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.
Patient Handout
belladonna alkaloids-opium rectal
OPIUM/BELLADONNA SUPPOSITORY - RECTAL
(OH-pee-um/bell-a-DON-a)
WARNING: Opium/belladonna has a risk for abuse and addiction, which can lead to overdose and death. Opium/belladonna may also cause severe, possibly fatal, breathing problems. To lower your risk, your doctor should have you use the smallest dose of opium/belladonna that works, and use it for the shortest possible time. See also How to Use section for more information about addiction.Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose. Teach your family or household members about the signs of an opioid overdose and how to treat it.The risk for severe breathing problems is higher when you start this product and after a dose increase, or if you use the wrong dose/strength. Using this product with alcohol or other drugs that can cause drowsiness or breathing problems may cause very serious side effects, including death. Be sure you know how to use this product and what other drugs you should avoid taking with it. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.Keep this medicine in a safe place to prevent theft, misuse, or abuse. If someone accidentally uses or swallows this drug, get medical help right away.Before using this product, women of childbearing age should talk with their doctor(s) about the risks and benefits. Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby. To lessen the risk, use the smallest effective dose for the shortest possible time. Babies born to mothers who use this drug for a long time may develop severe (possibly fatal) withdrawal symptoms. Tell the doctor right away if you notice any symptoms in your newborn baby such as crying that doesn't stop, slow/shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight.
USES: This product is used to treat moderate to severe pain from spasms of the urinary tract. It contains 2 medications, belladonna and opium. Belladonna helps to decrease the spasms. Opium is an opioid medication that helps to relieve pain.This product is not recommended for use in children 12 years or younger.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start using opium/belladonna and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Wash your hands before and after using the suppository. Unwrap the suppository and moisten it with water. Insert 1 suppository into the rectum as directed by your doctor. Lie down on your left side with right knee bent. Gently push the suppository into the rectum with your finger. Remain lying down for a few minutes, and avoid having a bowel movement for an hour or longer so the drug will be absorbed. The suppository is for use in the rectum only.If you have nausea, ask your doctor or pharmacist about ways to decrease nausea (such as lying down for 1 to 2 hours with as little head movement as possible).The dosage is based on your medical condition and response to treatment. Do not increase your dose, use the medication more often, or use it for a longer time than prescribed. Properly stop the medication when so directed.Pain medications work best if they are used when the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.If you suddenly stop using this medication, you may have withdrawal symptoms (such as restlessness, watering eyes, runny nose, nausea, sweating, muscle aches). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used this medication for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.When this medication is used for a long time, it may not work as well. Your doctor may need to increase your dose or change your medication. Talk with your doctor if this medication stops working well.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Use this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your pain lasts or gets worse.
SIDE EFFECTS: See also Warning section.Nausea, vomiting, constipation, blurred vision, increased eye discomfort in bright light, lightheadedness, dizziness, drowsiness, increased/decreased sweating, or dry mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as agitation, hallucinations, confusion), difficulty urinating, fainting, slow/fast heartbeat, eye pain, vision changes, signs of your adrenal glands not working well (such as loss of appetite, unusual tiredness, weight loss).Get medical help right away if you have any very serious side effects, including: severe stomach/abdominal pain, seizures, slow/shallow breathing, severe drowsiness/difficulty waking up.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using this product, tell your doctor or pharmacist if you are allergic to belladonna or opium; or to opioid pain medications (such as morphine, codeine); or to atropine or scopolamine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, brain disorders (such as head injury, tumor, seizures), breathing problems (such as asthma, sleep apnea, chronic obstructive pulmonary disease-COPD), a certain spinal problem (kyphoscoliosis), difficulty urinating (such as due to enlarged prostate), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), heart problems (such as irregular heartbeat, heart failure, coronary artery disease), gallbladder disease, disease of the pancreas (pancreatitis), adrenal gland problems (such as Addison's disease), mental/mood disorders (such as toxic psychosis), stomach/intestinal problems (such as blockage, constipation, diarrhea due to infection, paralytic ileus), glaucoma, a certain muscle/nerve disease (myasthenia gravis).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the effects of this drug, especially slow/shallow breathing and drowsiness.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. (See also Warning section.)It is unknown if belladonna passes into breast milk. Opium passes into breast milk, and the effect on a nursing infant is not known. Discuss the risks and benefits with your doctor before breast-feeding.
DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: certain pain medications (mixed opioid agonist-antagonists such as butorphanol, nalbuphine, pentazocine), cimetidine, naltrexone, potassium tablets/capsules, pramlintide, rifampin, samidorphan.The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as other opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This medication may interfere with certain lab tests (such as amylase and lipase levels), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
OVERDOSE: This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, give them naloxone if available, then call 911. If the person is awake and has no symptoms, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, slow/shallow breathing, severe dizziness, fast heartbeat, coma.
NOTES: Do not share this medication with others. Sharing it is against the law.This medication has been prescribed for your current condition only. Do not use it later for another condition unless told to do so by your doctor. A different medication may be necessary in that case.
MISSED DOSE: If you are using this medication regularly and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not refrigerate. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised June 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
