Drug reference

Atropine sulfate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1426, 1427

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Bradycardia due to acute massive overdosage of beta- blockers ▶BY INTRAVENOUS INJECTION ▶Child: 40 micrograms/kg (max. per dose 3 mg) ▶Adult: 3 mg Treatment of poisoning by organophosphorus insecticide or nerve agent (in combination with pralidoxime chloride) ▶BY INTRAVENOUS INJECTION ▶Child: 20 micrograms/kg every 5–10 minutes (max. per dose 2 mg) until the skin becomes ﬂushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity of poisoning ▶Adult: 2 mg every 5–10 minutes until the skin becomes ﬂushed and dry, the pupils dilate, and bradycardia is abolished, frequency of administration dependent on the severity of poisoning Symptomatic relief of gastro-intestinal disorders characterised by smooth muscle spasm ▶BY MOUTH ▶Adult: 0.6–1.2 mg daily, dose to be taken at night Premedication ▶BY INTRAVENOUS INJECTION ▶Child 12–17 years: 300–600 micrograms, to be administered immediately before induction of anaesthesia ▶Adult: 300–600 micrograms, to be administered immediately before induction of anaesthesia ▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Child 12–17 years: 300–600 micrograms, to be administered 30–60 minutes before induction of anaesthesia ▶Adult: 300–600 micrograms, to be administered 30–60 minutes before induction of anaesthesia Intra-operative bradycardia ▶BY INTRAVENOUS INJECTION ▶Child 12–17 years: 300–600 micrograms, larger doses may be used in emergencies ▶Adult: 300–600 micrograms, larger doses may be used in emergencies Control of muscarinic side-effects of neostigmine in reversal of competitive neuromuscular block ▶BY INTRAVENOUS INJECTION ▶Child 12–17 years: 0.6–1.2 mg ▶Adult: 0.6–1.2 mg Excessive bradycardia associated with beta-blocker use ▶BY INTRAVENOUS INJECTION ▶Adult: 0.6–2.4 mg in divided doses (max. per dose 600 micrograms) Bradycardia following myocardial infarction (particularly if complicated by hypotension) ▶BY INTRAVENOUS INJECTION ▶Adult: 500 micrograms every 3–5 minutes; maximum 3 mg per course

PDF pages 1426, 1427

Exceptions To Legal Category

▶With intramuscular use or intravenous use or subcutaneous use Prescription only medicine restriction does not apply where administration is for saving life in emergency.

PDF page 1427

Safety

Important Safety Information

Antimuscarinic drugs used for premedication to general anaesthesia should only be administered by, or under the direct supervision of, personnel experienced in their use.

PDF page 1427

Interactions

→Appendix 1: atropine

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Side Effects

▶Common or very common ▶With intravenous use Abdominal distension. anhidrosis. anxiety. arrhythmias. bronchial secretion decreased. dysphagia. gastrointestinal disorders. hallucination. hyperthermia. movement disorders. mydriasis. speech disorder. taste loss. thirst ▶Uncommon ▶With intravenous use Psychotic disorder ▶Rare or very rare ▶With intravenous use Angina pectoris. hypertensive crisis. seizure ▶Frequency not known ▶With intravenous use Insomnia ▶With oral use Angle closure glaucoma. arrhythmias. bronchial secretion altered. chest pain. dysphagia. fever. gastrointestinal disorders. mydriasis. staggering. thirst

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Pregnancy

Not known to be harmful; manufacturer advises caution.

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Breast Feeding

May suppress lactation; small amount present in milk—manufacturer advises caution.

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Monitoring Requirements

▶Control of muscarinic side-effects of neostigmine in reversal of competitive neuromuscular block ▶With intravenous use Since atropine has a shorter duration of action than neostigmine, late unopposed bradycardia may result; close monitoring of the patient is necessary. l LESS SUITABLE FOR PRESCRIBING Atropine tablets less suitable for prescribing. Any clinical beneﬁt as a gastro- intestinal antispasmodic is outweighed by atropinic side- effects.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution, solution for injection, solution for infusion Tablet ▶Atropine sulfate (Non-proprietary) Atropine sulfate 600 microgram Atropine 600microgram tablets | 28 tablet P £52.92 DT = £52.92 Solution for injection ▶Atropine sulfate (Non-proprietary) Atropine sulfate 100 microgram per 1 ml Atropine 500micrograms/5ml solution for injection pre-filled syringes | 1 pre- filled disposable injection P £13.00 | 10 pre-filled disposable injection P £130.00 Atropine sulfate 200 microgram per 1 ml Atropine 1mg/5ml solution for injection pre-filled syringes | 1 pre-filled disposable injection P £13.00 | 10 pre-filled disposable injection P £130.00 Atropine sulfate 300 microgram per 1 ml Atropine 3mg/10ml solution for injection pre-filled syringes | 1 pre-filled disposable injection P £7.29–£13.00 DT = £7.29 | 10 pre-filled disposable injection P £130.00 Atropine sulfate 600 microgram per 1 ml Atropine 600micrograms/1ml solution for injection ampoules | 10 ampoule P £11.71 DT = £11.71 Anaesthesia Atropine sulfate 1 mg per 1 ml Atropine 1mg/1ml solution for injection ampoules | 10 ampoule P £109.35 DT = £109.35 eiiii F 820

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Dose text by age group

Child

40 micrograms/kg (max. per dose 3 mg)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

3 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child

20 micrograms/kg every 5–10 minutes (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

2 mg every 5–10 minutes until the skin becomes

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

0.6–1.2 mg daily, dose to be taken at night

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

300–600 micrograms, to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

300–600 micrograms, to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, larger doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

300–600 micrograms, larger doses may be used

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Child 12–17 years

0.6–1.2 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

0.6–1.2 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

0.6–2.4 mg in divided doses (max. per dose

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

500 micrograms every 3–5 minutes; maximum

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Atropine sulfate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1426, 1427

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 1426, 1427

Exceptions To Legal Category

▶With intramuscular use or intravenous use or subcutaneous use Prescription only medicine restriction does not apply where administration is for saving life in emergency.

PDF page 1427

Safety

Important Safety Information

Antimuscarinic drugs used for premedication to general anaesthesia should only be administered by, or under the direct supervision of, personnel experienced in their use.

PDF page 1427

Interactions

→Appendix 1: atropine

PDF page 1427

Side Effects

PDF page 1427

Pregnancy

Not known to be harmful; manufacturer advises caution.

PDF page 1427

Breast Feeding

May suppress lactation; small amount present in milk—manufacturer advises caution.

PDF page 1427

Monitoring Requirements

PDF page 1427

Dose and formulations

Medicinal Forms

PDF page 1427

Dose text by age group

Child

40 micrograms/kg (max. per dose 3 mg)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

3 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child

20 micrograms/kg every 5–10 minutes (max. per

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

2 mg every 5–10 minutes until the skin becomes

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

0.6–1.2 mg daily, dose to be taken at night

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

300–600 micrograms, to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Adult

300–600 micrograms, to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1426

Child 12–17 years

300–600 micrograms, larger doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

300–600 micrograms, larger doses may be used

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Child 12–17 years

0.6–1.2 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

0.6–1.2 mg

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

0.6–2.4 mg in divided doses (max. per dose

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Adult

500 micrograms every 3–5 minutes; maximum

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1427

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.