Hyoscyamine
[(5R)-8-methyl-8-azabicyclo[3.2.1]octan-3-yl] (2S)-3-hydroxy-2-phenylpropanoate
Overview
Hyoscyamine belongs to Deliriants.
Effects
- At therapeutic (antispasmodic) doses: reduced gut and bladder cramping and secretions, commonly with dry mouth, blurred near vision, constipation, difficulty urinating and a faster heartbeat.
- At higher or toxic exposures: a deliriant state: confusion, disorientation, agitation and vivid, often frightening hallucinations that feel indistinguishable from reality, usually with amnesia for the episode.
- Autonomic signs dominate throughout: dilated pupils, flushed dry skin, raised temperature, urinary retention and tachycardia. Effects are long-lasting (many hours, sometimes a day or more) because vision and cognition recover slowly.
Dosing & duration
Not reported
Dose ranges
Duration
Chemical & Physical Properties
| Formula | C17H23NO3 |
| Molar mass | 289.4 g/mol |
| State | Not reported |
| Melting point | Not reported |
| Boiling point | Not reported |
| Density | Not reported |
| Vapor pressure | Not reported |
| pKa | Not reported |
| LogP | 1.8 (predicted, XLogP3) |
| Solubility | Not reported |
| Refractive index | Not reported |
Identifiers & Synonyms
| CAS | Not reported |
| CAS (enantiomer) | |
| PubChem CID | 154417 |
| InChIKey | RKUNBYITZUJHSG-VFSICIBPSA-N |
| InChI | InChI=1S/C17H23NO3/c1-18-13-7-8-14(18)10-15(9-13)21-17(20)16(11-19)12-5-3-2-4-6-12/h2-6,13-16,19H,7-11H2,1H3/t13-,14+,15?,16-/m1/s1 |
| SMILES | CN1C2CCC1CC(OC(=O)[C@@H](CO)c1ccccc1)C2 |
Synonyms
Pharmacodynamics & Biochemistry
Hyoscyamine is a tropane-alkaloid anticholinergic and the pharmacologically active (S)-(levorotatory) enantiomer of atropine: atropine is the racemate (±)-hyoscyamine, and almost all of atropine's antimuscarinic activity resides in this (S)-form. It occurs naturally in nightshade-family plants (deadly nightshade/belladonna, henbane, datura/jimsonweed, mandrake) and is used medically as an antispasmodic (e.g. Levsin, Levbid). It is a competitive antagonist at all five muscarinic acetylcholine receptor subtypes (M1–M5), binding with subnanomolar affinity and little subtype selectivity. Blocking muscarinic receptors reduces parasympathetic ('rest and digest') tone: peripherally it relaxes smooth muscle and cuts secretions and gut/bladder spasm, speeds the heart and dilates the pupils, while blockade of brain muscarinic receptors produces the central deliriant effects. At toxic exposures it produces the classic anticholinergic toxidrome: summarised as 'blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, full as a flask': blurred vision and dilated pupils, confusion, agitation, hallucinations and delirium, flushed skin, hyperthermia, dry mouth and skin, urinary retention and tachycardia. The quantitative receptor-affinity figures shown below are from atropine (the racemate) as the standard proxy, because the (R)-enantiomer is nearly inactive, hyoscyamine itself carries essentially the same broad, subnanomolar muscarinic antagonism.
Biological targets
- mAChR
Binding & functional measurements
| Target | Measurement | Species |
|---|---|---|
| M4 receptor | pKi 9.7 | Rat |
| M5 receptor | pKi 9.4 | Rat |
| M1 receptor | pKi 9.35 | Rat |
| M3 receptor | pKi 9.15 | Human |
| M4 receptor | pKi 9.1 | Human |
| M1 receptor | pKi 9.05 | Human |
| M2 receptor | pKi 9.05 | Rat |
| M3 receptor | pKi 9 | Rat |
| M5 receptor | pKi 8.8 | Human |
| M2 receptor | pKi 8.5 | Human |
Pharmacokinetics
| Bioavailability | Oral ≈50–80% (variable) |
| Tmax | ≈0.5–1 h (oral) |
| Half-life | ≈3–5 h |
| Vd | Not reported |
| Protein binding | Not reported |
| Metabolism | Partial hepatic hydrolysis to tropic acid and tropine. A substantial fraction is not metabolised |
| Excretion | Renal: roughly half excreted unchanged in urine |
Toxicology & Safety
Not reported
Hyoscyamine and the belladonna-alkaloid plants that contain it are dangerous in overdose. Excess exposure causes the anticholinergic toxidrome: agitation, confusion, frightening hallucinations and delirium, dilated pupils and blurred vision, flushed dry skin, high fever, urinary retention and a fast heartbeat, which can progress to seizures, dangerous arrhythmias, coma and death. Hyperthermia is a particular killer. Deliriant experiences are typically dysphoric, amnesic and genuinely delirious, people cannot tell hallucination from reality and may injure themselves, which is why these substances have little recreational following. Plant material (datura/jimsonweed, belladonna) is especially dangerous because alkaloid content varies enormously between plants and even between parts of one plant, so an apparently small amount can be lethal. The antidote for severe anticholinergic delirium is physostigmine, given only under medical supervision.[4]
Legal Status
US: Prescription only. UK: Prescription only. DE: Prescription only (Rx)
Interactions & Contraindications
Drug interactions
Contraindications
No interactions or contraindications listed.
Usage & Context
- Medically used as an antispasmodic for gastrointestinal and bladder spasm and as a drying/pre-anaesthetic agent, at low prescription doses (e.g. Levsin, Levbid, also in combination products).
- A principal toxic alkaloid of nightshade-family plants (belladonna, henbane, datura/jimsonweed, mandrake), responsible for accidental and deliberate poisonings.
- Occasionally taken as a deliriant, almost always via those plants, but its dysphoric, amnesic and dangerous profile gives it little recreational appeal.
Sources & Evidence
- PubChem: Hyoscyamine (CID 154417) — identifiers & computed properties
- FDA / DailyMed: Hyoscyamine prescribing information — pharmacokinetics & metabolism
- Drugs@FDA (U.S. Food & Drug Administration): hyoscyamine products — prescription-only medicine, not a controlled substance
- Broderick ED, Metheny KE, Crosby B. Anticholinergic Toxicity. StatPearls [Internet] (NCBI Bookshelf, NBK534798) — anticholinergic toxidrome, clinical features & management
- IUPHAR/BPS Guide to PHARMACOLOGY: atropine (ligand 320) — muscarinic M1–M5 antagonist binding data (proxy for hyoscyamine, its active (S)-enantiomer) CC BY-SA 4.0
- Wikipedia: Hyoscyamine (chemistry, pharmacology & medical use) CC BY-SA 4.0
- Kashihara K, Varga EV, Waite SL, et al. (1992). Cloning of the rat M3, M4 and M5 muscarinic acetylcholine receptor genes by the polymerase chain reaction (PCR) and the pharmacological characterization of the expressed genes. Life Sci 51:955-71.
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- Moriya H, Takagi Y, Nakanishi T, et al. (1999). Affinity profiles of various muscarinic antagonists for cloned human muscarinic acetylcholine receptor (mAChR) subtypes and mAChRs in rat heart and submandibular gland. Life Sci 64:2351-8.
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- Buckley NJ, Bonner TI, Buckley CM, et al. (1989). Antagonist binding properties of five cloned muscarinic receptors expressed in CHO-K1 cells. Mol Pharmacol 35:469-76.
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- Fruchart-Gaillard C, Mourier G, Marquer C, et al. (2006). Identification of various allosteric interaction sites on M1 muscarinic receptor using 125I-Met35-oxidized muscarinic toxin 7. Mol Pharmacol 69:1641-51.
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- PubChem computed properties (CID 154417)