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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

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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PubMedCureus2026-08-11

Chronic Cough With Reduced Diffusing Capacity and Preserved-Ratio Impaired Spirometry in a Young Never-Smoker With Systemic Lupus Erythematosus: A Diagnostic Pitfall.

Singh Nivedita N, Makkar Divya D, Kumar Govind G, Vanjarapu Vachan K VK et al.

Chronic cough in patients with systemic lupus erythematosus can be difficult to evaluate, especially when initial testing is unrevealing. We report the case of a 33-year-old woman with long-standing systemic lupus erythematosus, biopsy-proven lupus nephritis, prior extrapulmonary pericardial tuberculosis, and no active or passive smoking exposure who developed a persistent dry cough for six months. She was initially treated for gastroesophageal reflux disease with pantoprazole, without meaningful relief. Chest radiography and swallowing assessment were normal. Initial pulmonary function testing in July 2023 was formally interpreted as moderate obstructive airways disease, mild parenchymal restriction, and a moderately severe diffusion defect, without a significant bronchodilator response. High-resolution volumetric computed tomography of the chest with dynamic airway assessment showed no emphysema, bronchiectasis, interstitial lung disease, tracheomalacia, or acute cardiopulmonary process. Her cough improved substantially after inhaled therapy with albuterol and budesonide/glycopyrrolate/formoterol fumarate. Repeat pulmonary function testing in October 2023 showed improved spirometric values, but the forced expiratory volume in one second/forced vital capacity ratio remained preserved, and hemoglobin-adjusted diffusing capacity remained reduced at 64% predicted. This case highlights a diagnostic pitfall: inhaler-responsive chronic cough and a pulmonary function report suggesting obstruction should be evaluated together with post-bronchodilator spirometry, diffusing capacity, imaging, and exposure history. In systemic lupus erythematosus, a persistent cough may be associated with clinically relevant pulmonary function abnormalities even when chest imaging is unrevealing.

PMID 42578089
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PubMedAmerican journal of veterinary research2026-08-08

Atropine and glycopyrrolate significantly raise the heart rate of Sonoran Desert toads (Incilius alvarius).

Moyer Kaycee N KN, Brandão João J, Beaufrère Hugues H, Sanchez Andrea A et al.

To evaluate the effects of atropine and glycopyrrolate on the heart rate (HR) of Sonoran Desert toads (Incilius alvarius). In part 1, toads received 0.1 mg/kg atropine IM, 0.025 mg/kg glycopyrrolate IM, 0.05 mg/kg glycopyrrolate IM, saline, or negative control in a randomized crossover study. Heart rate was monitored at baseline and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, and 60 minutes. In part 2, toads received 10 mg/kg alfaxalone IM followed by 0.05 mg/kg glycopyrrolate or saline. Heart rate was monitored at baseline and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, 60, 80, 100, and 120 minutes. In part 1 (n = 19), all 3 anticholinergic protocols significantly increased the HR between 3 and 15 minutes versus both controls. Atropine significantly increased the HR versus saline between 3 and 30 minutes. Both glycopyrrolate doses significantly increased the HR versus saline at 60 minutes. In part 2 (n = 10), glycopyrrolate significantly increased the HR versus saline at 10 minutes (mean HR difference 6.8 beats/min, SE of the difference 1.467 [95% CI, 1.024 to 12.58]). Atropine and glycopyrrolate significantly increased the HR in conscious toads, with glycopyrrolate having longer efficacy. The effective period of glycopyrrolate was briefer in alfaxalone-sedated toads. Performing safe, effective anesthesia can be challenging in amphibians given their unique physiology. Anticholinergic drugs are commonly used in veterinary medicine to address anesthesia-induced bradycardia. Additional studies are indicated to further evaluate the clinical efficacy of anticholinergics in amphibians.

PMID 42567190
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PubMedHernia : the journal of hernias and abdominal wall surgery2026-08-07

Effect of neuromuscular blockade reversal strategy on gastrointestinal recovery following abdominal wall reconstruction: a randomized controlled trial.

Remulla Daphne D, Tocci Noah X NX, Ellis Ryan C RC, Bennett William C WC et al.

Evaluate the impact of sugammadex on gastrointestinal recovery following complex AWR. This single-center, double-blinded, randomized controlled trial randomized 184 patients undergoing open retromuscular AWR to receive either sugammadex or neostigmine/glycopyrrolate for neuromuscular blockade reversal per drug packaging protocol. The primary outcome was time to gastrointestinal recovery (GI-2), defined as tolerance of solid food and first bowel movement and univariate and multivariate analysis was used to compare sugammadex and neostigmine/glycopyrrolate cohorts. Secondary outcomes included incidence of POI, hospital length of stay, and opioid consumption among our two cohorts. The final analysis included 177 patients (88 sugammadex, 89 neostigmine/glycopyrrolate). Median time to GI-2 recovery was similar between groups (89 vs. 87 h, Wilcoxon rank-sum p = 0.637). No significant differences were observed in POI incidence (21% vs. 25%, p = 0.52) or length of stay (5 vs. 4 days, p = 0.90). Multivariable analysis confirmed sugammadex did not significantly affect time to GI-2 recovery (HR 0.96, 95% CI 0.69-1.32, p = 0.79). Independent predictors of delayed recovery included POI development and greater opioid consumption. Sugammadex did not result in faster return to gastrointestinal function when compared with neostigmine/glycopyrrolate when used for neuromuscular blockade reversal. Thus, avoidance of neostigmine/glycopyrrolate did not reduce POI incidence or hospital length of stay in patients undergoing complex AWR.

PMID 42565876
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