belladonna and opium (B and O Suppositories)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

woman with abdominal pain

Belladonna/opium suppositories are not recommended for use in children 12 years of age and younger.

DRUG INTERACTIONS: Alvimopan (Entereg) and belladonna/opium suppositories should not be used together. Alvimopan significantly increases belladonna and opium levels in the body; opioid medications must be stopped 7 days prior to starting Alvimopan.

Belladonna/opium suppositories should not be used with MAO inhibitors like phenelzine (Nardil), selegiline (Zelapar, Emsam, Eldepryl), and isocarboxazid (Marplan) as well as linezolid (Zyvox) antibiotic. Combining these drugs with belladonna/opium may lead to serious changes in blood pressure, fever, sleepiness, agitation, confusion and in severe cases, death. These medications have to be stopped or separated by 14 days before administering belladonna/opium suppositories.

Belladonna/opium suppositories should not be used with naltrexone (Revia) because naltrexone decreases levels and therapeutic effects of belladonna/opium, leading to treatment failure.

Belladonna/opium suppositories should be used with caution with other narcotic analgesics because of increased risks of dizziness, sedation, and respiratory depression.

Individuals should check with their physicians before using this suppository.

PREGNANCY: There are no adequate studies done on belladonna/opium suppositories to determine safe and effective use in pregnant women. They should be used only if clearly needed.

NURSING MOTHERS: Opium is converted to morphine. Morphine is excreted in breast milk, however, the American Academy of Pediatrics committee states that it is safe to use while nursing.

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