Monitoring

Before starting

  • Confirm no glaucoma, myasthenia gravis, bowel obstruction, or unstable cardiovascular disease.
  • Baseline kidney function.
  • Review of other anticholinergic medicines.

During treatment

  • Watch for signs of overheating, especially in hot weather or with exercise.
  • Monitor bowel habits and urinary function.
  • In children, monitor for irritability, drowsiness, or behavioural changes.
  • Dental care attention, since reduced saliva can affect oral health.
(2) (3)

Storage

Store oral glycopyrrolate at room temperature, about 20-25C (68-77F), with excursions permitted between 15-30C; the UK oral solution/tablets should be stored below 25C in the original container and any opened bottle discarded after the labelled period. The injectable form is stored and handled by healthcare staff.

Professional information

Clinician-facing context only, sourced from the current US FDA labelling (injection and oral solution) and UK SmPC; verify against the current full label before prescribing.

United States

Indication: Chronic severe drooling (oral solution, ages 3-16) and anaesthesia premedication/intraoperative use (injection, adults and paediatric)

Dose summary: Oral: start 0.02 mg/kg three times daily, titrate by 0.02 mg/kg every 5-7 days to a maximum of 0.1 mg/kg three times daily (max 1.5-3 mg/dose by weight); take apart from high-fat meals. Injection: individualised per anaesthesia protocol.

Renal context: Not detailed for the injection label in the sources reviewed; the oral paediatric-drooling label does not provide a specific renal dose-adjustment table. (2) (1)

United Kingdom

Indication: Severe sialorrhoea (drooling) due to chronic childhood-onset neurological disorders

Dose summary: Weight-based titration starting at 0.02 mg/kg three times daily, increasing by 0.02 mg/kg every 5-7 days to a maximum of 0.1 mg/kg three times daily (max 1.5-3 mg/dose by weight).

Renal context: 30% dose reduction for mild-to-moderate renal impairment; contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m2). (3)

Mechanism of action

Hepatic guidance

Not specifically addressed in detail in the sources reviewed.

Overdose note

Overdose produces an exaggerated anticholinergic picture -- tachycardia, hyperthermia, flushing, blurred vision, urinary retention, and potentially CNS effects at high doses; manage with supportive care and monitoring. (2) (1)

Frequently asked questions

Is glycopyrrolate available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, glycopyrrolate (glycopyrronium bromide) is approved and available in all of these regions, in oral and/or injectable forms depending on the country and indication. (1) (3) (4) (5) (6) (7)

Is glycopyrrolate approved for hyperhidrosis (excessive sweating)?

A different, topical form of glycopyrronium (a wipe/cloth product) is specifically approved in some countries for excessive underarm sweating. Oral and injectable glycopyrrolate are not themselves approved for hyperhidrosis in the sources reviewed for this page, though they share the same anticholinergic mechanism that reduces sweating. (2)

Why might glycopyrrolate make it harder for me to cool down in hot weather?

Glycopyrrolate reduces sweating as part of its anticholinergic effect. Because sweating is one of the body's main ways of cooling down, this can increase the risk of heat prostration (fever, heat-related illness) in hot weather or during vigorous exercise. Stay cool, avoid overheating, and tell your clinician if you feel unusually hot or unwell. (1)

What is the mechanism of action of glycopyrrolate (glycopyrronium bromide)?

Glycopyrrolate is a synthetic quaternary ammonium antimuscarinic compound. Its charged quaternary structure limits its ability to cross lipid membranes such as the blood-brain barrier, in contrast to tertiary amine anticholinergics like atropine, which may result in fewer central nervous system effects at equivalent peripheral antimuscarinic doses. (2) (1)

What is the generic name of Glycopyrrolate?

The generic name is glycopyrrolate (glycopyrronium bromide). (1) (2)

What class of drug is glycopyrrolate (glycopyrronium bromide)?

Glycopyrrolate is classed as: Antimuscarinic (anticholinergic). (1) (2)

References

  1. ROBINUL Injection (glycopyrrolate injection, USP) -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information -- Robinul Injection (glycopyrrolate injection, USP) · United States · accessed 2026-07-30 · source 1
  2. GLYCOPYRROLATE oral solution -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information -- glycopyrrolate oral solution (Cuvposa) · United States · accessed 2026-07-30 · source 2
  3. Glycopyrronium Bromide 1 mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Dawa Limited · United Kingdom · accessed 2026-07-30 · source 3
  4. Sialanar (glycopyrronium bromide) -- European Public Assessment Report (EPAR)European Medicines Agency (EMA) · European Union · accessed 2026-07-30 · source 4
  5. GLYCOPYRROLATE INJECTION USP / GLYCOPYRROLATE INJECTION MULTIDOSE -- Drug Product Database entriesHealth Canada Drug Product Database · Canada · accessed 2026-07-30 · source 5
  6. ROBINUL glycopyrronium bromide (glycopyrrolate) injection -- ARTG entries (e.g. ARTG 184356, 290709, 163586)Therapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 6
  7. Robinul Injection -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 7

Brand names by country

Single-ingredient glycopyrrolate (glycopyrronium bromide) names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • GLYRX-PF.2 mg/mL · exela pharma sciences, llc
  • Glycate1.5 mg · intra-sana laboratories
  • Cuvposa1 mg/5mL · merz pharmaceuticals, llc

United Kingdom

  • Glycopyrronium bromide tablets/oral solution; Robinul (injection) (3)MHRA licensed emc smpc confirmed · 1 mg tablet, 2 mg tablet, 1 mg/5 mL oral solution · Dawa Limited (tablets); other holders for injection

Canada

  • GLYCOPYRROLATE INJECTION MULTIDOSE

Australia

  • Robinul (injection); generic glycopyrronium bromide injection (6)TGA ARTG registered confirmed · 0.2 mg/1 mL, 0.4 mg/2 mL · Aspen Pharmacare Australia Pty Ltd

New Zealand

  • Robinul Injection (7)Medsafe approved confirmed · 0.2 mg/mL · multiple
View brands in additional countries.

European Union

Sialanar (centrally authorised); Robinul and other nationally authorised products (4)

This page provides general reference information about glycopyrrolate and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions should be made with your prescriber.

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