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Homatropine methylbromide is a quaternary ammonium muscarinic acetylcholine receptor antagonist belonging to the anti-muscarinic class of drugs. It acts as a peripherally acting anticholinergic agent that inhibits muscarinic acetylcholine receptors, thereby blocking the parasympathetic nervous system. This results in reduced motility and secretory activity of the gastrointestinal tract and relaxation of smooth muscle. Homatropine methylbromide does not cross the blood–brain barrier and is primarily used to treat peptic ulcers, gastric ulcers, duodenal ulcers, intestinal spasms, and abdominal cramps[1][8]. It is also included in combination with hydrocodone for cough suppression (as in Hycodan), where it serves both as an anticholinergic and as a deterrent against opioid overdose by being present at subtherapeutic doses[1][2][3][4].
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