Atropine

Atropine Overview

Updated: 

Atropine is a prescription medication used to reduce salivation and bronchial secretions before surgery. Atropine is also used to dilate the pupil before eye exams and to relieve pain caused by swelling and inflammation in the eye. Atropine belongs to a group of drugs called anticholinergic agents. These agents work by inhibiting the activity of acetylcholine, a neurotransmitter in the nervous system.

This medication comes in solution and ointment forms and is instilled in the eyes two to four times a day.

This medication is also available in injectable form to be given directly into a vein (IV) or muscle (IM) or directly under the skin (subcutaneously) by a healthcare professional.

Common side effects of atropine include confusion, irregular heartbeat, increased heart rate, irritability, and fever. Atropine preparations for the eye may cause eye irritation, swelling of the eyelids, and sensitivity to light.

Atropine can also cause blurred vision, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how atropine affects you.

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Atropine Cautionary Labels

precautionsprecautions

Uses of Atropine

Injectable:

Atropine is a prescription medication used to reduce salivation and bronchial secretions before surgery.

Atropine may also be used to restore cardiac rate and arterial pressure during anesthesia, to lessen the degree of atrioventricular heart block, to restore normal heart rate and rhythm, and as an antidote for the overdose or poisoning of a cholinergic drug.

Topical:

Atropine is also used to dilate the pupil before eye exams and to relieve pain caused by swelling and inflammation in the eye.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Atropine Brand Names

Atropine Drug Class

Atropine is part of the drug class:

Side Effects of Atropine

Serious side effects have been reported with atropine. See the “Atropine Precautions” section.

Injectable:

Common side effects of injectable atropine include the following:

  • Fever
  • Irritability
  • Increased heart rate
  • Irregular heartbeat
  • Confusion
  • Difficulty urinating
  • Dizziness
  • Drowsiness
  • Dry mouth

Topical:

Common side effects of ophthalmic atropine include the following:

  • Eye irritation and redness
  • Swelling of the eyelids
  • Sensitivity to bright light
  • Dry mouth
  • Red or dry skin
  • Blurred vision

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

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Atropine Interactions

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.

Atropine Precautions

Injectable:

Serious side effects have been reported with injectable atropine including:

  • Heat prostration. Tell your healthcare provider right away if you have some or all of the following symptoms of heat prostration.
    • Fever
    • Heat stroke
  • Intestinal obstruction. Diarrhea may be an early sign of incomplete intestinal obstruction.

Atropine can cause blurred vision, dizziness, and drowsiness. Do not drive or operate heavy machinery until you know how atropine affects you.

Do not take atropine if you are allergic to atropine or to any of its ingredients.

Atropine Food Interactions

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of atropine, there are no specific foods that you must exclude from your diet when receiving this medication.

Inform MD

Before taking atropine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are allergic to atropine or to any of its ingredients
  • have or have had narrow angle glaucoma
  • have liver problems
  • have heart problems
  • have kidney problems
  • have a gastrointestinal obstruction
  • have severe ulcerative colitis
  • have myasthenia gravis
  • are pregnant or breastfeeding

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

Atropine and Pregnancy

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.

Atropine and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if atropine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using atropine.

Atropine Usage

Use atropine exactly as prescribed.

Injectable:

This medication is available in an injectable form to be given directly into a vein (IV), the muscle (IM), or directly under the skin (subcutaneously) by a healthcare professional.

Topical:

This medication comes in solution and ointment forms and is instilled in the eyes two to four times a day.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of atropine at the same time.

Atropine Dosage

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

  • the condition being treated
  • other medical conditions you have
  • other medications you are taking
  • your weight
  • your age

Atropine Overdose

If you take too much atropine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If atropine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

Store atropine at room temperature.

Keep away from excess heat and moisture.

Keep this and all medicines out of the reach of children.