Atropine

Most of the side effects of atropine are directly related to its antimuscarinic action. Dryness of the mouth, blurred vision, photophobia and tachycardia commonly occur with chronic administration of therapeutic doses. Anhidrosis also may occur and produce heat intolerance or impair temperature regulation in persons living in a hot environment. Constipation and difficulty in micturition may occur in elderly patients. Occasional hypersensitivity reactions have been observed, especially skin rashes which in some instances progressed to exfoliation.

Adverse effects following single or repeated injections of atropine are most often the result of excessive dosage. These include palpitation, dilated pupils, difficulty in swallowing, hot dry skin, thirst, dizziness, restlessness, tremor, fatigue and ataxia. Toxic doses lead to marked palpitation, restlessness and excitement, hallucinations, delirium and coma. Depression and circulatory collapse occur only with severe intoxication. In such cases, blood pressure declines and death due to respiratory failure may ensue following paralysis and coma.

Atropine may be found in some form under the following brand names:

• Antispas

• Antrocol

• Atreza

• Atrohist Plus

• AtroPen

• Atropine-Care

• Atropisol

• Atrosept

• Atrosulf-1

• Barbidonna

• Barophen

• Bellalphen

• Bellatal

• Chardonna-2

• Colidrops

• Cystemms-V

• D-Tal

• Deconhist LA

• Di-Atro

• Dimotal

• Dolsed

• Donnaphen

• Donnapine

• Donnatal

• Duodote

• Elixiral

• Ex-Tuss

• Haponal

• Hyosophen

• Hypersed

• Isopto Atropine

• Lomocot

• Lomotil

• Lonox

• Malatal

• Mhp-a

• Motofen

• Ocu-Tropine

• Phenchlor S.H.A.

• Phenobel

• Protuss Tablet

• Q-Tuss

• Respa-A.R.M.

• Rolatuss-SR

• Ru-Tab

• Rutuss

• Sal-Tropine

• Servira

• Spasmolin

• Spasquid

• Spastolate

• Stahist

• Stahist Reformulated Apr 2013

• Trac Tabs 2x

• Uaa

• Urapine

• Uretron

• Uri-Sep SC

• Uridon Modified

• Urimar T

• Urised

• Uritin

• Usept

• Vi-Atro

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Anti-arrhythmia medications such as procainamide (Procanbid, Procan), disopyramide (Norpace, Rythmodan), quinidine, and digoxin (Lanoxin)
• Anticholinergic agents 
• Antihistamines such as diphenhydramine (Benadryl)
• Antipsychotics such as paliperidone (Invega), lurasidone (Latuda), olanzapine (Zyprexa), aripiprazole (Abilify), asenapine (Saphris), iloperidone (Fanapt), haloperidol (Haldol), prochlorperazine (Compazine), chlorpromazine (Thorazine), clozapine (Clozaril), risperidone (Risperdal), quetiapine (Seroquel), and ziprasidone (Geodon)
• Benzodiazepines such as diazepam (Valium), lorazepam (Ativan), alprazolam (Xanax), and midazolam (Versed)
• Methylphenidate (Concerta, Methylin, Ritalin)
• Metoclopramide (Reglan and others)
• Monoamine oxidase inhibitors such as tranylcypromine (Parnate), phenelzine (Nardil), selegiline (Eldepryl, Zelapar), isocarboxazid (Marplan), and rasagiline (Azilect)
• Nitrofurantoin (Macrobid)
• Tricyclic antidepressants such as trimipramine (Surmontil), amitriptyline (Elavil), nortriptyline (Pamelor, Aventyl), protriptyline (Vivactil), and clomipramine (Anafranil)

This is not a complete list of atropine drug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Injectable:

Atropine injection falls into category B.

There are no well-done studies that have been done in humans with atropine. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Topical:

Atropine ophthalmic ointment and solution fall into category C.

No studies have been done in animals, and no well-controlled studies have been done in pregnant women. Atropine should be given to a pregnant woman only if clearly needed.

Storage

Parenteral

25°C (may be exposed to 15–30°C).105

Protect from freezing and light.105

Compatibility

For information on systemic interactions resulting from concomitant use, see Interactions.

Parenteral

Ophthalmic atropine, homatropine, and scopolamine are used to dilate (enlarge) the pupil of the eye. They are used before eye examinations, before and after eye surgery, and to treat certain eye conditions, such as uveitis or posterior synechiae.

These medicines are available only with your doctor's prescription.

After you apply this medicine to your eyes:

• Your pupils will become unusually large and you will have blurring of vision, especially for close objects. Make sure your vision is clear before you drive, use machines, or do anything else that could be dangerous if you are not able to see well.
• Your eyes will become more sensitive to light than they are normally. Wear sunglasses to protect your eyes from sunlight and other bright lights.

These effects may continue for several days after you stop using this medicine. However, check with your doctor if they continue longer than:

• 14 days if you are using atropine.
• 3 days if you are using homatropine.
• 7 days if you are using scopolamine.

Atropine Sulfate Injection, USP, is indicated for temporary blockade of severe or life threatening muscarinic effects, e.g., as an antisialagogue, an antivagal agent, an antidote for organophosphorus or muscarinic mushroom poisoning, and to treat bradyasystolic cardiac arrest.

General Administration

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not administer unless solution is clear and seal is intact. Discard unused portion.

For intravenous administration.

Titrate based on heart rate, PR interval, blood pressure and symptoms.

Adult Dosage

Pediatric Dosage

Dosing in pediatric populations has not been well studied. Usual initial dose is 0.01 to 0.03 mg/kg.

Injection: 0.1 mg/mL in LifeShield™ Abboject™ Glass Syringes

Atropine Sulfate 0.1 mg/mL

5 mL Single-dose
NDC 0409-4910-34

Atropine SULFATE Inj., USP
0.5 mg (0.1 mg/mL)

Rx only

For I.V., I.M. or S.C. use. Usual dosage:
See insert. Sterile, nonpyrogenic.

Hospira, Inc., Lake Forest, IL 60045 USA

Hospira

RL-0260 (9/04)