Glycopyrrolate - Amneal Pharmaceuticals LLC

Manufacturer
Amneal Pharmaceuticals LLC
Effective date
2026-07-07
Label type
HUMAN PRESCRIPTION DRUG LABEL
Version
11
Source
daily-update
Hydrated at
2026-09-03 03:06:34

Label at a glance#

ProductGlycopyrrolate
Active ingredientGLYCOPYRROLATE
Label structure15 sections

Indications and uses

Glycopyrrolate injection is indicated in adults and pediatric patients for reduction of salivary, tracheobronchial, and pharyngeal secretions, reduction of volume and acidity of gastric secretions, and blockade of cardiac inhibitory reflexes during induction of anesthesia and intubation. Glycopyrrolate injection is indicated in adults and pediatric patients to counteract surgically or drug-induced or vagal reflex-...

Dosage and administration

NOTE: CONTAINS BENZYL ALCOHOL [see Use in Specific Populations (8.4)]. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Glycopyrrolate injection may be administered intramuscularly or intravenously, without dilution. This product is for single-dose and multiple - dose. The recommended dose of glycopyrrolat...

Storage and handling

Glycopyrrolate Injection USP, 0.2 mg/mL , is supplied as single and multiple-dose vials available in following strengths and package sizes: 0.2 mg/mL, 1 mL vial Single-dose vial:                                                         NDC 70121-1394-1 25 single-dose vials in a carton:                                 NDC 70121-1394-5 0.2 mg/mL, 2 mL vial Single-dose vial:                                            ...

Label contents#

Full prescribing information#

1 INDICATIONS AND USAGE

INDICATIONS & USAGE SECTION

1.1 Preanesthetic

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection is indicated in adults and pediatric patients for reduction of salivary, tracheobronchial, and pharyngeal secretions, reduction of volume and acidity of gastric secretions, and blockade of cardiac inhibitory reflexes during induction of anesthesia and intubation.

1.2 Intraoperative

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection is indicated in adults and pediatric patients to counteract surgically or drug-induced or vagal reflex-associated arrhythmias.

1.3 Reversal of Neuromuscular Blockade

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection is indicated in adults and pediatric patients for protection against peripheral muscarinic effects of cholinergic agents such as neostigmine and pyridostigmine given to reverse the neuromuscular blockade due to non- depolarizing agents.

1.4 Peptic Ulcer

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection is indicated in adults to reduce symptoms of a peptic ulcer as an adjunct to treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated.

Limitations of Use

Glycopyrrolate injection is not indicated as monotherapy for the treatment of peptic ulcer because effectiveness in peptic ulcer healing has not been established.

2 DOSAGE AND ADMINISTRATION

DOSAGE & ADMINISTRATION SECTION

NOTE: CONTAINS BENZYL ALCOHOL [see Use in Specific Populations (8.4)].

2.1 Important Dosage and Administration Instructions

SPL UNCLASSIFIED SECTION

  • Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.
  • Glycopyrrolate injection may be administered intramuscularly or intravenously, without dilution.
  • This product is for single-dose and multiple - dose.

2.6 Preparation and Handling

SPL UNCLASSIFIED SECTION

Diluent Compatibilities

Dextrose 5% and 10% in water, or saline, dextrose 5% in sodium chloride 0.45%, sodium chloride 0.9%, and Ringer’s Injection.

Diluent Incompatibilities

Lactated Ringer’s solution.

Admixture Compatibilities

Physical Compatibility

This list does not constitute an endorsement of the clinical utility or safety of co-administration of glycopyrrolate injection with these drugs. Glycopyrrolate injection is compatible for mixing and injection with the following injectable dosage forms: atropine sulfate, USP; physostigmine salicylate; diphenhydramine HCl; codeine phosphate, USP; benz-quinamide HCl; hydromorphone HCl, USP; droperidol; levorphanol tartrate; lidocaine, USP; meperidine HCl, USP; pyridostigmine bromide; morphine sulfate, USP; nalbuphine HCl; oxymorphone HCl; procaine HCl, USP; promethazine HCl, USP; neostigmine methylsulfate, USP; scopolamine HBr, USP; butorphanol tartrate; fentanyl citrate; trimethobenzamide HCl; and hydroxyzine HCl. Glycopyrrolate injection may be administered via the tubing of a running infusion of normal saline.

Admixture Incompatibilities

Physical Incompatibility

Because the stability of glycopyrrolate is questionable above a pH of 6.0 do not combine glycopyrrolate injection in the same syringe with methohexital Na; chloramphenicol Na succinate; dimenhydrinate; pentobarbital Na; thiopental Na; secobarbital Na; sodium bicarbonate; diazepam; dexamethasone Na phosphate; or pentazocine lactate. These mixtures will result in a pH higher than 6.0 and may result in gas production or precipitation.

3 DOSAGE FORMS AND STRENGTHS

DOSAGE FORMS & STRENGTHS SECTION

Glycopyrrolate injection, USP is a clear, colorless, solution for injection available as 0.2 mg/mL glycopyrrolate in presentation of 0.2 mg/1 mL, 0.4 mg/2 mL (0.2 mg/mL), 1 mg/5 mL (0.2 mg/mL) and 4 mg/20 mL (0.2 mg/mL) single and multiple-dose vials.

4 CONTRAINDICATIONS

CONTRAINDICATIONS SECTION

Glycopyrrolate injection is contraindicated in:

  • patients with known hypersensitivity to glycopyrrolate injection or any of its inactive ingredients.
  • peptic ulcer patients with the following concurrent conditions: glaucoma; obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy); obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.); paralytic ileus, intestinal atony of the elderly or debilitated patient; unstable cardiovascular status in acute hemorrhage; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; myasthenia gravis.

5 WARNINGS AND PRECAUTIONS

WARNINGS AND PRECAUTIONS SECTION

5.1 Precipitation of Acute Glaucoma

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection may cause mydriasis and increase intraocular pressure in patients with glaucoma. Advise patients with glaucoma to promptly seek medical care in the event that they experience symptoms of acute angle closure glaucoma (pain and reddening of the eyes, accompanied by dilated pupils).

5.2 Drowsiness or Blurred Vision

SPL UNCLASSIFIED SECTION

Glycopyrrolate injection may cause drowsiness or blurred vision. Warn patients not to participate in activities requiring mental alertness, such as operating a motor vehicle or other machinery or performing hazardous work, until these issues resolve.

5.3 Heat Prostration

SPL UNCLASSIFIED SECTION

In the presence of fever, high environmental temperature, and/or during physical exercise, heat prostration can occur with use of anticholinergic agents including glycopyrrolate injection (due to decreased sweating), particularly in children and the elderly. Advise patients to avoid exertion and high environmental temperature after receiving glycopyrrolate injection.

5.4 Intestinal Obstruction

SPL UNCLASSIFIED SECTION

Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. In this instance treatment with glycopyrrolate injection is inappropriate and possibly harmful. Glycopyrrolate is contraindicated in patients with these conditions.

5.5 Tachycardia

SPL UNCLASSIFIED SECTION

Investigate any tachycardia before giving glycopyrrolate injection because an increase in the heart rate may occur. Use with caution in patients with coronary artery disease, congestive heart failure, cardiac arrhythmias, hypertension, or hyperthyroidism.

5.6 Risk of Use in Patients with Renal Impairment

SPL UNCLASSIFIED SECTION

Renal elimination of glycopyrrolate may be significantly reduced in patients with renal failure. Dosage adjustments may be necessary in this population [see Clinical Pharmacology (12.3)].

5.7 Autonomic Neuropathy, Hepatic Disease, Ulcerative Colitis, Prostatic Hypertrophy, or Hiatal Hernia

SPL UNCLASSIFIED SECTION

Use glycopyrrolate injection with caution in the elderly and in all patients with autonomic neuropathy, hepatic disease, ulcerative colitis, prostatic hypertrophy, or hiatal hernia, because anticholinergic drugs may aggravate these conditions. Consider dose reduction and closely monitor the elderly and patients with autonomic neuropathy, hepatic disease, ulcerative colitis, prostatic hypertrophy, or hiatal hernia.

5.8 Delayed Gastric Emptying/Gastric Stasis

SPL UNCLASSIFIED SECTION

The use of anticholinergic drugs, including glycopyrrolate injection, in the treatment of peptic ulcer may produce a delay in gastric emptying due to antral stasis. Monitor patients for symptoms such as vomiting, dyspepsia, early satiety, abdominal distention, and increased abdominal pain. Discontinue glycopyrrolate injection treatment if these symptoms develop or worsen on treatment.

5.9 Light Sensitivity

SPL UNCLASSIFIED SECTION

Patients may experience sensitivity of the eyes to light. Advise patients to protect their eyes from light after receiving glycopyrrolate injection.

5.10 Risk of Benzyl alcohol Toxicity in Neonates

SPL UNCLASSIFIED SECTION

Exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates, and an increased incidence of kernicterus, particularly in small preterm infants. There have been rare reports of deaths, primarily in preterm infants, associated with exposure to excessive amounts of benzyl alcohol. The amount of benzyl alcohol from medications is usually considered negligible compared to that received in flush solutions containing benzyl alcohol. Administration of high dosages of medications containing this preservative must take into account the total amount of benzyl alcohol administered. The amount of benzyl alcohol at which toxicity may occur is not known. If the patient requires more than the recommended dosages or other medications containing this preservative, the practitioner must consider the daily metabolic load of benzyl alcohol from these combined sources [see Use In Specific Populations (8.4)].

6 ADVERSE REACTIONS

ADVERSE REACTIONS SECTION

The following adverse reactions were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Adverse reactions to anticholinergics include xerostomia (dry mouth); urinary hesitancy and retention; blurred vision and photophobia due to mydriasis (dilation of the pupil); cycloplegia; increased ocular tension; tachycardia; palpitation; decreased sweating; loss of taste; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; severe allergic reactions including anaphylactic/anaphylactoid reactions; hypersensitivity; urticaria, pruritus, dry skin, and other dermal manifestations; some degree of mental confusion and/or excitement, especially in elderly persons.

The following adverse events have been reported from post-marketing experience with glycopyrrolate: malignant hyperthermia; cardiac arrhythmias (including bradycardia, ventricular tachycardia, ventricular fibrillation); cardiac arrest; hypertension; hypotension; seizures; and respiratory arrest. Post-marketing reports have included cases of heart block and QTc interval prolongation associated with the combined use of glycopyrrolate and an anticholinesterase. Injection site reactions including pruritus, edema, erythema, and pain have also been reported.

7 DRUG INTERACTIONS

DRUG INTERACTIONS SECTION

The concurrent use of glycopyrrolate injection with other anticholinergics or medications with anticholinergic activity, such as phenothiazines, antiparkinson drugs, or tricyclic antidepressants, may intensify the antimuscarinic effects and result in an increase in anticholinergic side effects.

Concomitant administration of glycopyrrolate injection and potassium chloride in a wax matrix may increase the severity of potassium chloride-induced gastrointestinal lesions as a result of a slower gastrointestinal transit time.

8 USE IN SPECIFIC POPULATIONS

USE IN SPECIFIC POPULATIONS SECTION

8.1 Pregnancy

PREGNANCY SECTION

Risk Summary

Limited available data over decades of use with glycopyrrolate in pregnant women have not identified a drug-associated risk of birth defects and miscarriage, however, most of the reported exposures occurred after the first trimester. Most of the available data are based on studies with exposures that occurred at the time of Cesarean section delivery, and these studies have not identified an adverse effect on maternal outcomes or infant Apgar scores (see Data).

In animal reproduction studies in pregnant rats and rabbits administered glycopyrrolate orally (rats) and intramuscularly (rabbits) during the period of organogenesis, no teratogenic effects were seen at 320-times and 5-times the maximum recommended human dose (MRHD) of 2 mg (on a mg/m2 basis), respectively (see Data).

The background risk for major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in the clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

Data

Human Data

Published, randomized, controlled trials over several decades, which compared the use of glycopyrrolate to another antimuscarinic agent in pregnant women during Cesarean section, have not identified adverse maternal or infant outcomes. In normal doses (0.004 mg/kg), glycopyrrolate does not appear to affect fetal heart rate or fetal heart rate variability to a significant degree. Concentrations of glycopyrrolate in umbilical venous and arterial blood and in the amniotic fluid are low after intramuscular administration to parturients. Therefore, glycopyrrolate does not appear to penetrate through the placental barrier in significant amounts.

There are no studies on the safety of glycopyrrolate exposure during the period of organogenesis, and therefore, it is not possible to draw any conclusions on the risk of birth defects following exposure to glycopyrrolate during pregnancy. In addition, there are no data on the risk of miscarriage following fetal exposure to glycopyrrolate.

Animal Data

Reproduction studies with glycopyrrolate were performed in rats at a dietary dose of approximately 65 mg/kg/day (exposure was approximately 320 times the maximum recommended daily human dose of 2 mg on a mg/m2 basis) and rabbits at intramuscular doses of up to 0.5 mg/kg/day (exposure was approximately 5 times the maximum recommended daily human dose on a mg/m2 basis). These studies produced no teratogenic effects to the fetus.

A preclinical study on reproductive performance of rats given glycopyrrolate resulted in a decreased rate of conception and survival at weaning.

8.2 Lactation

LABOR & DELIVERY SECTION

Risk Summary

There are no data on the presence of glycopyrrolate in either human milk or animal milk, the effects on the breastfed infant, or the effects on milk production. As with other anticholinergics, glycopyrrolate may cause suppression of lactation [see Adverse Reactions (6)]. The developmental and health benefits of breast feeding should be considered along with the mother’s clinical need for glycopyrrolate injection and any potential adverse effects on the breastfed child from glycopyrrolate injection or from the underlying maternal condition.

8.4 Pediatric Use

PEDIATRIC USE SECTION

Glycopyrrolate injection is indicated in pediatric patients:

  • for reduction of salivary, tracheobronchial, and pharyngeal secretions, reduction of volume and acidity of gastric secretions, and blockade of cardiac inhibitory reflexes during induction of anesthesia and intubation
  • intraoperatively to counteract surgically or drug-induced or vagal reflex-associated arrhythmias
  • for protection against peripheral muscarinic effects of cholinergic agents such as neostigmine and pyridostigmine given to reverse the neuromuscular blockade due to non- depolarizing agents
  • Due to its benzyl alcohol content, glycopyrrolate injection should not be used in neonates, i.e., patients less than 1 month of age.

Heat prostration can occur in pediatric patients in the presence of fever, high environmental temperature, and/or during physical exercise with use of anticholinergic agents including glycopyrrolate injection [see Warnings and Precautions (5.3)].

Young pediatric patients (and especially those less than 1 month of age), patients with Down syndrome, and pediatric patients with spastic paralysis or brain damage may experience an increased response to anticholinergics, thus increasing the potential for side effects.

A paradoxical reaction characterized by hyperexcitability may occur in pediatric patients receiving large doses of anticholinergics including glycopyrrolate injection. Dysrhythmias associated with the use of glycopyrrolate intravenously as a premedicant or during anesthesia have been observed in pediatric patients.

The safety and effectiveness of glycopyrrolate injection for treatment of peptic ulcer have not been established in pediatric patients.

Benzyl alcohol, a component of glycopyrrolate injection, has been associated with serious adverse events and death, particularly in pediatric patients. The “gasping syndrome,” (characterized by central nervous system depression, metabolic acidosis, gasping respirations, and high levels of benzyl alcohol and its metabolites found in the blood and urine) has been associated with benzyl alcohol dosages > 99 mg/kg/day in neonates and low-birth-weight neonates. Additional symptoms may include gradual neurological deterioration, seizures, intracranial hemorrhage, hematologic abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. Although normal therapeutic doses of this product deliver amounts of benzyl alcohol that are substantially lower than those reported in association with the “gasping syndrome,” the minimum amount of benzyl alcohol at which toxicity may occur is not known. Premature and low-birthweight infants, as well as patients receiving high dosages, may be more likely to develop toxicity. Practitioners administering this and other medications containing benzyl alcohol should consider the combined daily metabolic load of benzyl alcohol from all sources.

8.5 Geriatric Use

NURSING MOTHERS SECTION

Clinical studies of glycopyrrolate injection did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other therapy.

8.6 Renal Impairment

GERIATRIC USE SECTION

Renal elimination of glycopyrrolate may be significantly reduced in patients with renal failure. Dosage adjustments may be necessary [see Clinical Pharmacology (12.3)].

10 OVERDOSAGE

OVERDOSAGE SECTION

To combat peripheral anticholinergic effects, a quaternary ammonium anticholinesterase such as neostigmine methylsulfate (which does not cross the blood-brain barrier) may be given intravenously in increments of 0.25 mg in adults. This dosage may be repeated every five to ten minutes until anticholinergic overactivity is reversed or up to a maximum of 2.5 mg.

Proportionately smaller doses should be used in pediatric patients. Indication for repetitive doses of neostigmine should be based on close monitoring of the decrease in heart rate and the return of bowel sounds.

If CNS symptoms (e.g., excitement, restlessness, convulsions, psychotic behavior) occur, physostigmine (which does cross the blood–brain barrier) may be used. Physostigmine 0.5 to 2 mg should be slowly administered intravenously and repeated as necessary up to a total of 5 mg in adults. Proportionately smaller doses should be used in pediatric patients.

To combat hypotension, administer intravenous (IV) fluids and/or pressor agents along with supportive care. Fever should be treated symptomatically.

Following overdosage, a curare-like action may occur, i.e., neuromuscular blockade leading to muscular weakness and possible paralysis. In the event of a curare-like effect on respiratory muscles, artificial respiration should be instituted and maintained until effective respiratory action returns.

11 DESCRIPTION

DESCRIPTION SECTION

Glycopyrrolate injection, USP is a synthetic anticholinergic agent.

It is a quaternary ammonium salt with the following chemical name: 3[(cyclopentylhydroxyphenylacetyl)oxy]-1,1-dimethyl pyrrolidinium bromide. The molecular formula is C19H28BrNO3 and the molecular weight is 398.33 g/mol.

Its structural formula is as follows:

                                                                                       11

                                                                                C19H28BrNO3                          MW 398.33

Glycopyrrolate, USP occurs as a white, odorless, crystalline powder. It is soluble in water and alcohol, and practically insoluble in chloroform and ether. It is completely ionized at physiological pH values. Glycopyrrolate injection, USP, is a clear, colorless, sterile liquid with a pH of 2.0 to 3.0. The partition coefficient of glycopyrrolate in n-octanol/water system is 0.304 (log10 P = -1.52) at ambient room temperature (24°C).

Glycopyrrolate injection, USP, is intended for intramuscular (IM) or intravenous (IV) administration. Each 1 mL contains 0.2 mg of glycopyrrolate, USP; water for injection; and hydrochloric acid or sodium hydroxide as pH adjusters. Glycopyrrolate injection  contains benzyl alcohol, 0.9% (preservative).

12 CLINICAL PHARMACOLOGY

CLINICAL PHARMACOLOGY SECTION

12.1 Mechanism of Action

MECHANISM OF ACTION SECTION

Glycopyrrolate, like other anticholinergic (antimuscarinic) agents, inhibits the action of acetylcholine on structures innervated by postganglionic cholinergic nerves and on smooth muscles that respond to acetylcholine but lack cholinergic innervation. These peripheral cholinergic receptors are present in the autonomic effector cells of smooth muscle, cardiac muscle, the sinoatrial node, the atrioventricular node, exocrine glands and, to a limited degree, in the autonomic ganglia. Thus, it diminishes the volume and free acidity of gastric secretions and controls excessive pharyngeal, tracheal, and bronchial secretions.

12.2 Pharmacodynamics

PHARMACODYNAMICS SECTION

Glycopyrrolate antagonizes muscarinic symptoms (e.g., bronchorrhea, bronchospasm, bradycardia, and intestinal hypermotility) induced by cholinergic drugs such as the anticholinesterases. The highly polar quaternary ammonium group of glycopyrrolate limits its passage across lipid membranes, such as the blood-brain barrier, in contrast to atropine sulfate and scopolamine hydrobromide, which are highly non-polar tertiary amines which penetrate lipid barriers easily. For this reason, the occurrence of CNS-related side effects is lower, in comparison to their incidence following administration of anticholinergics which are chemically tertiary amines that can cross this barrier readily. With intravenous injection, the onset of action is generally evident within one minute. Following intramuscular administration, the onset of action is noted in 15 to 30 minutes, with peak effects occurring within approximately 30 to 45 minutes. The vagal blocking effects persist for 2 to 3 hours and the antisialagogue effects persist up to 7 hours, periods longer than for atropine.

12.3 Pharmacokinetics

PHARMACOKINETICS SECTION

The following pharmacokinetic information and conclusions were obtained from published studies that used nonspecific assay methods.

Distribution

The mean volume of distribution of glycopyrrolate was estimated to be 0.42 ± 0.22 L/kg.

Elimination

Metabolism

The in vivo metabolism of glycopyrrolate in humans has not been studied.

Excretion

The mean clearance and mean t1/2 values were reported to be 0.54 ± 0.14 L/kg/hr and 0.83 ± 0.27 hr, respectively post Intravenous (IV) administration. After Intravenous (IV) administration of a 0.2 mg radiolabeled glycopyrrolate, 85% of dose recovered was recovered in urine 48 hours post dose and some of the radioactivity was also recovered in bile. After Intramuscular (IM) administration of glycopyrrolate to adults, the mean t1/2 value is reported to be between 0.55 to 1.25 hrs. Over 80% of Intramuscular (IM) dose administered was recovered in urine and the bile as unchanged drug and half the Intramuscular (IM) dose is excreted within 3 hrs. The following table summarizes the mean and standard deviation of pharmacokinetic parameters from a study.

Group

t1/2

(hr)

Vss

(L/kg)

CL

(L/kg/hr)

Tmax

(min)

Cmax

(mcg/L)

AUC

(mcg/L•hr)

[6 mcg/kg Intravenous

(IV)]

 0.83 ± 0.27

0.42 ± 0.22

0.54 ± 0.14

–

–

8.64 ± 1.49*

[8 mcg/kg Intramuscular (IM)]

–

–

–

27.48 ± 6.12

3.47 ± 1.48

6.64 ± 2.33*

 *0 to 8 hr

Specific Populations

Pediatric Patients

Following Intravenous (IV) administration (5 mcg/kg glycopyrrolate) to infants and children, the mean t1/2 values were reported to be between 21.6 and 130.0 minutes and between 19.2 and 99.2 minutes, respectively.

Patients with Renal Impairment

In one study glycopyrrolate was administered Intravenous (IV) in uremic patients undergoing renal transplantation. The mean elimination half-life was significantly longer (46.8 minutes) than in healthy patients (18.6 minutes). The mean area-under-the-concentration-time curve (10.6 hr- mcg/L), mean plasma clearance (0.43 L/hr/kg), and mean 3-hour urine excretion (0.7%) for glycopyrrolate were also significantly different than those of controls (3.73 hr-mcg/L, 1.14 L/hr/kg, and 50%, respectively). These results suggest that the elimination of glycopyrrolate is significantly reduced in patients with renal failure.

13 NONCLINICAL TOXICOLOGY

NONCLINICAL TOXICOLOGY SECTION

13.1 Carcinogenesis, Mutagenesis and Impairment of Fertility

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY SECTION

Carcinogenesis

Long-term studies in animals have not been performed to evaluate carcinogenic potential.

Mutagenesis

Studies to evaluate the mutagenic potential of glycopyrrolate have not been conducted.

Impairment of Fertility

In reproduction studies in rats, dietary administration of glycopyrrolate resulted in diminished rates of conception in a dose-related manner. Other studies in dogs suggest that this may be due to diminished seminal secretion which is evident at high doses of glycopyrrolate.

16 HOW SUPPLIED/STORAGE AND HANDLING

HOW SUPPLIED SECTION

Glycopyrrolate Injection USP, 0.2 mg/mL, is supplied as single and multiple-dose vials available in following strengths and package sizes:

0.2 mg/mL, 1 mL vial

Single-dose vial:                                                         NDC 70121-1394-1

25 single-dose vials in a carton:                                 NDC 70121-1394-5

0.2 mg/mL, 2 mL vial

Single-dose vial:                                                         NDC 70121-1395-1

25 single-dose vials in a carton:                                 NDC 70121-1395-5

0.2 mg/mL, 5 mL vial

Multiple-dose vial:                                                     NDC 70121-1396-1

25 multiple-dose vials in a carton:                             NDC 70121-1396-5

0.2 mg/mL, 20 mL vial

Multiple-dose vial:                                                     NDC 70121-1397-1

10 multiple-dose vials in a carton:                             NDC 70121-1397-7

Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].

Discard unused portion.

17 PATIENT COUNSELING INFORMATION

INFORMATION FOR PATIENTS SECTION

Drowsiness or Blurred Vision: Inform patients that glycopyrrolate injection may cause drowsiness or blurred vision. Warn patients not to operate a motor vehicle or other machinery or perform hazardous work until these issues resolve [see Warnings and Precautions (5.2)].

Heat Prostration: Inform patients that in the presence of fever, high environmental temperature and/or during physical exercise, heat prostration can occur with use of anticholinergic agents, including glycopyrrolate injection (due to decreased sweating), particularly in children and the elderly. Advise patients to avoid exertion and high environmental temperature after receiving glycopyrrolate injection [see Warnings and Precautions (5.3)].

Light Sensitivity: Advise patients that glycopyrrolate injection may cause sensitivity of the eyes to light and to protect their eyes from light after receiving glycopyrrolate injection [see Warnings and Precautions (5.9)].

Drug Interactions: Inform patients that glycopyrrolate injection may interact with other drugs. Advise patients to report to their healthcare provider the use of any other medication [see Drug Interactions (7)].

Benzyl Alcohol Toxicity: Advise patients that exposure to excessive amounts of benzyl alcohol has been associated with toxicity in neonates and an increased incidence of kernicterus in small preterm infants [see Warnings and Precautions (5.10) and Use in Specific Populations (8.4)].

Manufactured by:

Amneal Pharmaceuticals Pvt. Ltd.

Ahmedabad 382213, INDIA

Distributed by:

Amneal Pharmaceuticals LLC

Bridgewater, NJ 08807

Rev. 07-2026-04

PRINCIPAL DISPLAY PANEL

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

NDC 70121-1394-1

Glycopyrrolate Injection USP, 0.2 mg/mL

Rx only

1 mL Single-Dose Vial

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1394-5

Glycopyrrolate Injection USP, 0.2 mg/mL

Rx only

25 x 1 mL Single-Dose Vials

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1395-1

Glycopyrrolate Injection USP, 0.4 mg/2 mL

Rx only

2 mL Single-Dose Vial

Amneal Pharmaceuticals LLC

2
2

NDC 70121-1395-5

Glycopyrrolate Injection USP, 0.4 mg/2 mL

Rx only

25 x 2 mL Single-Dose Vials

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1396-1

Glycopyrrolate Injection USP, 1 mg/5 mL

Rx only

5 mL Single-Dose Vial

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1396-5

Glycopyrrolate Injection USP, 1 mg/5 mL

Rx only

25 x 2 mL Single-Dose Vials

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1397-1

Glycopyrrolate Injection USP, 4 mg/20 mL

Rx only

20 mL Single-Dose Vial

Amneal Pharmaceuticals LLC

1
1

NDC 70121-1397-7

Glycopyrrolate Injection USP, 4 mg/20 mL

Rx only

10 x 20 mL Multiple-Dose Vials

Amneal Pharmaceuticals LLC

1
1

Product Linked Resources#

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GTIN storage (14 digits): 00370121139515
glycopyrrolate-injection-usp-4.jpg
BarcodeDataBar Stacked(01)00370121139614GTIN-14: 00370121139614
GTIN-12: 370121139614
UPC-A: 370121139614
EAN-13: 0370121139614
GTIN storage (14 digits): 00370121139614
glycopyrrolate-injection-usp-6.jpg

DailyMed Product Concepts#

Product concept, Relation, Version table
Product conceptRelationVersionEffective
138c3de2-4b03-4255-92b5-f022482d81bcProduct name420260113
4dc252b1-bb5f-8bb6-4fa8-f3a45efd810eProduct name520250304
f58f10d3-5fa9-4c2e-9a6e-77029e9ed80bProduct name120231002
76dcac30-469f-4f92-9c55-70950d209446Product name120230809
132196a6-5117-4b6e-a9dd-27f2793580c6Product name120230112
ac1f888b-a1db-4d2e-abbc-973f21c2ce1bProduct name120220720
d84dd569-7bf0-1410-25eb-017ef37dd406Product name920210902
7d8c8d5a-f174-4e6b-97b1-6fd615c5df9aProduct name120210204
58b12de9-b891-41c7-9be6-ff47de5ec28bProduct name120180828
9aff7b10-8e47-4b10-9a92-803440a37ce2Product name120180206
ce066c73-ca6f-49fc-83d4-d3cf6728e8a1Product name120160616
fb29b8a9-c2d0-42bb-aea8-9bc2a87db75aProduct name120151113
ab7ba50c-5a47-47e6-8dd6-fa32a52559f6Product name120151109
29ae08d1-069f-9822-4820-152d5dc67797Product name120140508

DailyMed Billing Units#

Package NDC, Billing unit, Product NDC table
Package NDCBilling unitProduct NDCDailyMed indexing SPLSPL versionEffective
70121-1394-1ML - Milliliter70121-1394fb886dcf-d591-4f4a-8069-892461cb4f0312017-07-07
70121-1394-5ML - Milliliter70121-1394b69c7725-d16f-4d1a-b890-e8988e237eb012017-07-07
70121-1395-1ML - Milliliter70121-13955c393af5-ccb7-40df-8122-416808004a3512017-07-07
70121-1395-5ML - Milliliter70121-1395f38efc78-0056-4d69-854f-c9c79356dd6612017-07-07
70121-1396-1ML - Milliliter70121-1396d4667179-88ba-4933-ab97-5a9c291ac4a312017-07-07
70121-1396-5ML - Milliliter70121-1396b355673c-736f-490e-82ca-e7aedb8e8bf212017-07-07
70121-1397-1ML - Milliliter70121-13970896de02-42ec-4271-ac03-57381530fd6212017-07-07
70121-1397-7ML - Milliliter70121-13974066d685-f308-4ded-9e5d-adce0fb49fe712017-07-07

Products#

Every source-derived product name is available through these pages.

DailyMed product names page 1 of 1 · 6 matching rows.

NDC Codes#

Ingredients#

Every source-derived ingredient row is available through these pages.

DailyMed ingredient rows page 1 of 1 · 20 matching rows.

Source Document#

Source XML

Older Hydrated Versions#

Version, Effective date, Source table
VersionEffective dateSourceHydrated
102025-12-01full-release2026-05-31 21:48:15

Orange Book application contexts#

All distinct exact application/product contexts derived from this label’s complete NDC list are paginated below.

Orange Book application contexts page 1 of 1 · 1 matching rows.

Source provenance: Browse the complete Orange Book source catalog · source snapshot 43.

Orange Book products#

Current product rows page 1 of 1 · 1 matching rows.

Application-product, Trade name, Ingredient table
Application-productTrade nameIngredientStrengthDosage form / routeTE codesRLD / RSApproval date
A208973-001GLYCOPYRROLATEGLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15

Therapeutic equivalence codes#

Current TE-code rows page 1 of 1 · 1 matching rows.

Application-product, TE code table
Application-productTE code
A208973-001AP

Observed Orange Book product history#

Observed FDA ZIP history: Each table is queried independently by exact application/product key from successfully parsed Orange Book snapshots. Capture times identify archived source observations; absence or a change between snapshots is not inferred. FDA publication files that were not recoverable as structured ZIP data are not represented as states.

Product history page 1 of 2 · 43 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTrade nameStrengthDosage form / routeProduct TE source textRLD / RSApproval dateSource SHA-256
2026-09-14 22:38:342026-08A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1584e616aacf4f…
2026-08-18 06:07:402026-07A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15caaa826d4ba7…
2026-02-19 14:30 UTC2026-02A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1531067a03dcf5…
2025-08-23 18:47 UTC2025-08A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-156a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1503ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-152680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-155bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15d8e5a09893c0…
2024-10-29 15:01 UTC2024-10A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1579d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-151e350fbaab3a…
2024-05-31 18:47 UTC2024-05A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-158072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-155c6f7cd8ea54…
2022-04-08 23:34 UTC2022-04A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-155d02ea3f76ae…
2022-04-04 05:41 UTC2022-04A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-154b0b4de00fa7…
2019-12-13 00:20 UTC2019-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1574a2ff9319b5…
2022-03-09 01:35 UTC2022-03A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15bb7c543d1eb4…
2021-12-28 21:50 UTC2021-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15782e0a99824c…
2021-05-05 16:15 UTC · 3 captures of this ZIP2021-05A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-1587673890dc5c…
2021-03-12 10:30 UTC2021-03A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-155aa47cf7b7d7…
2020-12-22 03:56 UTC2020-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-158869cabd3fbd…
2020-11-12 02:37 UTC2020-11A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15c0c555d07b60…
2019-12-14 00:12 UTC2019-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-153f01610625f2…
2019-09-15 20:21 UTC2019-09A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15b00525d2431f…
2019-07-19 19:46 UTC2019-07A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15ea99ee380514…
2024-03-16 18:09 UTC · 4 captures of this ZIP2024-03A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-156a51e52b5d6a…
2024-02-18 07:12 UTC2024-02A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-151c564ffb4f44…
2023-12-20 04:57 UTC2023-12A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15ea1830bbd6c7…
2023-11-28 05:40 UTC · 2 captures of this ZIP2023-11A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15a72a2bbeb626…
2023-10-25 00:34 UTC · 2 captures of this ZIP2023-10A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-159b2671bbb829…
2023-07-15 15:27 UTC · 2 captures of this ZIP2023-07A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15a67488948f0b…
2023-06-13 01:57 UTC · 3 captures of this ZIP2023-06A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-153f0d92c62455…
2023-05-13 08:27 UTC2023-05A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15053a50430f4f…
2023-01-26 05:58 UTC2023-01A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-153bdfa0b2c4d7…
2022-11-12 20:34 UTC · 5 captures of this ZIP2022-11A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-153a93d1ddd44b…
2022-10-28 04:53 UTC2022-10A208973-001GLYCOPYRROLATE0.2MG/MLINJECTABLE / INJECTIONAP2017-06-15f41ea6bd6efb…

Observed Orange Book normalized TE history#

Normalized TE history page 1 of 2 · 43 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTE codeOrderSource SHA-256
2026-09-14 22:38:342026-08A208973-001AP184e616aacf4f…
2026-08-18 06:07:402026-07A208973-001AP1caaa826d4ba7…
2026-02-19 14:30 UTC2026-02A208973-001AP1011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12A208973-001AP131067a03dcf5…
2025-08-23 18:47 UTC2025-08A208973-001AP16a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03A208973-001AP1fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02A208973-001AP1b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01A208973-001AP103ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12A208973-001AP12680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09A208973-001AP15bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11A208973-001AP1d8e5a09893c0…
2024-10-29 15:01 UTC2024-10A208973-001AP1d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08A208973-001AP179d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07A208973-001AP1301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06A208973-001AP11e350fbaab3a…
2024-05-31 18:47 UTC2024-05A208973-001AP18072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06A208973-001AP15c6f7cd8ea54…
2022-04-08 23:34 UTC2022-04A208973-001AP15d02ea3f76ae…
2022-04-04 05:41 UTC2022-04A208973-001AP14b0b4de00fa7…
2019-12-13 00:20 UTC2019-12A208973-001AP174a2ff9319b5…
2022-03-09 01:35 UTC2022-03A208973-001AP1bb7c543d1eb4…
2021-12-28 21:50 UTC2021-12A208973-001AP1782e0a99824c…
2021-05-05 16:15 UTC · 3 captures of this ZIP2021-05A208973-001AP187673890dc5c…
2021-03-12 10:30 UTC2021-03A208973-001AP15aa47cf7b7d7…
2020-12-22 03:56 UTC2020-12A208973-001AP18869cabd3fbd…
2020-11-12 02:37 UTC2020-11A208973-001AP1c0c555d07b60…
2019-12-14 00:12 UTC2019-12A208973-001AP13f01610625f2…
2019-09-15 20:21 UTC2019-09A208973-001AP1b00525d2431f…
2019-07-19 19:46 UTC2019-07A208973-001AP1ea99ee380514…
2024-03-16 18:09 UTC · 4 captures of this ZIP2024-03A208973-001AP16a51e52b5d6a…
2024-02-18 07:12 UTC2024-02A208973-001AP11c564ffb4f44…
2023-12-20 04:57 UTC2023-12A208973-001AP1ea1830bbd6c7…
2023-11-28 05:40 UTC · 2 captures of this ZIP2023-11A208973-001AP1a72a2bbeb626…
2023-10-25 00:34 UTC · 2 captures of this ZIP2023-10A208973-001AP19b2671bbb829…
2023-07-15 15:27 UTC · 2 captures of this ZIP2023-07A208973-001AP1a67488948f0b…
2023-06-13 01:57 UTC · 3 captures of this ZIP2023-06A208973-001AP13f0d92c62455…
2023-05-13 08:27 UTC2023-05A208973-001AP1053a50430f4f…
2023-01-26 05:58 UTC2023-01A208973-001AP13bdfa0b2c4d7…
2022-11-12 20:34 UTC · 5 captures of this ZIP2022-11A208973-001AP13a93d1ddd44b…
2022-10-28 04:53 UTC2022-10A208973-001AP1f41ea6bd6efb…

openFDA label cross-check#

OpenFDA label data provides additional search and identifier links. DailyMed’s Structured Product Label is the canonical label on FDA.report. Matching records are deduplicated before they are shown below.

Matched openFDA labels page 1 of 1 · 1 matching rows.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
GlycopyrrolateGLYCOPYRROLATEAmneal Pharmaceuticals LLCbbab4cf1-0441-4fc4-9de9-e4117fa19faa2026-07-07Warnings, Adverse reactionsExact identifier
ndc (package): 70121-1394-5
ndc (package): 70121-1397-7
ndc (package): 70121-1396-1
ndc (package): 70121-1396-5
ndc (package): 70121-1395-1
ndc (package): 70121-1394-1
ndc (package): 70121-1395-5
ndc (package): 70121-1397-1
ndc (product): 70121-1396
ndc (product): 70121-1397
ndc (product): 70121-1394
ndc (product): 70121-1395
ndc11 (package): 70121139707
ndc11 (package): 70121139505
ndc11 (package): 70121139701
ndc11 (package): 70121139401
ndc11 (package): 70121139605
ndc11 (package): 70121139405
ndc11 (package): 70121139501
ndc11 (package): 70121139601
spl id: da35ede9-1b30-45a3-8600-f44a085a37f0
spl set id: bbab4cf1-0441-4fc4-9de9-e4117fa19faa

Reported adverse events (FAERS/openFDA)#

Adverse event summaries are temporarily unavailable. Other product information remains available.