Non-CYP metabolism. No data pointing to clinical CYP induction or inhibition. Without references warned against in Martindale, however no other reports of observed porphyrogenicity are present.

Butylscopolamine is a quarternary ammonium compound.

butylscopolamine is an antispasmodic drug used in the treatment of gastrointestinal, bile duct, renal and urogenital spastic conditions, often together with opioid analgesics. It is also used prior to diagnostic procedures such as X-ray and gastro-duodenal endoscopy. It is administered as a subcutaneous, intramuscular or slow intravenous injection. It can also be administered orally.

Given orally the bioavailability of butylscopolamine is very low because of its very high affinity to gastrointestinal muscarin and nicotine receptors. Even in the high systemic concentrations after parenteral administratration, the majority of the dose may conceivably be trapped by tissue receptors prior to liver passage. Low degree of binding to plasma proteins. The main metabolic pathway of butylscopolamine is hydrolytic cleavage of the ester bond. The metabolites are excreted by the kidneys. 50 % is excreted as unchanged drug in urine. (Tytgat 2007).

Uneventful use reported in 1 patient with acute porphyria. Also uneventful use of butylscopolamine in combination with analgesics (ATC A03D B04) has been reported in 1 patient with acute porphyria.