atropine

What is atropine?

Atropine produces many effects in the body, including relief from spasms of the gastrointestinal tract (stomach and intestines), the bladder, and the biliary tract. This is helpful in controlling conditions such as colitis, spastic bladder, diverticulitis, infant colic, renal and biliary colic, peptic ulcer, and irritable bowel syndrome.

Atropine also reduces the secretions of many organs, thereby helping to control conditions such as excessive stomach acid production and excessive secretion from the pancreas; to reduce secretions of the nose, lungs, salivary glands, and stomach before surgery; and to help dry up excessive mucus production associated with diseases, infections, and allergies.

Atropine is used to treat the rigidity, tremor, excessive salivation, and sweating caused by Parkinson's disease.

Atropine also has effects on the heart. It is used during surgery to maintain proper heart function, during emergencies involving the heart, and to treat certain heart disorders.

Atropine is used to control laughing and crying episodes that are caused by brain tumors.

Atropine also has effect on the eyes and is available in an ophthalmic (eye) formulation.

Atropine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about atropine?

Use caution when driving, operating machinery, or performing other hazardous activities. Atropine may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking atropine.

Avoid becoming overheated in hot weather. Atropine increases the risk of heat stroke because it causes decreased sweating.

What should I discuss with my healthcare provider before taking atropine?

Do not take atropine if you have

• kidney disease;
• a blockage of your urinary tract (difficulty urinating);
• a blockage in your intestines, severe ulcerative colitis, or ulcerative colitis complicated by toxic megacolon;
• glaucoma; or
• myasthenia gravis.

Before taking this medication, tell your doctor if you have

• numbness or tingling in your hands or feet;
• liver disease;
• ulcerative colitis;
• thyroid problems;
• high blood pressure, an irregular heartbeat, or any type of heart disease;
• hiatal hernia or reflux disease;
• enlargement of the prostate; or
• asthma, chronic lung disease, or allergies.

You may not be able to take atropine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

It is not known whether atropine will harm an unborn baby. Do not take atropine without first talking to your doctor if you are pregnant. It is not known whether atropine passes into breast milk. Do not take atropine without first talking to your doctor if you are breast-feeding a baby.

How should I take atropine?

Take atropine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Store atropine at room temperature away from moisture and heat

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a atropine overdose include headache; nausea; vomiting; dry mouth; difficulty swallowing; blurred vision; dilated pupils; hot, dry skin; dizziness; drowsiness; confusion; anxiety; seizures; weak pulse; and an irregular heartbeat.

What should I avoid while taking atropine?

Use caution when driving, operating machinery, or performing other hazardous activities. Atropine may cause dizziness, drowsiness, or blurred vision. If you experience dizziness, drowsiness, or blurred vision, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking atropine.

Avoid becoming overheated in hot weather. Atropine increases the risk of heat stroke because it causes decreased sweating.

Atropine side effects

If you experience any of the following serious side effects, stop taking atropine and seek emergency medical attention:

• an allergic reaction (swelling of your lips, tongue, or face, difficulty breathing, closing of your throat, or hives);
• an irregular or fast heart rate;
• rash or flushing; or
• eye pain.

Other, less serious side effects may be more likely to occur. Continue to take atropine and talk to your doctor if you experience

• headache, dizziness or lightheadedness;
• weakness or nervousness;
• blurred vision, large pupils, or sensitivity of the eyes to bright light;
• nausea, bloating, heartburn, or constipation;
• changes in taste;
• difficulty urinating;
• decreased sweating; or
• nasal congestion, stuffiness, or a dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Atropine Dosing Information

Usual Adult Dose for Bradyarrhythmia:

0.4 to 1 mg IV one time. An effective dose within this range may be repeated every 1 to 2 hours as needed to achieve an adequate heart rate or within 5 to 10 minutes if the initial heart rate is inadequate. In rare instances, repeated doses as high as 2 mg are needed.

Usual Adult Dose for AV Heart Block:

0.4 to 1 mg IV one time. An effective dose within this range may be repeated every 1 to 2 hours as needed to promote normal AV node conduction or within 5 to 10 minutes if the initial effect is inadequate to overcome the heart block. In rare instances, repeated doses as high as 2 mg are needed.

Usual Adult Dose for Organophosphate Poisoning:

Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
2 mg/0.7 mL (green) by AtroPen auto-injector into midlateral thigh followed by 2 additional 2 mg/0.7 mL (AtroPen) injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 2 mg/0.7 mL (green) by AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

Usual Adult Dose for Anticholinesterase Poisoning:

2 to 3 mg IV one time. Doses may be repeated as needed to prevent or treat signs of parasympathomimetic activity, coma, and/or cardiovascular collapse.

Usual Pediatric Dose for Bradyarrhythmia:

0.01 to 0.03 mg/kg IV every 5 minutes for 2 to 3 doses as needed. The minimum dose is 0.1 mg and the maximum dose is 0.5 mg. The maximum total dose is 1 mg.

When treating bradycardia in neonates, reserve use for those patients unresponsive to improved oxygenation and epinephrine. Note: Doses less than 0.1 mg have been associated with paradoxical bradycardia.

Endotracheal: 0.04 to 0.06 mg/kg; may repeat once if needed.

Usual Pediatric Dose for AV Heart Block:

0.01 to 0.03 mg/kg IV every 5 minutes for 2 to 3 doses as needed. The minimum dose is 0.1 mg and the maximum dose is 0.5 mg. The maximum total dose is 1 mg.

When treating bradycardia in neonates, reserve use for those patients unresponsive to improved oxygenation and epinephrine. Note: Doses less than 0.1 mg have been associated with paradoxical bradycardia.

Endotracheal: 0.04 to 0.06 mg/kg; may repeat once if needed.

Usual Pediatric Dose for Organophosphate Poisoning:

Infants weighing less than 15 lbs. (generally less than six months of age): use 0.25 mg/ 0.3 mL (yellow)AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
0.25 mg/0.3 mL (yellow) AtroPen auto-injector into midlateral thigh followed by 2 additional 0.25 mg/0.3 mL (blue) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 0.25 mg/0.3 mL (yellow) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.


15 to 40 pounds: use 0.5 mg/0.7 mL (blue) AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
0.5 mg/0.7 mL (blue) AtroPen auto-injector into midlateral thigh followed by 2 additional 0.5 mg/0.7 mL (blue) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 0.5 mg/0.7 mL (blue) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

40 to 90 pounds: use 1 mg/0.7 mL (dark red) AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
1 mg/0.7 mL (dark red) AtroPen auto-injector into midlateral thigh followed by 2 additional 1 mg/0.7 mL (dark red) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 1 mg/0.7 mL (dark red) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness

More than 90 pounds: use 2 mg/0.7 mL (green) AtroPen auto-injector

2 mg/0.7 mL (green) AtroPen auto-injector into midlateral thigh followed by 2 additional 2 mg/0.7 mL (green) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 2 mg/0.7 mL (green) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness

What other drugs will affect atropine?

Many other drugs may increase the side effects of atropine. Before taking this medication, tell your doctor if you are taking any of the following medicines:

• belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
• digoxin (digitalis, Lanoxin);
• glycopyrrolate (Robinul);
• mepenzolate (Cantil);
• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).

Drugs other than those listed here may also interact with atropine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.