Side Effects of Donnatal (belladonna/phenobarbital)

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Donnatal (belladonna/phenobarbital) is a combination of naturally occurring belladonna alkaloids and a barbiturate used to treat abdominal pain, bloating and cramps in patients with irritable bowel syndrome.

Donnatal is also used in patients with acute inflammation of the stomach and intestines (gastroenteritis) to reduce pain and diarrhea.

It is used occasionally as additional therapy in patients with duodenal ulcer. Belladonna alkaloids block the action of acetylcholine, a chemical that nerves to use to communicate with other nerves and muscles.

Acetylcholine stimulates the muscles of the intestines that propels digesting food through the intestine. It also affects the secretion of fluids by salivary glands and the stomach.

By blocking acetylcholine, belladonna alkaloids relax intestinal muscles, slow passage of digesting food through the intestines, and reduce gastric secretion. Phenobarbital produces sedation. 

Common side effects of Donnatal include

Serious side effects of Donnatal include

Patients with an unstable cardiac status, severe ulcerative colitis and acute intermittent porphyria should avoid Donnatal. Elderly patients may experience confusion, depression, and excitement even from small doses.

Drug interactions of Donnatal include voriconazole, bocepravir, ranolazine, and protease inhibitors, because phenobarbital reduces the blood levels of these drugs by increasing their breakdown in the body.

Donnatal should not be combined with potassium tablets because Donnatal slows the passage of potassium tablets through the gastrointestinal tract, leading to potassium-induced ulcers and high potassium levels in the blood.

Use of Donnatal during pregnancy has not been adequately evaluated. Pregnant women should use Donnatal only when the expected benefit outweighs the potential but unknown risks.

Donnatal is secreted in breast milk and may also reduce milk production. Consult your doctor before breastfeeding.

What are the important side effects of Donnatal (belladonna/phenobarbital)?

Adverse reactions include:

Caution is advised in patients with glaucoma, myasthenia gravis, and urinary obstruction since symptoms of these conditions may worsen with the use of belladonna/phenobarbital.

Patients with an unstable cardiac status, severe ulcerative colitis and acute intermittent porphyria should avoid belladonna/phenobarbital. Elderly patients may experience confusion, depression, and excitement even from small doses.

Donnatal (belladonna/phenobarbital) side effects list for healthcare professionals

Adverse reactions may include

Elderly patients may react with symptoms of excitement, agitation, drowsiness, and other untoward manifestations to even small doses of the drug.

Phenobarbital may produce excitement in some patients, rather than a sedative effect. In patients habituated to barbiturates, abrupt withdrawal may produce delirium or convulsions.

What drugs interact with Donnatal (belladonna/phenobarbital)?

No information provided.

Summary

Donnatal (belladonna/phenobarbital) is a combination of naturally occurring belladonna alkaloids and a barbiturate used to treat abdominal pain, bloating and cramps in patients with irritable bowel syndrome. Common side effects of Donnatal include constipation, dry eyes, dry mouth, urinary hesitancy and retention (particularly in men), blurred vision, rapid heart rate, palpitations, headache, nervousness, drowsiness, and dizziness. Use of Donnatal during pregnancy has not been adequately evaluated. Donnatal is secreted in breast milk and may also reduce milk production.

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Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.