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ATROPINE SULPHATE (LOMOTIL (WITH DIPHENOXYLATE))

Brand Name(s) : Lomotil (with diphenoxylate), Valonorm (with peppermint oil, magnesium carbonate, aluminium hydroxide, calcium carbonate, magnesium trisilicate and sodium bicarbonate)
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

ATROPINE SULPHATE WARNINGS

Atropine should be used with caution in: the elderly, children, patients with Down's syndrome, high blood pressure, elevated thyroid levels (hyperthyroidism), heart failure, those with gastro-oesophageal reflux disease (sometimes called GORD, dyspepsia or heartburn), severe constipation, fever, ulcerative colitis (a disease of the lower intestine [colon] characterised by open sores [ulcers] with symptoms such as frequent diarrhoea mixed with blood), those having difficulty or pain passing urine (water), or women who are pregnant or breastfeeding.

It should not be used in: patients with paralytic ileus (lack of bowel movements, leading to blockage of the gut), myasthenia gravis (a muscle weakness disease), those with an enlarged prostate (which can cause problems with urination), toxic megacolon (a life-threatening complication of other intestinal conditions), pyloric stenosis (narrow opening from the stomach to the intestines), or with increased pressure in the eye (narrow-angle glaucoma).

Also see list of precautions and interactions.

STORAGE

Protect from light and store below 25°C.

ATROPINE SULPHATE USES

What is it used for?

  • Atropine is used to treat a number of problems.
  • It is a direct relaxant of smooth muscle, such as is found in the gut (intestine), and is sometimes known as an antispasmodic, antimuscarinic or anticholinergic drug.
  • It is used to relieve cramps in the stomach, intestine and other conditions characterised by spasm of the smooth muscles found in these areas.
  • In general this drug is used to manage the symptoms of irritable bowel syndrome, a common intestinal condition which causes spasm and pain in the intestine, as well as stomach pain, persistent diarrhoea (sometimes alternating with periods of constipation) and wind (flatulence). When used in the eye (eye drops) it enlarges the pupil, which can be useful as it allows a doctor to examine the eye. It also temporarily paralyses the muscles of the eye which can help the eye to focus, allowing short medical procedures to be performed, and can also be used to reduce pain felt by patients with some types of eye conditions.
  • Benefits of being on this drug include reducing the painful and troublesome symptoms of irritable bowel syndrome, and the use of eye drops allows examinations and medical procedures to be performed on the eye, as well as relieving pain in the eye.

Listed below are the typical uses of atropine.

  • Relief from the symptoms of irritable bowel syndrome
  • Mydriasis (excessive enlargement of the pupil to allow examination of the eye) and cycloplegia (temporary paralysis of the ciliary muscle of the eye) to allow medical procedures to be performed on the eye.

On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Use as a pre-medication (now rarely used) before surgery to reduce the volume of secretions from the mouth and airways, also to treat poisoning with a beta-blocker or organophosphorus insecticide, to increase heart rate in patients with very low heart rates (bradycardia) and use during a cardiac arrest for resuscitation purposes.

HOW TO USE/TAKE

How often do I take it?

  • Take tablets orally, usually daily with a glass of water. This medication is also available in liquid form for use as eye drops or for injection.
  • Use this medication as directed by your doctor.
  • Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
  • It may take a while before the full benefit of this drug takes effect.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Patients should not drive or operate machinery if their vision is blurred or they feel drowsy after taking this medication. Consult your doctor or pharmacist for more details.

When can I stop?

  • It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

ATROPINE SULPHATE SIDE EFFECTS

  • Dryness of the mouth
  • Flushing of the skin
  • Fever
  • Constipation
  • Difficulty passing urine (water)
  • Increased heart rate
  • Producing less sweat than normal
  • Dilation of the pupils and blurred vision
  • Dizziness
  • Confusion.

Only the most common side effects have been listed. If any of these persist or you consider them severe then inform your doctor.

Tell your doctor immediately if you develop any of the following symptoms: painful red eye with loss of sight.

Remember that your doctor has prescribed this medication because he or she 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.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), 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.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

ATROPINE SULPHATE PRECAUTIONS

Before taking atropine, tell your doctor or pharmacist if you are allergic to it; or to other antispasmodic drugs; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: paralytic ileus (lack of bowel movements, leading to blockage of the gut), myasthenia gravis (a muscle weakness disease), increased pressure in the eye (narrow-angle glaucoma), toxic megacolon (a life-threatening complication of other intestinal conditions), an enlarged prostate (which can cause problems with urination), or pyloric stenosis (narrow opening from the stomach to the intestines).

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: any previous history of gastro-oesophageal reflux disease (sometimes called dyspepsia or heartburn), severe constipation, having difficulty or pain when passing urine (water), recent fever, or bloody stools.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol may interact with atropine, when atropine is taken orally.

The elderly: atropine should be used with caution in the elderly as it may cause more side effects than in younger patients.

Pregnancy and breast-feeding - please ensure you read the detailed information below.

PREGNANCY

The safety of atropine has not been established during pregnancy. Ask your doctor or pharmacist if you have any doubts or questions about this.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

The safety of atropine has not been established in breastfeeding

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

ATROPINE SULPHATE INTERACTIONS

Before using this me dicine, tell your prescriber of all the medicines you are taking including prescription medicines and medicines you have bought over the counter without a prescription. Tell your prescriber if you are taking vitamins or complementary remedies such as herbal products, as these can also interact with medicines.

If you are taking more than one medicine, these may interact with each other. Your prescriber may decide to use medicines which interact with each other if the benefit outweighs the risks. In these cases, the dose of your medicines may need to be adjusted or you may be monitored more closely.

The following medicines may interact with atropine:

This information does not contain all possible interactions. Therefore, tell your prescriber of all the products you are using before taking this medicine.

If you have a question or want to discuss anything about your medicine, speak to your local pharmacist.

ATROPINE SULPHATE OVERDOSE

Symptoms of an overdose include: dryness of the mouth, reddening and dryness of the skin, dilated pupils, rapid heart beat, rapid breathing, fever, high blood pressure (hypertension), feeling sick (nausea), vomiting, rash, restlessness, confusion, lack of co-ordination, convulsions, coma (unable to wake), heart failure, respiratory (breathing) failure, and death.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of atropine or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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