Dosing & Uses
Dosage Forms & Strengths
suppository: Schedule II
- 16.2mg/30mg
- 16.2mg/60mg
Ureteral Spasm Pain
Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
1 suppository PR qDay or q12hr
Not to exceed 4 doses/day
Dosage Forms & Strengths
suppository: Schedule II
- 16.2mg/30mg
- 16.2mg/60mg
Ureteral Spasm Pain
<12 years
- Not recommended
>12 years
- Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
- 1 suppository PR qDay or q12hr
- Not to exceed 4 doses/day
Ureteral Spasm Pain
Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
1 suppository PR qDay or q12hr
Not to exceed 4 doses/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- alvimopan
alvimopan, belladonna and opium. receptor binding competition. Contraindicated. Contraindicated in opioid tolerant patients (ie, those who have taken therapeutic doses of opioids for >7 consecutive days immediately prior to taking alvimopan). Patients recently exposed to opioids are expected to be more sensitive to the effects of alvimopan and therefore may experience abdominal pain, nausea and vomiting, and diarrhea.
Serious - Use Alternative (20)
- buprenorphine
buprenorphine, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- buprenorphine buccal
buprenorphine buccal, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- butorphanol
butorphanol, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- calcium/magnesium/potassium/sodium oxybates
belladonna and opium, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- cimetidine
cimetidine increases effects of belladonna and opium by decreasing metabolism. Avoid or Use Alternate Drug.
- diazepam intranasal
diazepam intranasal, belladonna and opium. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- isocarboxazid
isocarboxazid increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- linezolid
linezolid increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- methylene blue
methylene blue and belladonna and opium both increase serotonin levels. Avoid or Use Alternate Drug. If drug combination must be administered, monitor for evidence of serotonergic or opioid-related toxicities
- metoclopramide intranasal
belladonna and opium, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- nalbuphine
nalbuphine, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- oliceridine
belladonna and opium, oliceridine. Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant use may reduce analgesic effect of oliceridine and/or precipitate withdrawal symptoms.
- pentazocine
pentazocine, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- phenelzine
phenelzine increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
- pramlintide
pramlintide, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- selegiline transdermal
selegiline transdermal increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death.
- selinexor
selinexor, belladonna and opium. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sodium oxybate
belladonna and opium, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tramadol
tramadol, belladonna and opium. Other (see comment). Avoid or Use Alternate Drug. Comment: Tramadol may reinitiate opiate dependence in pts. previously addicted to other opiates; it may also provoke withdrawal Sx. in pts. who are currently opiate dependent.
- tranylcypromine
tranylcypromine increases toxicity of belladonna and opium by unknown mechanism. Avoid or Use Alternate Drug. Risk of hypotension, hyperpyrexia, somnolence, or death; separate by 14 d.
Monitor Closely (229)
- aclidinium
belladonna and opium and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- albuterol
belladonna and opium increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and belladonna and opium both increase sedation. Use Caution/Monitor.
- alprazolam
alprazolam and belladonna and opium both increase sedation. Use Caution/Monitor.
- amantadine
belladonna and opium, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.
- amitriptyline
belladonna and opium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and amitriptyline both increase sedation. Use Caution/Monitor. - amobarbital
amobarbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- amoxapine
belladonna and opium and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and amoxapine both increase sedation. Use Caution/Monitor. - anticholinergic/sedative combos
anticholinergic/sedative combos and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- apomorphine
belladonna and opium and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
belladonna and opium increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
belladonna and opium and aripiprazole both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - armodafinil
belladonna and opium increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atracurium
atracurium and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- azelastine
azelastine and belladonna and opium both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and belladonna and opium both increase sedation. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
belladonna and opium and benperidol both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benzphetamine
belladonna and opium increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
benztropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- bethanechol
bethanechol increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brompheniramine
brompheniramine and belladonna and opium both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and belladonna and opium both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and belladonna and opium both increase sedation. Use Caution/Monitor.
- butabarbital
butabarbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and belladonna and opium both increase sedation. Use Caution/Monitor.
- caffeine
belladonna and opium increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbachol
carbachol increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and belladonna and opium both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and belladonna and opium both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, belladonna and opium. Either increases effects of the other by sedation. Use Caution/Monitor.
- cevimeline
cevimeline increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and belladonna and opium both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and belladonna and opium both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and belladonna and opium both increase sedation. Use Caution/Monitor.
- chlorpromazine
belladonna and opium and chlorpromazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - chlorzoxazone
chlorzoxazone and belladonna and opium both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and belladonna and opium both increase sedation. Use Caution/Monitor.
- cisatracurium
cisatracurium and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clemastine
clemastine and belladonna and opium both increase sedation. Use Caution/Monitor.
- clomipramine
belladonna and opium and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and clomipramine both increase sedation. Use Caution/Monitor. - clonazepam
clonazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- clorazepate
clorazepate and belladonna and opium both increase sedation. Use Caution/Monitor.
- clozapine
belladonna and opium and clozapine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - codeine
codeine and belladonna and opium both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclizine and belladonna and opium both increase sedation. Use Caution/Monitor. - cyclobenzaprine
cyclobenzaprine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclobenzaprine and belladonna and opium both increase sedation. Use Caution/Monitor. - cyproheptadine
cyproheptadine and belladonna and opium both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and belladonna and opium both increase sedation. Use Caution/Monitor.
- daridorexant
belladonna and opium and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- desflurane
desflurane and belladonna and opium both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- desipramine
belladonna and opium and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and desipramine both increase sedation. Use Caution/Monitor. - dexchlorpheniramine
dexchlorpheniramine and belladonna and opium both increase sedation. Use Caution/Monitor.
- dexfenfluramine
belladonna and opium increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and belladonna and opium both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
belladonna and opium increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
belladonna and opium increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromoramide
dextromoramide and belladonna and opium both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and belladonna and opium both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- dicyclomine
dicyclomine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diethylpropion
belladonna and opium increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and belladonna and opium both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and belladonna and opium both increase sedation. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate and belladonna and opium both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
diphenhydramine and belladonna and opium both increase sedation. Use Caution/Monitor. - diphenoxylate hcl
diphenoxylate hcl and belladonna and opium both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and belladonna and opium both increase sedation. Use Caution/Monitor.
- dobutamine
belladonna and opium increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil
donepezil increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopamine
belladonna and opium increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
belladonna and opium increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
belladonna and opium and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and dosulepin both increase sedation. Use Caution/Monitor. - doxepin
belladonna and opium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and doxepin both increase sedation. Use Caution/Monitor. - doxylamine
doxylamine and belladonna and opium both increase sedation. Use Caution/Monitor.
- droperidol
belladonna and opium and droperidol both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- eltrombopag
eltrombopag increases levels of belladonna and opium by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- ephedrine
belladonna and opium increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
belladonna and opium increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
belladonna and opium increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, belladonna and opium. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and belladonna and opium both increase sedation. Use Caution/Monitor.
- ethanol
belladonna and opium and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and belladonna and opium both increase sedation. Use Caution/Monitor.
- fenfluramine
belladonna and opium increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
fesoterodine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
flavoxate and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fluphenazine
belladonna and opium and fluphenazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - flurazepam
flurazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- formoterol
belladonna and opium increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gabapentin
gabapentin, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- galantamine
galantamine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
belladonna and opium and haloperidol both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
henbane and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydromorphone
hydromorphone and belladonna and opium both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and belladonna and opium both increase sedation. Use Caution/Monitor.
- hyoscyamine
hyoscyamine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
belladonna and opium and iloperidone both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
belladonna and opium and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and imipramine both increase sedation. Use Caution/Monitor. - ipratropium
ipratropium and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- isoproterenol
belladonna and opium increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketamine
ketamine and belladonna and opium both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
belladonna and opium and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- levalbuterol
belladonna and opium increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
levorphanol and belladonna and opium both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
belladonna and opium increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofepramine
belladonna and opium and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and lofepramine both increase sedation. Use Caution/Monitor. - lofexidine
belladonna and opium and lofexidine both increase sedation. Use Caution/Monitor.
- loprazolam
loprazolam and belladonna and opium both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- lormetazepam
lormetazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- loxapine
belladonna and opium and loxapine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
belladonna and opium and loxapine inhaled both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - lurasidone
lurasidone, belladonna and opium. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
belladonna and opium and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and maprotiline both increase sedation. Use Caution/Monitor. - marijuana
belladonna and opium and marijuana both increase sedation. Use Caution/Monitor.
- meclizine
meclizine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- melatonin
belladonna and opium and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and belladonna and opium both increase sedation. Use Caution/Monitor.
- meprobamate
belladonna and opium and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
belladonna and opium increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and belladonna and opium both increase sedation. Use Caution/Monitor.
- methadone
methadone and belladonna and opium both increase sedation. Use Caution/Monitor.
- methamphetamine
belladonna and opium increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and belladonna and opium both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylenedioxymethamphetamine
belladonna and opium increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
midazolam and belladonna and opium both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
belladonna and opium increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
belladonna and opium and mirtazapine both increase sedation. Use Caution/Monitor.
- modafinil
belladonna and opium increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and belladonna and opium both increase sedation. Use Caution/Monitor.
- motherwort
belladonna and opium and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
belladonna and opium and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
belladonna and opium and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and belladonna and opium both increase sedation. Use Caution/Monitor.
- neostigmine
neostigmine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- norepinephrine
belladonna and opium increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
belladonna and opium and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and nortriptyline both increase sedation. Use Caution/Monitor. - olanzapine
belladonna and opium and olanzapine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - onabotulinumtoxinA
onabotulinumtoxinA and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- opium tincture
belladonna and opium and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
belladonna and opium and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
orphenadrine and belladonna and opium both increase sedation. Use Caution/Monitor. - oxazepam
oxazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- oxybutynin
belladonna and opium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
belladonna and opium and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
belladonna and opium and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
belladonna and opium and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
belladonna and opium and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
belladonna and opium and paliperidone both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
belladonna and opium and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- papaveretum
belladonna and opium and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
belladonna and opium and papaverine both increase sedation. Use Caution/Monitor.
- pegvisomant
belladonna and opium decreases effects of pegvisomant by unknown mechanism. Use Caution/Monitor.
- pentazocine
belladonna and opium and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- perphenazine
belladonna and opium and perphenazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - phendimetrazine
belladonna and opium increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- phentermine
belladonna and opium increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
belladonna and opium increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
belladonna and opium increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
belladonna and opium and pholcodine both increase sedation. Use Caution/Monitor.
- physostigmine
physostigmine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
belladonna and opium and pimozide both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pirbuterol
belladonna and opium increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pralidoxime
belladonna and opium and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pregabalin
pregabalin, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primidone
primidone and belladonna and opium both increase sedation. Use Caution/Monitor.
- procarbazine
procarbazine increases toxicity of belladonna and opium by unknown mechanism. Use Caution/Monitor. Potential for increased CNS depression. Use caution during coadministration.
- prochlorperazine
belladonna and opium and prochlorperazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
promethazine and belladonna and opium both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
belladonna and opium and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- propofol
propofol and belladonna and opium both increase sedation. Use Caution/Monitor.
- propylhexedrine
belladonna and opium increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
belladonna and opium and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and protriptyline both increase sedation. Use Caution/Monitor. - pyridostigmine
pyridostigmine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quazepam
quazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- quetiapine
belladonna and opium and quetiapine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - ramelteon
belladonna and opium and ramelteon both increase sedation. Use Caution/Monitor.
- rapacuronium
belladonna and opium and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- risperidone
belladonna and opium and risperidone both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rocuronium
belladonna and opium and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- salmeterol
belladonna and opium increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scopolamine
belladonna and opium and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scullcap
belladonna and opium and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and belladonna and opium both increase sedation. Use Caution/Monitor.
- selegiline
selegiline increases toxicity of belladonna and opium by unknown mechanism. Use Caution/Monitor. Risk of hypotension, hyperpyrexia, somnolence, or death.
- sevoflurane
sevoflurane and belladonna and opium both increase sedation. Use Caution/Monitor.
- shepherd's purse
belladonna and opium and shepherd's purse both increase sedation. Use Caution/Monitor.
- solifenacin
belladonna and opium and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- succinylcholine
succinylcholine increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sufentanil
belladonna and opium and sufentanil both increase sedation. Use Caution/Monitor.
- tapentadol
belladonna and opium and tapentadol both increase sedation. Use Caution/Monitor.
- temazepam
temazepam and belladonna and opium both increase sedation. Use Caution/Monitor.
- terbutaline
belladonna and opium increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
belladonna and opium and thioridazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
belladonna and opium and thiothixene both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
belladonna and opium and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tolterodine
belladonna and opium and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- topiramate
belladonna and opium and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
belladonna and opium and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
belladonna and opium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and trazodone both increase sedation. Use Caution/Monitor. - triazolam
triazolam and belladonna and opium both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and belladonna and opium both increase sedation. Use Caution/Monitor.
- trifluoperazine
belladonna and opium and trifluoperazine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trihexyphenidyl
belladonna and opium and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimipramine
belladonna and opium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and trimipramine both increase sedation. Use Caution/Monitor. - triprolidine
triprolidine and belladonna and opium both increase sedation. Use Caution/Monitor.
- trospium chloride
belladonna and opium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- vecuronium
belladonna and opium and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- xylometazoline
belladonna and opium increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
belladonna and opium increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
belladonna and opium and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
belladonna and opium and ziprasidone both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
belladonna and opium and zotepine both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (10)
- brimonidine
brimonidine increases effects of belladonna and opium by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- dextroamphetamine
dextroamphetamine increases effects of belladonna and opium by unspecified interaction mechanism. Minor/Significance Unknown.
- dimenhydrinate
dimenhydrinate increases toxicity of belladonna and opium by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of belladonna and opium by pharmacodynamic antagonism. Minor/Significance Unknown.
- eucalyptus
belladonna and opium and eucalyptus both increase sedation. Minor/Significance Unknown.
- galantamine
galantamine decreases effects of belladonna and opium by pharmacodynamic antagonism. Minor/Significance Unknown.
- levodopa
belladonna and opium, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .
- lidocaine
lidocaine increases toxicity of belladonna and opium by pharmacodynamic synergism. Minor/Significance Unknown. Risk of increased CNS depression.
- sage
belladonna and opium and sage both increase sedation. Minor/Significance Unknown.
- ziconotide
ziconotide, belladonna and opium. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Additive decreased GI motility. Additive analgesia. Ziconotide does NOT potentiate opioid induced respiratory depression.
Adverse Effects
Frequency Not Defined
Pruritus
Urticaria
Nausea
Vomiting
Photophobia
Anticholinergic
- Dizziness
- Sedation
- Urticaria
- Constipation
- Dry mouth
- Blurred vision
- Urinary retention
Warnings
Contraindications
Hypersensitivity
Respiratory disease/depression, acute or severe bronchial asthma in unmonitored setting or absence of resuscitative equipment, convulsive disorders, GI obstruction including paralytic ileus, glaucoma, severe renal or hepatic disease, within 14 days of taking a monoamine oxidase inhibitor, acute alcoholism, delirium tremens, premature labor
Cautions
Use caution in patients with head trauma, including injury, intracranial lesions, or elevated intracranial pressure (ICP); significant ICP may occur
Use caution in patients with toxic psychosis; may exacerbate symptoms
Use caution in prostatic hyperplasia; may cause urinary retention
Use caution in cardiovascular disease or with thyroid dysfunction resulting in myxedema; may exacerbate symptoms
Use caution in patients with seizure disorders; may cause or exacerbate preexisting seizures
Use caution in patients with biliary tract impairment, including acute pancreatitis, may cause constriction of sphincter of Oddi
Serious life-threatening or fatal respiratory depression may occur monitor closely for respiratory depression, especially during initiation or dose escalation; carbon dioxide retention resulting from respiratory depression can exacerbate sedating effects of opioids; educate patients and caregivers about how to recognize respiratory depression and getting emergency assistance immediately in the event of an overdose
May cause severe hypotension, including syncope and orthostatic hypotension; use caution in patients with cardiovascular disease, hypovolemia, circulatory shock, or therapeutic agents that may significantly decrease blood pressure, including anesthetics or phenothiazines; monitor for hypotension upon initiating or titrating dose; avoid use in patients with circulatory shock
In patients with significant COPD or cor pulmonale or patients with significant reduction in respiratory reserve, hypercapnia, hypoxia, or preexisting respiratory depression, especially when initiating and titrating therapy; significant respiratory depression may occur, including at therapeutic dosages; consider using nonopioid analgesics in these patients
Use caution in patients with adrenal insufficiency, including Addison disease; long-term opioid use of one or more months may cause secondary hypogonadism, with may lead to osteoporosis and mood disorders
Patients with history of opioid abuse or alcoholism are at greater risk for drug dependency; psychological, physical dependence, and tolerance may occur with prolonged use
May cause CNS depression, impairing physical or mental abilities; caution patients about performing tasks requiring mental alertness or operating heavy machinery
Pregnancy & Lactation
Pregnancy
Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome; there are no available data on belladonna and opium suppositories in pregnant women to inform a drug-associated risk for major birth defects and miscarriage
Chronic use of opioids may cause reduced fertility in females and males of reproductive potential; not known whether effects on fertility are reversible
Fetal/Neonatal Adverse Reactions
- Prolonged use of opioid analgesics during pregnancy for medical or nonmedical purposes can result in physical dependence in neonate and neonatal opioid withdrawal syndrome shortly after birth
- Neonatal opioid withdrawal syndrome presents as irritability, hyperactivity and abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea, and failure to gain weight
- The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn; observe newborns for symptoms of neonatal opioid withdrawal syndrome and manage accordingly
Labor or delivery
- Opioids cross the placenta and may produce respiratory depression and psycho-physiologic effects in neonates; an opioid antagonist, such as naloxone, must be available for reversal of opioid-induced respiratory depression in the neonate
- Belladonna and opium suppositories is not recommended for use in pregnant women during or immediately prior to labor when other analgesic techniques are more appropriate; opioid analgesics, including belladonna and opium suppositories, can prolong labor through actions that temporarily reduce strength, duration, and frequency of uterine contractions
- However, this effect is not consistent and may be offset by increased rate of cervical dilation, which tends to shorten labor; monitor neonates exposed to opioid analgesics during labor for signs of excess sedation and respiratory depression
Lactation
Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for belladonna and opium suppositories and any potential adverse effects on breastfed infant from belladonna and opium suppositories or from underlying maternal condition
Infants exposed to belladonna and opium suppositories through breast milk should be monitored for excess sedation and respiratory depression; withdrawal symptoms can occur in breastfed infants when maternal administration of an opioid analgesic is stopped, or when breast-feeding is stopped
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Opium: analgesic, antispasmodic, antimuscarinic; because of its morphine content, inhibits GI motility and propulsion, diminishes digestive secretion
Belladonna: anticholinergic alkaloids; competitively inhibit Ach actions at muscarinic receptors
Pharmacokinetics
Onset: Opium: 30 min, Belladonna: 1-2 hr
Metabolism: opium: extensively in liver, undergoes conjugation with glucuronic acid; belladonna: no data
Metabolites: opium: morphine-3-glucuronide, morphine-3-6-diglucuronide; belladonna: no data
Excretion: opium: mainly by kidney, little amount in bile; belladonna: urine
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| belladonna alkaloids-opium rectal - | 16.2-30 mg suppos |  | |
| belladonna alkaloids-opium rectal - | 16.2-30 mg suppos |  | |
| belladonna alkaloids-opium rectal - | 16.2-60 mg suppos |  | |
| belladonna alkaloids-opium rectal - | 16.2-60 mg suppos |  |
Copyright © 2010 First DataBank, Inc.
Formulary
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