BMA Concise Guide to Medicine & Drugs

Atropine

Brand name Minims Atropine

Used in the following combined preparations Co-phenotrope, Lomotil, Minims Atropine

QUICK REFERENCE

Drug group Drug for irritable bowel syndrome and mydriatic drug

Overdose danger rating High

Dependence rating Low

Prescription needed Yes (most preparations)

Available as generic Yes

GENERAL INFORMATION

Atropine is an anticholinergic drug. Because of its antispasmodic action, which relaxes the muscle wall of the intestine, the drug has been used to relieve abdominal cramps in irritable bowel syndrome. Atropine may also be prescribed in combination with diphenoxylate, an antidiarrhoeal drug. However, this combination can be dangerous in overdosage, particularly in young children.

Atropine eye drops are used to enlarge the pupil during eye examinations and are part of the treatment for inflammatory eye disorders such as uveitis. Atropine may be used as part of premedication before a general anaesthetic. The drug is occasionally injected to restore normal heart beat in heart block.

Atropine must be used with caution in children and the elderly due to their sensitivity to the drug’s effects.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, injection, eye ointment, eye drops.

Frequency and timing of doses Once only, or up to 4 times daily according to condition (eye drops); as directed (other forms).

Adult dosage range 1–2 drops as directed (eye drops); as directed (other forms).

Onset of effect Varies according to method of administration. 30 minutes (eye drops).

Duration of action 7 days or longer (eye drops); several hours (other forms).

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor.

OVERDOSE ACTION

Seek immediate medical advice in all cases. Take emergency action if palpitations, tremor, delirium, seizures, or loss of consciousness occur.

POSSIBLE ADVERSE EFFECTS

The use of atropine is limited by the frequency of anticholinergic effects, which commonly include blurred vision, dry mouth, and constipation; the drug may also cause nausea, vomiting, and dizziness. You should discuss with your doctor if any of these symptoms becomes severe or if you have difficulty in passing urine. If palpitations or confusion occur, you should stop taking the drug and contact your doctor immediately. The eye drops may cause stinging. If they also cause pain and irritation or if a rash develops on contact, stop using them and contact your doctor without delay.

INTERACTIONS

General note Atropine delays stomach emptying and may therefore alter the absorption of other drugs.

Anticholinergic drugs Atropine increases the risk of side effects from drugs that also have anticholinergic effects.

Ketoconazole Atropine reduces the absorption of this drug from the digestive tract. Increased dose may be necessary.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You have prostate problems.

· You have gastro-oesophageal reflux.

· You have glaucoma.

· You have urinary difficulties.

· You have ulcerative colitis.

· You wear contact lenses (eye drops).

· You have heart problems.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding The drug may pass into the breast milk and affect the baby. Discuss with your doctor.

Infants and children Combination with diphenoxylate not recommended under 4 years; reduced dose necessary in older children.

Over 60 Increased likelihood of adverse effects.

Driving and hazardous work Avoid such activities until you have learned how atropine affects you because the drug can cause blurred vision and may impair concentration.

Alcohol Avoid. Alcohol increases the likelihood of confusion and affects your concentration when taken with atropine.

PROLONGED USE

No problems expected.