Atropine (oral)

Contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Prostatic enlargement
• Paralytic ileus
• Pyloric stenosis
• Angle-closure glaucoma
• Myasthenia gravis

Cautions

• Pregnancy
• Breastfeeding
• Elderly
• Children
• Urinary retention
• Acute myocardial infarction
• Hypertension
• Tachycardia 
• Pyrexia
• Diarrhoea
• Ulcerative colitis
• Down's syndrome
• Gastroesophageal reflux
• May impair ability to drive and operate machinery

Pregnancy

• Caution
• Atropine sulfate crosses the placenta. There is insufficient evidence to establish the safety of atropine in human pregnancy. Atropine should, therefore, be used during pregnancy only if considered essential

Breastfeeding 

• Caution
• Atropine sulfate is excreted in breast milk. Atropine should, therefore, only be used during breastfeeding if considered essential

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment 

• No dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended
  Not recommended (high risk of the anticholinergic syndrome)

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Confusion
• Unsteadiness

Cardiovascular Disorders

• Bradycardia
• Tachycardia
• Palpitations
• Arrhythmias

Respiratory Disorders

• Reduced bronchial secretions
• Mucous plug formation

Gastrointestinal Disorders

• Dry mouth
• Dysphagia
• Nausea and vomiting
• Constipation
• Retrosternal pain

Genitourinary Disorders

• Urinary urgency
• Urinary difficulty
• Urinary retention

Skin and Subcutaneous Tissue Disorders

• Flushing
• Skin dryness
• Rash

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity
• Fever

Sensory Disorders

• Blurred vision
• Photophobia
• Increased intraocular pressure
• Angle-closure glaucoma

• Alcohol
• Disopyramide
• Anticholinergic agents
• Antidepressants
• Antifungals
• Antihistamines
• Antipsychotics
• Antivirals
• Dopaminergics
• Metoclopramide
• Domperidone
• Nitrates
• Parasympathomimetics
• Phenylephrine

Atropine is an antimuscarinic agent which acts as a competitive inhibitor of acetylcholine at the muscarinic receptors of autonomic effector sites with parasympathetic innervation.  This anticholinergic action is thought to relieve gastrointestinal smooth muscle spasm.