belladonna and opium (B and O Suppositories) (cont.)

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PREPARATIONS: Belladonna/opium is available as rectal suppositories. Each package contains 12 suppositories. They are manufactured in two different strengths:

  • 16.2 mg of belladonna and 30 mg of opium in each suppository.
  • 16.2 mg of belladonna and 60 mg of opium in each suppository.

STORAGE: Store belladonna/opium suppositories at room temperature. Do not refrigerate the suppositories and protect them from moisture during storage.

PRESCRIBED FOR: Belladonna/opium suppositories are used for the relief of moderate to severe pain caused by bladder spasms when non-narcotic pain medications are not effective. They are also used to space intervals between opiate injections.

DOSING: Adults: Insert one suppository rectally once or twice daily. Not to exceed more than 4 suppositories per day or as directed by physician.

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.

Medically Reviewed by a Doctor on 7/21/2014

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