belladonna and opium

Belladonna/opium is a man-made narcotic analgesic and anti-spasmodic combination medication. Belladonna and opium suppositories are used for relief of moderate to severe pain associated with ureteral spasm not responsive to non-narcotic analgesics and to space intervals between injections of opiates.

Is belladonna and opium available as a generic drug?

Yes

Side effects of belladonna/opium are:

• drowsiness,
• dizziness,
• blurred vision,
• dry mouth,
• urine retention,
• nausea,
• vomiting,
• constipation,
• itching, and
• hives.

Belladonna/opium suppositories can be habit forming and has abuse potential because of its opium content.

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.

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.

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.

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.

What preparations of belladonna and opium are available?

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.

How should I keep belladonna and opium stored?

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

How does belladonna and opium work?

Belladonna/opium is a man-made narcotic analgesic and anti-spasmodic combination medication. Belladonna relaxes smooth muscles and stops muscle spasms. Opium is converted to morphine which is an opioid pain reliever. Opioids can reduce gastrointestinal motility, propulsion, secretions, and increase gastrointestinal muscle tone. Opioids also stimulate receptors on nerves in the brain to increase the threshold to pain (increasing the amount of stimulation it takes to feel pain) and reduce the perception of pain (the perceived importance of the pain). These effects help in controlling pain and relieving spasms, especially bladder spasms. Belladonna/opium is a controlled substance.