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glycopyrrolate (Robinul Forte / Robinul / Cuvposa)

✓ Approved

Merz · CHRM1 · Small Molecule

What is glycopyrrolate?

glycopyrrolate is a small molecule developed by Merz. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesRobinul Forte, Robinul, Cuvposa
CompanyMerz
Drug ClassSmall Molecule
Molecular TargetCHRM1, CHRM3
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Merz

Mechanism of Action

Molecular Targets

glycopyrrolate acts on 2 molecular targets:

CHRM1cholinergic receptor muscarinic 1 (M1, HM1)
CHRM3cholinergic receptor muscarinic 3 (HM3, PBS)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

glycopyrrolate is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersSalivary hypersecretion✓ Approved

Related Research Articles

PubMedPoultry science2026-09-06

Inhibition of either the sympathetic or parasympathetic nervous system increases tonic immobility duration in laying hens.

von Seggern I C IC, Sutherland H L HL, Erasmus M A MA, Fraley G S GS

Tonic immobility (TI) is a temporary state where a chicken remains immobile after restraint. It is a commonly used fear test in research, where a longer latency to right is equated with more fear. Despite its commonality, there is limited research done on the physiological systems that underlie TI. The objective of our study was to examine the roles of the sympathetic (SNS) and parasympathetic nervous systems (PNS) on TI. In experiment 1, sixteen Dekalb White hens (43 weeks of age) were given 0.1 mL/kg of either saline as a control (CON), labetalol (5 mg/mL) to inhibit the SNS (LAB), or glycopyrrolate (0.2 mg/mL) to inhibit the PNS (GLY). In experiment 2, eight Hy-Line Silver hens (20 weeks of age) were given either 0.2 mL/kg of saline as a control (CON2) or 0.2 mg/kg of a 1:1 glycopyrrolate and labetalol mixture (DRUG). For both experiments, latency to first leg movement, first head movement, and to right were measured, as well as thermal temperatures. In experiment 1, heart rate (HR) and respiratory rate (RR) were also measured. The MIXED procedure was used to analyze latencies for experiment 1. Experiment 2 utilized a Welch's T-test. An ANOVA was used for all RR, HR, and thermal temperatures. Data were considered significant when P < 0.05 and trending when 0.05 < P < 0.10. For experiment 1, after injection and before induction, GLY had a lower respiratory rate (p = 0.019) compared to LAB and CON. This trend continued through the first minute (p = 0.020) and the average time under TI (p = 0.010). The CON group was quicker to right than the GLY (p = 0.007) and LAB (p = 0.0726). For experiment 2, the CON2 group was also quicker to right than DRUG (p = 0.052). These results indicate that both the PNS and SNS play a role in TI recovery, however further studies need to be undertaken to better understand the neurobiology of tonic immobility.

PMID 42700504
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PubMedFrontiers in pharmacology2026-09-04

Effects of premedication with atropine, penehyclidine, and glycopyrrolate on postoperative delirium in older patients undergoing endoscopic gastric or esophageal submucosal dissection: a randomized, double-blind, multicenter, controlled clinical trial.

Xian Wen Lin WL, Peng Jing J, Wei Qinxian Q, Wang Na N et al.

Anticholinergic drugs are commonly used as premedication in clinical practice. The effects of premedication of atropine, penehyclidine, and glycopyrrolate on postoperative delirium in older patients remain unclear. The aim of this study was to observe the effects of premedication with atropine, penehyclidine, and glycopyrrolate on postoperative delirium (POD) in older patients undergoing endoscopic gastric or esophageal submucosal dissection. Older patients undergoing endoscopic gastric or esophageal submucosal dissection were randomly divided into atropine group (A group), glycopyrrolate group (G group), penehyclidine group (P group), and normal saline group (NS group), with 144 cases in each group. The primary outcome was the incidence of POD 24 h after surgery. The secondary outcomes were the incidence of POD 48 h and 72 h after surgery, perioperative saliva secretion levels, RASS scores, QoR-15 scores, VAS scores of dry mouth, postoperative nausea VAS scores, and severity of postoperative vomiting. The incidence of POD 24 h after surgery was significantly higher in the A (20.1%) and P (23.6%) groups than in the NS group (9%) (95% CI, 0.030-0.191, p = 0.006, and 95% CI, 0.062-0.229, p = 0.001, respectively), and the incidence of POD between the NS group (9.0%) and G group (10.4%) was comparable (95% CI, -0.054-0.082, p = 0.843). Oral saliva secretion in the A, G, and P groups at T1-T5 was significantly lower than that in the NS group (all p < 0.001). Twenty four hours after surgery, the QoR-15 score in the A group (124.0 ± 13.3) was significantly lower than that in the NS group (132.4 ± 12.1) (95% CI, -11.338 to -5.397, p < 0.001). Glycopyrrolate is more suitable as a premedication for older patients without aggravating postoperative delirium or prolonging dry mouth. http://www.chictr.org.cn/showproj.html?proj=212300; Registration number: ChiCTR2300078413.

PMID 42694852
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PubMedDental clinics of North America2026-09-03

Pharmacology of Commonly Used Sedative Agents.

Miller Jared J, Corpus Devin D, Pallas Danielle D

This article reviews the role of outpatient dental sedation in managing patients with dental anxiety or phobia. Sedation helps reduce pain, fear, and memory of procedures while improving patient cooperation and treatment outcomes. The article discusses commonly used sedative and adjunct medications, including midazolam, remimazolam, propofol, ketamine, opioids such as fentanyl and remifentanil, and supportive drugs like dexmedetomidine, diphenhydramine, atropine, glycopyrrolate, and ondansetron. Newer agents such as remimazolam and ketofol combinations may offer improved safety and recovery profiles. Overall, the article emphasizes individualized patient care and thorough pharmacologic knowledge to ensure safe and effective outpatient dental sedation.

PMID 42686247
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PubMedBioinformation2026-08-28

Prospective randomized study to assess the effect of intramuscular glycopyrrolate on hypotension prevention among elderly patients following subarachnoid block during lower limb surgeries.

Gautam Neetesh N, Sharma Narayan Hari NH, Khan Irfan I, Mittal Shubham S

Spinal anesthesia is a preferred technique for lower limb surgeries in elderly patients but often leads to hypotension due to sympathetic blockade and diminished cardiovascular adaptability. Glycopyrrolate, an anticholinergic agent, may mitigate this response by sustaining heart rate and venous return. Hence, this prospective randomized study evaluated 50 elderly patients (≥ 60 years) undergoing elective lower limb surgery under spinal anesthesia, divided into a glycopyrrolate group (0.2 mg IM given 30 minutes pre-block) and a control group without premedication. Hemodynamic parameters were recorded intraoperatively and compared between groups. The glycopyrrolate group showed significantly fewer cases of hypotension, better maintenance of mean arterial pressure and heart rate and a reduced need for vasopressors, without notable adverse effects such as tachycardia or dry mouth. Thus, we show that the pre-anesthetic intramuscular glycopyrrolate is a simple, safe and effective measure to enhance hemodynamic stability and prevent hypotension in elderly patients receiving spinal anesthesia.

PMID 42662307
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PubMedThe Laryngoscope2026-08-22

Intraoperative Bradycardia: Evaluating Vasovagal Events in Adult Suspension Microlaryngeal Surgery.

McClelland Thomas Q TQ, Abrahamson Cyrus W CW, Landini Abbey L AL, Stein Andrew P AP et al.

To measure the incidence and severity of bradycardia during suspension microlaryngoscopy (SML), identify risk factors predictive of vasovagal responses (VVR) during SML, and propose immediate interventions. This study retrospectively assessed intraoperative vital signs in all patients who underwent SML with a single surgeon between September 2023 and June 2025. A VVR was defined as a drop in HR of ≥ 10 beats per minute (bpm) resulting in a nadir of < 60 bpm within a five-minute period. Patient demographics, medical history, anesthetic medications administered, and intraoperative vital signs were recorded. Chi-squared tests and Fisher's Exact tests compared patients with and without VVR during suspension. Significant bradycardia occurred in 17/190 (8.9%) of patients undergoing SML. No significant differences were identified based on demographics, comorbidities, intubation VVR, laryngoscope size, or perioperative medications. The pulse dropped an average of 16 bpm in symptomatic patients. On average, it took patients 9 min to recover. The laryngoscope was removed in all 17 cases; 8/17 recovered without further intervention, and 9/17 received IV glycopyrrolate reactively. No patients developed asystole. VVR occurred in 8.9% of patients undergoing SML, often with significant bradycardia and the need for glycopyrrolate intervention. Otolaryngologists performing SML should be aware of patients' heart rate during SML and be prepared to treat acute changes immediately. Data presented can serve as foundational research for future, prospective investigations into this phenomenon.

PMID 42629622
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PubMedJournal of pharmaceutical sciences2026-08-12

Pharmaceutical assessment of low global warming potential alternatives to HFA-134a in a budesonide, glycopyrrolate, and formoterol fumarate pressurized metered-dose inhaler.

Lachacz Kellisa K, Kaye Richard R, Mello Lauren L, Stoker Ashley A et al.

Manufacturers are adopting propellants for use in pressurized metered-dose inhalers (pMDIs) that have lower global warming potentials (GWPs) than the propellants traditionally used in pMDIs. Hydrofluoroalkane (HFA)-134a has been used as the propellant in the pMDI used to deliver the fixed-dose triple combination of budesonide, glycopyrrolate, and formoterol fumarate (BGF); following successful clinical evaluation, the BGF pMDI is now being transitioned to the next generation propellant hydrofluoroolefin (HFO)-1234ze(E), which has near-zero GWP. We describe formulation development efforts that led to the selection of HFO-1234ze(E) over another propellant, HFA-152a, for reformulation. Propellant-specific studies evaluated active pharmaceutical ingredient (API) stability and aerodynamic particle size distribution (aPSD). Those analyses have been complemented by in silico regional lung deposition modeling conducted after the clinical evaluation of the reformulated BGF pMDI. HFO-1234ze(E) supported favorable stability and aPSD characteristics for BGF pMDI reformulation, compared with HFA-152a, and modeling predicted regional deposition consistent with therapeutic intent. Given that each pMDI is a unique combination of APIs, device, propellant, and excipients, propellant substitution requires product-specific evidence and regulatory approval, and typically takes several years. Targeted analyses, such as those described here, helped to identify the most suitable candidate propellant for successful substitution in the BGF pMDI.

PMID 42586434
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