Classifications: autonomic nervous system agent; anticholinergic (parasympatholytic); antimuscarinic, antispasmodic
Prototype: Atropine
Pregnancy Category: C


27–33 mg/100 mL tincture


Reversibly blocks action of acetylcholine at parasympathetic neuroeffector sites.

Therapeutic Effects

Belladonna inhibits smooth muscle contractions and suppresses secretions of secretory glands.


Adjunct in treatment of peptic ulcer disease, irritable bowel syndrome, and neurogenic bowel disturbances. Also has been used for dysmenorrhea, nocturnal enuresis, spasms of urinary tract, nausea and vomiting of pregnancy, vertigo, and for symptomatic relief of parkinsonism.


Hypersensitivity to anticholinergic drugs; obstructive uropathy, atony of urinary bladder; esophageal reflux, obstructive disease of GI tract, intestinal atony, paralytic ileus, severe ulcerative colitis, toxic megacolon; myasthenia gravis; narrow-angle glaucoma; unstable cardiovascular status in acute hemorrhages. Safety during pregnancy (category C), lactation, or in children is not established.

Cautious Use

Autonomic neuropathy; heart disease, hypertension; patients >40 y (higher incidence of glaucoma).

Route & Dosage

Adult: PO 0.6–1 mL t.i.d. or q.i.d.
Child: PO 0.1 mL/kg/d in 3–4 divided doses (max: 3.5 mL/d)



Adverse Effects (1%)

All: Dose related. CNS: Excitement (young children and the older adults), confusion, delirium. CV: Rapid heart beat, tachycardia, palpitation. Special Senses: Blurred vision, mydriasis, photophobia. GI: Dry mouth, constipation. Urogenital: Urinary retention, urgency.


Drug: Amantadine, antihistamines, tricyclic antidepressants, quinidine, disopyramide, procainamide have additive anticholinergic effects; levodopa effects decreased; methotrimeprazine may precipitate extrapyramidal effects; antipsychotic effects of phenothiazines decreased (decreased absorption).


Absorption: Readily absorbed from GI tract. Onset: 1–2 h. Distribution: Well distributed in body; crosses blood brain barrier. Elimination: Excreted unchanged in urine.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug