Belladonna (Atropa belladona L.)
- Atc Codes:A03B
Table of contents
- Brand Names
- Drug Combinations
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Germany: Anore, Belladonna; Ireland: Belladonna; Netherlands: Belladonna.
North America
Canada: Belladonna.
Drug combinations
Belladonna: Achillea millefolium; Aconitum napellus; Aconite Tincture; Aesculus hippocastanum; Ailanthus altísima; Amanita muscaria; Ambra grisea; Ammi visnaga; Ammonium; Anamirta cocculus; Apis mellifica; Aralia racemosa; Arctostaphylos uva-ursi; Arisaema triphyllum; Arnica montana; Arsenic Acid; Artemisia absinthium; Artichoke; Asa foetida; Asclepias tuberosa; Avena sativa; Baking Soda; Baptisia tinctoria; Barium Iodate; Berberis vulgaris; Betula pendula; Bile Salts; Bismuth Subsalicylate; Bryonia spp.; Calcium Carbonate; Calendula officinalis; Camphor; Capillary Fluid Extract; Capsicum annuum; Carbo animalis; Carbo vegetabilis; Caulophyllum thalictroides; Cetraria islandica; Chamomile; Chelidonium majus; Chininum sulfuricum; Cholesterol; Cicuta virosa; Cimicifuga racemosa; Cinchona pubescens; Citrullus colocynthis; Coffea arabica; Colchicum autumnale; Collinsonia canadensis; Conium maculatum; Convallaria majalis; Copper; Corallium rubrum; Cyclamen purpurascens; Dactylopius coccus; Daphne mezereum; Delphinium staphisagria; Dioscorea villosa; Drosera spp.; Echinacea spp.; Equisetum arvense; Equisetum hyemale; Eriodictyon californicum; Ethylmorphine; Eucalypti aetheroleum; Eucalyptus globulus; Eupatorium perfoliatum; Euphrasia spp.; Euspongia officinalis; Filipendula ulmaria; Formica rufa; Frangula alnus; Fumaria officinalis; Galium aparine; Gelsemium sempervirens; Guaifenesin; Helleborus niger; Helichrysum arenarium; Henbane; Hydrastis canadensis; Hyoscyamus niger; Hypericum perforatum; Inula helenium; Iodine; Ipecac Syrup; Iris versicolor; Iron; Juniperus communis; Kalmia latifolia; Laburnum anagyroides; Lachesis mutus; Ledum palustre; Levisticum officinale; Liatris spicata; Lobaria pulmonaria; Lobelia inflata; Lycopodium clavatum; Lytta vesicatoria; Magnesium Carbonate; Magnesium Oxide; Matricaria recutita; Melilotus officinalis; Melissa officinalis; Merc sol Hahnemanni; Myosotis arvensis; Nicotiana tabacum; Nitroglycerin; Ocimum basilicum; Oenanthe aquatica; Paeonia officinalis; Papaverine Hydrochloride; Petroselinum crispum; Peumus boldus; Phosphorus; Phytolacca americana; Pimpinella anisum; Plantago major; Podophyllum peltatum; Potassium; Potentilla anserina; Primula veris; Psychotria ipecacuanha; Pulsatilla pratensis; Ranunculus bulbosus; Rauwolfia serpentina; Resina piceae; Rhododendron spp.; Riboflavin (Vitamin B~2~); Rosmarinus officinalis; Ruta graveolens; Salicylic Acid; Sallowthorns; Sanguinaria canadensis; Saponaria officinalis; Secale cornutum; Selenicereus grandiflorus; Selenium; Sempervivum tectorum; Serenoa repens; Silver *nitrate; Silybum marianum; Sisymbrium officinale; Sodium Bicarbonate; Sodium Chloride; Solanum dulcamara; Spigelia anthelmia; Strophanthus gratus; Strychnos ignatii; Sulfur; Symphytum officinale; Taraxacum officinale; Terebinthinae aetheroleum; Teucrium marum; Tolu Balsam; Toxicodendron quercifolium; Thuja occidentalis; Turnera diffusa; Valeriana officinalis; Veratrum album; Verbascum densiflorum; Veronica beccabunga; Veronica virginica; Virola sebifera; Viscum album; Vitex agnus-castus; White Clay; Zinc*
Chemistry
Pharmacologic Category
Anticholinergic Agents; Antimuscarinics/Antispasmodics. (ATC-Code: A03B).
Mechanism of action
Belladonna is a mixture of the anticholinergic alkaloids atropine, hyoscyamine, and scopolamine (hyoscine). Antimuscarinic activity results principally from the atropine (D-L-hyoscyamine) content. Competitively inhibits cholinergic stimuli at autonomic effectors innervated by postganglionic cholinergic nerves and, to a lesser extent, on smooth muscles that lack cholinergic innervation. At usual doses, principally antagonizes cholinergic stimuli at muscarinic receptors and has little or no effect on cholinergic stimuli at nicotinic receptors. Scopolamine has a more potent activity on the iris, ciliary body, and certain secretory glands, the heart, intestine, and bronchial muscle, and a more prolonged duration of action.
Therapeutic use
In functional bowel disorders to decrease gastrointestinal activity and gastric secretion, and to delay gastric emptying. Adjunct in the treatment of peptic ulcer disease. In functional disturbances of gastrointestinal motility (e.g. irritable bowel syndrome) and neurogenic bowel disturbances. In moderate/severe pain related to previous genitourinary surgery or ureteral spasm. In recurrent, throbbing headaches in combination with other drugs (e.g. ergotamine, phenobarbital). In mild cases of parkinsonian syndrome.
Pregnancy and lactiation implications
Atropine, hyoscyamine, and scopolamine cross the placenta. Unknown whether belladonna is distributed into milk. Caution if used in nursing women.
Unlabeled use
Contraindications
Hypersensitivity to belladonna or any component of the formulation. Angle-closure glaucoma, elevated intraocular pressure. Obstructive gastrointestinal disease (e.g. pyloroduodenal stenosis, achalasia), paralytic ileus, intestinal atony (especially in geriatric or debilitated patients), hiatal hernia with reflux esophagitis, severe ulcerative colitis or toxic megacolon complicating ulcerative colitis. Significant hepatic disease. Acute hemorrhage when cardiovascular status is unstable. Tachycardia secondary to cardiac insufficiency or thyrotoxicosis. Obstructive uropathy (e.g. bladder neck obstruction secondary to prostatic hypertrophy). Myasthenia gravis (unless used to reduce adverse muscarinic effects of an anticholinesterase agent such as neostigmine). Pulmonary insufficiency.
Warnings and precautions
Exposure to high environmental temperatures may result in heat prostration. Incomplete intestinal obstruction may occur (caution in ileostomy or colostomy). Doses used to decrease gastric secretions are likely to cause dryness of the mouth (xerostomia) and interfere with visual accommodation, and possibly cause difficulty in urinating. Extreme caution in gastrointestinal infections because of decreased gastrointestinal motility and retention of causative organism and/or toxins. Extreme caution in mild to moderate ulcerative colitis because of suppressed intestinal motility and resultant paralytic ileus and toxic megacolon. Caution in gastric ulcer because of delayed gastric emptying and possible antral stasis. Caution in esophageal reflux and hiatal hernia because of decreased gastric motility and lower esophageal sphincter pressure. Extreme caution in partial obstructive uropathy because of decreased tone and amplitude of contractions of ureters and bladder. Caution with systemically-administered antimuscarinics in debilitated patients with chronic pulmonary disease. Down’s syndrome, spastic paralysis, and brain damage conditions increase sensitivity to antimuscarinic effects (e.g. mydriasis, positive chronotropic effect).