glycopyrrolate
Cuvposa (glycopyrrolate) is an anticholinergic used to treat excessive drooling in children with certain conditions affecting the brain, such as cerebral palsy. The dosage that each child needs can vary. It comes as an oral solution and is available both as a brand-name and generic medications. Side effects include dry mouth, constipation, and sweating less.
What is Cuvposa (glycopyrrolate)?
What is Cuvposa (glycopyrrolate) used for?
Excessive drooling in children ages 3 to 16 with certain conditions affecting the brain
How Cuvposa (glycopyrrolate) works
Cuvposa (glycopyrrolate) is an anticholinergic. It blocks a chemical called acetylcholine on salivary glands, where saliva is made and released into the mouth. While saliva can help with swallowing and chewing, too much can cause drooling. This is often seen in conditions that affect the brain, such as cerebral palsy.
Cuvposa (glycopyrrolate) helps manage this by lowering the amount of saliva that's made.
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What are the side effects of Cuvposa (glycopyrrolate)?
Common Side Effects
- Dry mouth (40%)
- Vomiting (40%)
- Constipation (35%)
- Flushing (30%)
- Nasal congestion (30%)
- Headache (15%)
- Sinus inflammation (15%)
- Upper respiratory infection (15%)
- Difficulty urinating (15%)
Other Side Effects
- Stomach bloating
- Stomach pain or discomfort
- Chapped lips
- Gas
- Feeling irritated or agitated
- Pneumonia
- Urinary tract infection
- Faster heart rate
- Dehydration
- Changes in taste
- Uncontrolled eye movement
- Restlessness
- Aggressive behavior
- Crying
- Moaning
- Mood changes
- Dry nose
- Dry skin
- Itching
- Rash
Serious Side Effects
- Intestinal blockage: diarrhea, stomach pain, bloating, nausea, vomiting
- Serious allergic reaction: itchy red rash (hives), shortness of breath, chest tightness, swelling of lips, tongue, face, or eyes
Source: DailyMed
More on Cuvposa (glycopyrrolate) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Diarrhea
- Fever that does not go away, decreased sweating
- Trouble passing urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Blurry vision
- Constipation
- Dry mouth
- Drowsiness
- Flushing
- Vomiting
Pros and cons of Cuvposa (glycopyrrolate)
Pros
Works well to treat severe drooling
Convenient to prepare the dose
Available in a liquid cherry flavor, making it easier for children to take
Cons
Has many unpleasant anticholinergic side effects
Needs to be taken multiple times per day
Must be taken on an empty stomach
Pharmacist tips for Cuvposa (glycopyrrolate)
Take Cuvposa (glycopyrrolate) on an empty stomach, which is at least 1 hour before or 2 hours after meals. Food can lower the amount of medication that gets absorbed into the body, so it might not work as well.
Use a dosing cup to measure out your child's dose of Cuvposa (glycopyrrolate). Then, using an oral syringe, draw up the dose from the cup and place it in your child's mouth. Avoid using a kitchen teaspoon, as it doesn't provide an accurate measurement.
Constipation, a common side effect of Cuvposa (glycopyrrolate), typically happens within the first 4 to 5 days of starting the medication or after a dose is raised. If your child is constipated, stop the medication and let their pediatrician know because this could be a sign of a more serious stomach problem.
Cuvposa (glycopyrrolate) can sometimes cause difficulty urinating. Dry diapers or underwear, crying, and irritability can be signs that your child is having difficulty urinating. Stop the medication and call their pediatrician if your child isn't urinating.
Try to keep your child away from hot environments when they are taking Cuvposa (glycopyrrolate). This medication can reduce sweating which can lead to overheating.
Cuvposa (glycopyrrolate) interacts with certain medications that might require dose adjustments (e.g. metformin (Glucophage), atenolol (Tenormin), haloperidol (Haldol)). Talk to a pharmacist or pediatrician before they start any new medications
Store Cuvposa (glycopyrrolate) at room temperature and out of reach from children to avoid potential overdose.
Frequently asked questions about Cuvposa (glycopyrrolate)
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What are the risks and warnings for Cuvposa (glycopyrrolate)?
Cuvposa (glycopyrrolate) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Constipation
Risk factors: Taking other medications that cause constipation
Constipation is a common side effect of Cuvposa (glycopyrrolate), especially within the first 4 to 5 days of starting the medication and after a dose is raised. If your child complains of constipation, stomach pain, swelling, nausea, and vomiting, stop Cuvposa (glycopyrrolate) and tell their pediatrician because this could be a sign of intestinal pseudo-obstruction (a rare condition that prevents your intestinal muscles from moving).
Blockage in the intestine
Risk factors: History of surgical procedures of the intestines, such as ileostomy or colostomy
Cuvposa (glycopyrrolate) can cause blockage in the intestine. Diarrhea can be an early sign of this blockage, especially if your child has a history of surgical procedures in the intestines, like an ileostomy or colostomy. If your child has diarrhea, stop Cuvposa (glycopyrrolate) and let their pediatrician know.
Heat stroke or fever
Risk factors: Hot weather | Strenuous activity or exercise | Taking other anticholinergic medications
Cuvposa (glycopyrrolate) can cause your child to sweat less, which can lead to fever or heat strokes in hot weather. To avoid overheating, have your child cool down and rest in the shade, drink cold water, and take breaks while running around or playing. Call their pediatrician right away if your child becomes sick, less alert, passes out, or has any other symptoms of heatstroke, such as hot and red skin, fast heartbeat, difficulty breathing, or fever.
Sleepiness or blurred vision
Risk factors: Taking other medications that cause sleepiness or blurred vision
Cuvposa (glycopyrrolate) can cause sleepiness or blurred vision. Don’t let your child do any activities that require concentration until you know how Cuvposa (glycopyrrolate) affects your child.
Worsening of other health conditions
Some health conditions can worsen if your child takes Cuvposa (glycopyrrolate). For example, if your child has heart problems, be careful when giving this medication because it can raise their heart rate.
If your child has an inflamed colon (ulcerative colitis), higher doses of Cuvposa (glycopyrrolate) can slow their stomach and intestinal muscles, which can lead to life-threatening conditions of the intestine. Talk to their pediatrician if you’re concerned about certain worsening conditions for your child.
Cuvposa (glycopyrrolate) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 473ml of 1mg/5ml | 1 bottle | $493.01 | $493.01 |
Typical dosing for Cuvposa (glycopyrrolate)
The dosing is based on your child's weight.
The typical starting dose is 0.02 mg/kg by mouth three times daily. Your child's pediatrician will slowly raise the dose every 5 to 7 days, depending on how well the medication is working and if your child experiences side effects.
The maximum dose is 0.1 mg/kg three times daily, with no doses greater than 1.5 to 3 mg per dose based on weight.
How much does Cuvposa (glycopyrrolate) cost?
Cuvposa (glycopyrrolate) contraindications
Taking oral potassium chloride
Loss of movement in the intestinal muscles (paralytic ileus)
Unstable heart during serious blood loss
Inflammation of the intestines (ulcerative colitis)
Life-threatening inflammation of the colon (toxic megacolon)
Abnormal muscle weakness (myasthenia gravis)
What are alternatives to Cuvposa (glycopyrrolate)?
Excessive drooling in children ages 3 to 16 with certain conditions affecting the brain
Long-term excessive drooling (sialorrhea) in people 2 years and older
Arm spasms in people 2 years and older
Uncontrollable neck spasms (cervical dystonia) in adults
Uncontrollable eye twitching (blepharospasm) in adults
Frown lines in adults
Cuvposa (glycopyrrolate) images
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References
Best studies we foundCanadian Agency for Drugs and Technologies in Health. (2020). Discussion. Clinical Review Report: Glycopyrrolate Oral Solution (Cuvposa): (Medexus Pharmaceuticals, Inc.): Indication: Chronic severe drooling, neurologic (pediatric).
Desai, J., et al. (2020). Toxic megacolon: Background, pathophysiology, management challenges and solutions. Clinical and Experimental Gastroenterology.
Inenaga, K., et al. (2010). Oral dryness and thirst: – The central effect of acetylcholine on drinking behavior–. Journal of Oral Biosciences.
Jackson, P. G., et al. (2011). Evaluation and management of intestinal obstruction. American Family Physician.
MedlinePlus. (2022). Ileostomy.
MedlinePlus. (2022). Intestinal obstruction and ileus.
MedlinePlus. (2024). Colostomy.
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Intestinal Pseudo-obstruction.
Suven Pharmaceuticals Limited. (2024). Glycopyrrolate oral solution liquid [package insert]. DailyMed.
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