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ALIMENTARY TRACT AND METABOLISM › DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS › ANTISPASMODICS IN COMBINATION WITH PSYCHOLEPTICS › Belladonna and derivatives in combination with psycholeptics
belladonna total alkaloids and psycholeptics
A03CB02
Forms & Strengths
- Combination capsules containing belladonna alkaloids and psycholeptics (e.g., phenobarbital or benzodiazepines)
- Combination tablets
- Oral liquid formulations
Adult Dosing
- Typically 1 to 2 tablets or capsules orally 2 to 3 times daily before meals
- Dose adjusted based on individual patient response and tolerance to anticholinergic and sedative effects
Pediatric Dosing
- Safety and efficacy in pediatric patients not established; generally not recommended
- If used off-label in older children, dosing must be strictly calculated by body weight according to specific product guidelines
Indications
- Adjunctive treatment of functional gastrointestinal disorders characterized by hypermotility and spasm
- Management of irritable bowel syndrome (IBS) and peptic ulcer disease associated with anxiety or tension
Mechanism of Action
- Belladonna alkaloids competitively block muscarinic acetylcholine receptors, reducing smooth muscle tone and GI secretions
- Psycholeptic component (e.g., barbiturate) acts on the central nervous system to reduce anxiety and dampens autonomic visceral responses
Contraindications
- Glaucoma (narrow-angle)
- Obstructive uropathy (e.g., bladder neck obstruction due to prostatic hypertrophy)
- Obstructive disease of the gastrointestinal tract (achalasia, paralytic ileus, pyloroduodenal stenosis)
- Severe hepatic or renal impairment
- Myasthenia gravis
- Acute intermittent porphyria
- Known hypersensitivity to belladonna alkaloids or psycholeptics
Adverse Reactions
- Xerostomia (dry mouth)
- Blurred vision and mydriasis
- Constipation and urinary retention
- Tachycardia and palpitations
- Drowsiness, sedation, and dizziness from the psycholeptic component
- Reduced sweating leading to potential hyperthermia
Drug Interactions
- Additive anticholinergic effects with other antimuscarinics, antihistamines, tricyclic antidepressants, and antipsychotics
- Central nervous system depression enhanced when co-administered with alcohol, opioids, or other sedatives/hypnotics
- May alter absorption of other concurrently administered oral medications due to decreased GI motility and delayed gastric emptying
Curated Content: Needs Vetting Before Put to Clinical Use