Hyoscine hydrobromide (Kwells and Joy-Rides)

Hyoscine hydrobromide is a travel sickness (motion sickness) medicine that belongs to a group of medicines called anticholinergics or antimuscarinics.

It's thought to work by affecting your inner ear and your brain to control vomiting. It also relaxes the muscles in the walls of your stomach.

Hyoscine hydrobromide comes as patches that you stick to your skin and tablets that you suck, chew or swallow.

It can also be given by injection, but this is usually only done in hospital. It is given to reduce the amount of saliva in your mouth which can help with symptoms if you're having palliative or end of life care.

You can buy the tablets and patches at pharmacies.

Hyoscine hydrobromide is not the same as hyoscine butylbromide, better known as Buscopan.

Hyoscine hydrobromide travel sickness tablets can be taken by most adults and children from the age of 3 years.

Patches for travel sickness can be used by most adults and children from the age of 10 years.

Hyoscine hydrobromide is not suitable for some people. To make sure it's safe for you, tell a pharmacist or doctor before taking it if you:

• have ever had an allergic reaction to hyoscine hydrobromide or any other medicine
• have an eye problem called primary angle closure glaucoma
• have difficulty peeing or a bowel blockage
• have myasthenia gravis, a condition that causes muscle weakness
• have heart problems, including a very fast heart rate
• have thyroid, kidney or liver problems
• have epilepsy (seizures)
• have digestive problems, such as acid reflux or severe constipation
• have ulcerative colitis
• have a high temperature
• are pregnant or trying to get pregnant, as hyoscine hydrobromide is not recommended in pregnancy

Pharmacies sell 2 different strengths of hyoscine hydrobromide tablets:

• 150 micrograms (including Kwells Kids and Joy-Rides)
• 300 micrograms (including Kwells and Boots Travel Calm)

Take (or give your child) a dose at least 20 to 30 minutes before starting your journey, or as soon as you start to feel sick when travelling.

Different brands of tablets may have different recommended doses. Check the instructions on the packet for the dose you need to give yourself or your child.

For long journeys, you can repeat the dose every 6 hours.

Tablets

Suck or chew the tablets, or swallow them whole with a drink of water.

You can take the tablets with or without food.

Patches for travel sickness

The patches work like a plaster and you stick them on your skin.

1. Stick a patch to the skin behind the ear, 5 to 6 hours before the start of your journey (or the evening before you travel).
2. Remove the patch at the end of your journey.

For long journeys, you can keep the patch on for up to 72 hours (3 days).

If you're still travelling after 72 hours, remove the first patch and stick a new patch behind the other ear. You can keep this on for another 72 hours if needed.

Do not apply more than 1 patch at a time.

For travel sickness, you only need to take the tablets or use the patches before and during your journey.

Taking 1 extra dose of hyoscine hydrobromide is unlikely to harm you or your child.

But you may get more side effects, such as a dry mouth or blurred vision.

Taking more than 1 extra dose of hyoscine hydrobromide can be dangerous. In serious cases, you may have a fast heartbeat, you can become unconscious or have a seizure or fit, and you'll need emergency treatment in hospital.

The amount of hyoscine hydrobromide that can lead to an overdose varies from person to person.

• you or your child take 2 or more extra doses of hyoscine hydrobromide

Get help from 111 online or call 111. Call 111 if you need advice for a child under 5 years old

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the hyoscine hydrobromide packet or leaflet inside it, any remaining medicine, and any other medicines you take.

These common side effects of hyoscine hydrobromide happen in more than 1 in 100 people. There are things you can do to help cope with them:

Do not drive, cycle or use tools or machinery if you're feeling this way. Try to avoid drinking alcohol as this will make you feel more tired.

Talk to your doctor if this bothers you as you may need to switch to a different medicine.

Try chewing sugar-free gum or sucking sugar-free sweets.

Eat more high-fibre foods, such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise more regularly (for example, by going for a daily walk or run). If this does not help, talk to a pharmacist or doctor.

If this keeps happening after taking hyoscine hydrobromide, speak to a doctor. You may need to change to a different type of medicine.

It may help to cut down on alcohol, smoking, caffeine and big meals, as these can make the problem worse.

Avoid driving, cycling or using tools or machines while this is happening. If it lasts for more than a day or two speak to your doctor as they may need to change your treatment.

Try to relax when you pee. Do not try to force the flow of urine. If it does not happen, try again later.

Talk to a doctor urgently if you cannot pee at all.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

It happens rarely, but some people may have a serious side effect when taking hyoscine hydrobromide.

Stop taking hyoscine hydrobromide (or remove your patch) if this happens to you.

Call your doctor or call 111 straight away if you:

• have a painful red eye with loss of vision – this could be caused by an increase in pressure in your eye
• are feeling confused or seeing things that are not real (hallucinations)
• cannot pee at all
• have a fast, pounding heart rate that does not settle or keeps coming back
• have a high temperature

• you have difficulty breathing or short, shallow breathing
• you have a fit or seizure
• you're unable to stay awake and cannot keep your eyes open for more than a few seconds

Find your nearest A&E

Do not drive yourself to A&E.

The person you speak to at 999 will give you advice about what to do.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to hyoscine hydrobromide.

Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of hyoscine hydrobromide. For a full list, see the leaflet inside your medicine packet.

Hyoscine hydrobromide is not recommended during pregnancy because not enough is known about its effects.

However, your doctor may offer you hyoscine hydrobromide if you have severe travel sickness that cannot be treated any other way.

It is not known how much hyoscine hydrobromide gets into breast milk, but it's likely to be a very small amount.

If you are only taking occasional doses of hyoscine hydrobromide for a short time, for example for travel sickness, it's OK to use while breastfeeding and your baby does not need to be monitored for side effects.

If you need to take hyoscine hydrobromide more regularly, this is still OK while breastfeeding, but monitor your baby for possible side effects, such as sleepiness, constipation, and peeing less than usual.

If your baby is not feeding as well as usual, or you have any other concerns about your baby while you're breastfeeding, talk to your doctor, pharmacist, health visitor or midwife.

There's no good evidence to suggest that taking hyoscine hydrobromide reduces fertility in either men or women.

Tell your doctor if you're:

• trying to get pregnant
• pregnant
• breastfeeding

Hyoscine hydrobromide can be affected by some medicines and affect the way other medicines work. Taking it with other medicines can also increase your risk of side effects.

Do not take hyoscine hydrobromide if you're taking medicines such as domperidone or metoclopramide, which are used to increase the movement of food through your gut. Taking these with hyoscine hydrobromide can stop it working properly.

Tell your pharmacist or doctor before taking hyoscine hydrobromide if you're taking any of these medicines:

• amantadine, a medicine for Parkinson's disease
• quinidine or disopyramide, heart medicines
• allergy medicines, such as antihistamines
• some medicines for depression, such as amitriptyline
• some inhaled asthma medicines, including ipratropium or tiotropium
• medicines for mental health problems, such as chlorpromazine or clozapine

There might be a problem taking some herbal remedies and supplements alongside hyoscine hydrobromide, especially ones that cause side effects such as sleepiness, a dry mouth or making it difficult to pee.

Ask a pharmacist for advice.

There's not enough information to say whether other complementary medicines, herbal remedies and supplements are safe to take with hyoscine hydrobromide. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.