Treatment of bladder pain associated with smooth muscle spasm in palliative care
To manage pain associated with smooth muscle spasm of the bladder in palliative care, consider combination therapy with an opioid and one of the following. Use:
1oxybutynin 2.5 to 5 mg orally, 2 to 3 times daily. If response is inadequate after 2 days, seek expert advice. Monitor response and wean to cease if possible oxybutynin
OR
1hyoscine butylbromide 10 to 20 mg subcutaneously, 4-hourly. If response is inadequate after 2 days, seek expert advice. Monitor response and wean to cease if possible hyoscine butylbromide
OR
1hyoscine butylbromide 60 to 80 mg/24 hours by continuous subcutaneous infusion, adjust to effective dose. Maximum dose 120 mg/24 hours. If response is inadequate after 2 days, seek expert advice. Monitor response and wean to cease if possible. hyoscine butylbromide