Composition

• Each teaspoonful ( 5 ml) contains: Active ingredient: Tiemonium Methyl sulphate 10 mg.
• Each 2 ml ampoule contains: Active ingredient: Tiemonium Methyl sulphate5 mg.

Pharmaceutical form

• Syrup.
• Ampoules.

Therapeutic indications

• Symptomatic treatment of acute painful manifestations related to functional disorders of the gastrointestinal and biliary tracts.
• Symptomatic treatment of painful gynecological manifestations. 
• Symptomatic treatment of spasmodic and painful urinary tract manifestations. 

Posology and method of administration

Viscera syrup

• For Adults: 1 -3 tablespoonfuls per day.
• For children: 3 teaspoonfuls for each 5 kg body weight per day.

Viscera ampoule : Recommended injectable dose is one or two Tiemonium methylsulphate Injection three times daily, through Intravenous route slowly or intramuscular route. 

Contraindications

• if you are hypersensitive to the active substances or any of the excipient. 
• Urethroprostatic disorders with risk of urine retention.
• Risk of closed angle Glaucoma. 

Special Warnings

• Viscera Ampoules – In case of severe, unexplained abdominal pain persists or worsens,or occurs together with symptoms like fever, nausea, vomiting, changes in bowel movements, abdominal tenderness, decreased blood pressure, fainting, or blood in stool, appropriate diagnostic measures are needed to investigate the etiology of symptoms.
• Viscera ampoules should be used with caution in conditions characterized by tachycardia such as thyrotoxicosis, cardiac insufficiency or failure and in cardiac surgery where it may further accelerate the heart rate.
• Because of the possibility that anticholinergics may reduce sweating, Viscera should be administered with caution to patients with pyrexia. 
• Elevation of intraocular pressure may be produced by the administration of anticholinergic agents such as Viscera’ in patients with undiagnosed and therefore patients should seek urgent ophthalmological advice in case they should develop a painful, red eye with loss of vision after the injection of Viscera.
• After parenteral administration of Viscera, cases of anaphylaxis including episodes of shock have been observed. as with all drugs causing such reactions. patients receiving Viscera by injection should be kept under observation.
• Viscera syrup contains Saccharose, its use is not recommended in patients with fructose intolerance, glucose-galactose malabsorption syndrome or sucrase isomaltase deficiency. .
• Viscera syrup contains methyl parahydroxybenzoate sodium; this may causes allergic reactions such as rash, breathing hardness, itching and swelling of lips, face, tongue and throat.
• There are reports of infants, 3 months of age and under, administered anticholinergic syrup who have evidenced respiratory symptoms( breathing difficulty, shortness of breath. breathlessness, respiratory collapse, apnoea) as well as seizures, syncope, asphyxia, pulse rate fluctuations, muscular hypotonia and coma .The above symptoms have occurred within minutes of ingestion and lasted minutes. 
• Tiemonium is contraindicated in infants less than 6 months of age.
• Products containing Tiemonium, which acts as an anticholinergic agent with antimuscarinic action, should be used with caution in any patient with or suspected of having glaucoma or prostatic Hypertrophy. use with care in patients with hiatus hernia associated with reflux oesophagitis because anticholinergic drugs may aggravate the condition. 

Special Precautions for Use

Use with caution in case of: 

• Prostatic hypertrophy.
•  Renal and/ or hepatic failure.
• Coronary heart disease, arrhythmias, hyperthyroidism.
• Chronic bronchitis due to the increased viscosity of the bronchial secretions.
• Paralytic rieus, intestinal atony, in the elderly, toxic megacolon .

Interaction with other medicines and other forms of interaction

Atropine like drugs: Take into account the fact that atropinic substances can be add up their side effects and more easily lead to urine retention, acute onset of glaucoma, constipation, dry mouth, etc.

The various Atropine like drugs are represented by imipramine antidepressants, most of H1 Antihistamines, antiparkinsonian anticholinergics, antispasmodics, disopyramide, phenothiazine neuroleptics and clozapine. 

Caution must be taken in consideration if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. 

Pregnancy and lactation

• Results of animal studies for Tiemonium revealed no evidence of a teratogenic effect, Although they do not prejudge the effect in humans, no defects were reported so far during the current use.
• In breast-feeding women, without sufficient data, caution is the rule, although no problem has been reported during routine use .

Effects on ability to drive and use machines

vehicles drivers and machinery operators of risk related to accommodation disoniers. 

Side effects

Viscera ampoules

• Immune system disorders: anaphylactic shock including cases with fatal outcome, anaphylactic reactions, difficult in breathing, difficult breath, skin reactions (e.g. urticaria, rash, erythema, pruritus) and other hypersensitivity.
• Eye disorders:  accommodation disorders ,  mydriasis, increased intraocular pressure.
• Cardiac disorders:  tachycardia.
• Vascular disorders: dizziness, blood pressure decreased, flushing.
• Gastrointestinal disorders: dry mouth,Constipation.
• Skin and subcutaneous tissue disorders: dyshidrosis.
• Renal and urinary disorders : urinary. retention .
• Injection site pain, particularly after intramuscular use, occurs.

Viscera syrup 

• dry mouth.
• Thickening of bronchial secretions.
• Decreased lacrimation. 
• Accommodation disorders.
• Tachycardia, palpitations. 
• Constipation.
• Urine retention.
• Excitability.
• Irritability.
• Mental confusion in the elderly. 

Viscera- Product information

Viscera – Patient Information Leaflet

Product of: AMOUN PHARMACEUTICAL CO. El-Obour City, Cairo, Egypt. 

Contact Pharmacily administrator: If you have any notes or feedback you need to reach us with, feel free contacting us any time via e-mail( Listen2article@gmail.com). Please contact us via email (listen2article@gmail.com) or via contact us form, if the information on this page is incorrect, or if you have other information to update this page.