Atropine Sulfate

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Side Effects & Adverse Reactions

This drug is effective in very low dosage and overdose may cause permanent damage or death, especially in children.

Doses of 0.5 to 1 mg of atropine are mildly stimulating to the central nervous system. Larger doses may produce mental disturbances; still larger doses are depressing. Death from atropine poisoning, though rare, is usually due to paralysis of the medullary centers.

Pregnancy Category B. Reproduction studies have been performed in mice in doses of 50 mg/kg of body weight and have revealed no evidence of impaired fertility or harm to the fetus due to Atropine Sulfate. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

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Legal Issues

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FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

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Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

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FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

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Uses

In the treatment of parkinsonism. Rigidity and tremor relieved by the apparently selective depressant action.
In the gastrointestinal tract to relieve pylorospasm, hypertonicity of the small intestine and the hypermotility of the colon.
To relieve hypertonicity of the uterine muscle.
To relax the spasm of biliary and uretered colic and bronchial spasm.
To diminish the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders.
To control the crying and laughing episodes in patients with brain lesions.
In cases of closed head injuries which cause acetylcholine to be released or to be present in cerebrospinal fluid which in turn causes abnormal EEG patterns, stupor and neurological signs.
In the management of peptic ulcer.
In anesthesia to control excessive salivation and bronchial secretions.
To control rhinorrhea of acute rhinitis or hay fever.
As an antidote for pilocarpine, physostigmine, isoflurophate, choline esters, certain species of Aminata and in cases of anticholinesterase insecticide poisoning.
In poisoning by the organic phosphate cholinesterase inhibitors found in certain insecticides and by chemical warfare “nerve gases”, large doses of atropine relieve the muscarine-like symptoms and some of the central-nervous-system manifestations. Adults suspected of contact with organic phosphorus insecticides of the parathion type should be given atropine sulfate, 0.8 mg, intramuscularly. If an atropine effect is not apparent within thirty minutes or if definite symptoms of the poisoning occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements, and excessive sweating, salivation, and bronchial secretion), atropine sulfate, 2 mg, should be given intramuscularly at hourly intervals until signs of atropinization are observed. Up to two or three times this dose (4 to 6 mg) may be required in severe cases. Removing contaminated clothing, washing the skin, and commencing artificial respiration and supportive therapy are also indicated.

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History

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Other Information

Atropine Sulfate Injection, USP is a sterile, isotonic solution of Atropine Sulfate in Water for Injection q.s. Sodium Chloride added for isotonicity. pH adjusted with Sulfuric Acid. Preservative free.

Atropine is a white crystalline alkaloid which may be extracted from belladonna root and hyoscyamine or may be produced synthetically. It is used in the form of atropine sulfate because this compound has much greater solubility in water. The structural formula of Atropine is as follows:

Sources

Atropine Sulfate Manufacturers

Remedyrepack Inc.

Atropine Sulfate | Remedyrepack Inc.

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:
7 - 16 pounds - 0.1 mg 17 - 24 pounds - 0.15 mg 24 - 40 pounds - 0.2 mg 40 - 65 pounds - 0.3 mg 65 - 90 pounds - 0.4 mg Over 90 pounds - 0.4 to 0.6 mg
As indicated previously, however, these doses may be considerably exceeded in certain cases.

Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit.

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:
7-16 pounds
0.1 mg
17-24 pounds
0.15 mg
24-40 pounds
0.2 mg
40-65 pounds
0.3 mg
65-90 pounds
0.4 mg
Over 90 pounds
0.4 to 0.6 mg
As indicated previously, however, these doses may be considerably exceeded in certain cases. Parenteral drug products should be inspected visually for particulate matter and discoloration,
whenever solution and container permit.

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:
7-16 pounds
0.1 mg
17-24 pounds
0.15 mg
24-40 pounds
0.2 mg
40-65 pounds
0.3 mg
65-90 pounds
0.4 mg
Over 90 pounds
0.4 to 0.6 m

As indicated previously, however, these doses may be considerably exceeded in certain cases. Parenteral drug products should be inspected visually for particulate matter and discoloration,
whenever solution and container permit.

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:

7 - 16 pounds - 0.1 mg
17 - 24 pounds - 0.15 mg
24 - 40 pounds - 0.2 mg
40 - 65 pounds - 0.3 mg
65 - 90 pounds - 0.4 mg
Over 90 pounds - 0.4 to 0.6 mg

As indicated previously, however, these doses may be considerably exceeded in certain cases. Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit.

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

Atropine Sulfate Injection, USP may be administered subcutaneously, ntramuscularly or intravenously. The average adult dose is 0.5 mg (5 mL of a 0.1 mg/mL solution), range 0.4 to 0.6 mg (4 to 6 mL). As an antisialogogue it is usually injected intramuscularly prior to induction of anesthesia. This produces only minimal blocking of vagal activity. In children, the dosage ranges from 0.1 mg in the newborn to 0.6 mg (6 mL of a 0.1 mg/mL solution) in a child age 12 years, injected subcutaneously 30 minutes before surgery. During surgery, the drug is given intravenously when reduction in pulse rate and cessation of cardiac action are due to increased vagal activity; however, if the anesthetic is cyclopropane, doses less than 0.4 mg should be used and should be given slowly to avoid the possible production of ventricular arrhythmia. Usual doses are used to reduce severe bradycardia and syncope associated with hyperactive carotid sinus reflex. For bradyarrhythmias the usual intravenous adult dosage ranges from 0.4 to 1 mg (4 to 10 mL of a 0.1 mg/mL solution) every one to two hours as needed; larger doses up to a maximum of 2 mg may be required. In children, intravenous dosage ranges from 0.01 to 0.03 mg per kg of body weight. Atropine is also a specific antidote for cardiovascular collapse resulting from injudicious
administration of choline ester. When cardiac arrest has occurred, external cardiac massage or other method of resuscitation is required to distribute the drug after intravenous injection. In anticholinesterase poisoning from exposure to insecticides, large doses of at least 2 to 3 mg (20 to 30 mL of a 0.1 mg/mL solution) should be administered parenterally and repeated until signs of atropine intoxication appear. In the ‘‘rapid’’ type of mushroom poisoning, atropine should be given in doses sufficient to control parasympathomimetic signs before coma and cardiovascular collapse supervene. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. (See PRECAUTIONS.)

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual dose of atropine sulfate is 0.4 to 0.6 mg. Suggested dosages for pediatric patients are as follows:
7-16 lbs
0.1 mg
17-24 lbs
0.15 mg
24-40 lbs.
0.2 mg
40-65 lbs.
0.3 mg
65-90 lbs.
0.4 mg
Over 90 lbs.
0.4 to 0.6 mg

Table of Dosage Equivalents Atropine sulfate Solution (mL required) mg required
1 mg per mL
0.4 mg per mL
1
1

0.80
0.80

0.60
0.60

0.50
0.50

0.40
0.40
1
0.30
0.30
0.75
0.25
0.25
0.63
0.20
0.20
0.50
0.18
0.18
0.45
0.15
0.15
0.38
0.12
0.12
0.30
0.10
0.10
0.25
These doses may be exceeded in certain cases.

The hypotonic radiography of the gastrointestinal tract, the usual adult dose is 1 mg intramuscularly.

Adults suspected of contact with organic phosphorous insecticides of the parathion type should be given atropine sulfate 0.8 mg intramuscularly. If an atropine effect is not apparent wihin 30 minutes or if definite symptoms of the poisoning occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements and excessive sweating, salivation and bronchial secretion), atropine sulfate 2 mg should be given intramuscularly at hourly intervals until signs of atropinization are observed. Up to 2 or 3 times of this dose (4 to 6 mg) may be required in severe cases.

Perenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

No Recall
Hospira, Inc.

Atropine Sulfate | Hospira, Inc.

Atropine Sulfate Injection, USP in the Ansyr Syringe is intended for intravenous use, but may be administered subcutaneously or intramuscularly. Its use usually requires titration, using heart rate, PR interval, blood pressure and/or patient’s symptoms as a guide for having reached an appropriate dose.

Adults

Initial single doses in adults vary from around 0.5 mg to 1 mg (5-10 mL of the 0.1 mg/mL solution for antisialagogue and other antivagal effects, to 2 to 3 mg (20-30 mL) of the 0.1 mg/mL solution) as an antidote for organophosporous or muscarinic mushroom poisoning. When used as an antidote, the 2 to 3 mg dose should be repeated no less often than every 20 to 30 minutes until the signs of poisoning are sufficiently lessened or signs of atropine poisoning (see ADVERSE REACTIONS and OVERDOSAGE) occur.

When the recurrent use of atropine is essential in patients with coronary artery disease, the total dose should be restricted to 2 to 3 mg (maximum 0.03 to 0.04 mg/kg) to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand. For patients with bradyasystolic cardiac arrest, a 1 mg dose of atropine is administered intravenously and is repeated every 3-5 minutes if asystole persists. Three milligrams (0.04 mg/kg) given I.V. is a fully vagolytic dose in most patients. The administration of this dose of atropine should be reserved for patients with bradyasystolic cardiac arrest. Administration of less than 0.5 mg can produce a paradoxical bradycardia because of the central or peripheral parasympathomimetic effects of low doses in adults.

Endotracheal administration of atropine can be used in patients without I.V. access. The recommended adult dose of atropine for endotracheal administration is 1 to 2 mg diluted to a total not to exceed 10 mL of sterile water or normal saline.

Titration intervals of one or two hours are recommended in circumstances that are not life-threatening.

Pediatrics

Dosing information in pediatric populations has not been well studied. Usage history of initial dose has been in the range of 0.01 to 0.03 mg/kg body weight.

Parenteral drug products should be inspected visually for particulate matter and/or discoloration prior to administration (see PRECAUTIONS).

No Recall
Sparhawk Laboratories, Inc.

Atropine Sulfate | Sparhawk Laboratories, Inc.

Cattle: 20 mg per 100 lbs. of body weight
Horses: 6.5 mg per 100 lbs. of body weight
Sheep: 20 mg per 100 lbs. of body weight

The recommended average initial dose should be split, injecting one quarter (1/4) to one-third (1/3) slowly I.V. and the remainder I.M. or S.C. After symptoms appear to be under control, repeated maintenance doses should be administered at 3 to 6 hour intervals based on the individual response of the animal.

No Recall
Sparhawk Laboratories, Inc

Atropine Sulfate | American Health Packaging

THE USUAL DOSAGE AND FREQUENCY OF ADMINISTRATION OF DOXYCYCLINE DIFFERS FROM THAT OF THE OTHER TETRACYCLINES. EXCEEDING THE RECOMMENDED DOSAGE MAY RESULT IN AN INCREASED INCIDENCE OF SIDE EFFECTS.

Adults: The usual dose of oral doxycycline is 200 mg on the first day of treatment (administered 100 mg every 12 hours or 50 mg every 6 hours) followed by a maintenance dose of 100 mg/day. The maintenance dose may be administered as a single dose or as 50 mg every 12 hours. In the management of more severe infections (particularly chronic infections of the urinary tract), 100 mg every 12 hours is recommended.

For pediatric patients above eight years of age: The recommended dosage schedule for pediatric patients weighing 100 pounds or less is 2 mg/lb of body weight divided into two doses on the first day of treatment, followed by 1 mg/lb of body weight given as a single daily dose or divided into two doses, on subsequent days. For more severe infections up to 2 mg/lb of body weight may be used. For pediatric patients over 100 pounds the usual adult dose should be used.

Uncomplicated gonococcal infections in adults (except anorectal infections in men): 100 mg, by mouth, twice a day for 7 days. As an alternate single visit dose, administer 300 mg stat followed in one hour by a second 300 mg dose.

Acute epididymo-orchitis caused by N. gonorrhoeae: 100 mg, by mouth, twice a day for at least 10 days.

Primary and secondary syphilis: 300 mg a day in divided doses for at least 10 days.

Uncomplicated urethral, endocervical, or rectal infection in adults caused by Chlamydia trachomatis: 100 mg, by mouth, twice a day for at least 7 days.

Nongonococcal urethritis caused by C. trachomatis and U. urealyticum: 100 mg, by mouth, twice a day for at least 7 days.

Acute epididymo-orchitis caused by C. trachomatis: 100 mg, by mouth, twice a day for at least 10 days.

Inhalational anthrax (post-exposure):

ADULTS: 100 mg of doxycycline, by mouth, twice a day for 60 days.

CHILDREN: weighing less than 100 pounds (45 kgs): 1mg/lb (2.2 mg/kg) of body weight, by mouth, twice a day for 60 days. Children weighing 100 pounds or more should receive the adult dose.

When used in streptococcal infections, therapy should be continued for 10 days.

Administration of adequate amounts of fluid along with capsule and tablet forms of drugs in the tetracycline class is recommended to wash down the drugs and reduce the risk of esophageal irritation and ulceration. (See ADVERSE REACTIONS.) If gastric irritation occurs, doxycycline may be given with food. Ingestion of a high fat meal has been shown to delay the time to peak plasma concentrations by an average of one hour and 20 minutes. However, in the same study, food enhanced the average peak concentration by 7.5% and the area under the curve by 5.7%.

No Recall
Alcon Laboratories, Inc.

Atropine Sulfate | Alcon Laboratories, Inc.

One drop topically in the eye(s) as required, with care to avoid overdosage. Discard unused portion. May be used during ocular surgery.

No Recall
American Regent, Inc.

Atropine Sulfate | American Regent, Inc.

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:
7 - 16 pounds - 0.1 mg 17 - 24 pounds - 0.15 mg 24 - 40 pounds - 0.2 mg 40 - 65 pounds - 0.3 mg 65 - 90 pounds - 0.4 mg Over 90 pounds - 0.4 to 0.6 mg
As indicated previously, however, these doses may be considerably exceeded in certain cases.

Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit.

No Recall
Falcon Laboratory Ltd

Atropine Sulfate | Falcon Laboratory Ltd

Adults: For uveitis, administer one or two drops topically to the eye(s) up to four times daily.

The lacrimal sac should be compressed by digital pressure for two to three minutes after instillation. Heavily pigmented irides may require larger doses.

No Recall
General Injectables & Vaccines, Inc.

Atropine Sulfate | General Injectables & Vaccines, Inc.

Atropine Sulfate Injection, USP may be administered subcutaneously, intramuscularly
or intravenously. The average adult dose is 0.5 mg (5 mL of a 0.1 mg/mL solution), range 0.4 to
0.6 mg (4 to 6 mL). As an antisialogogue it is usually injected intramuscularly prior to induction of
anesthesia. This produces only minimal blocking of vagal activity. In children, the dosage ranges
from 0.1 mg (2 mL of a 0.05 mg solution) in the newborn to 0.6 mg (6 mL of a 0.1 mg/mL
solution) in a child age 12 years, injected subcutaneously 30 minutes before surgery. During
surgery, the drug is given intravenously when reduction in pulse rate and cessation of cardiac action
are due to increased vagal activity; however, if the anesthetic is cyclopropane, doses less than
0.4 mg should be used and should be given slowly to avoid the possible production of ventricular
arrhythmia. Usual doses are used to reduce severe bradycardia and syncope associated with
hyperactive carotid sinus reflex. For bradyarrhythmias the usual intravenous adult dosage ranges
from 0.4 to 1 mg (4 to 10 mL of a 0.1 mg/mL solution) every one to two hours as needed; larger
doses up to a maximum of 2 mg may be required. In children, intravenous dosage ranges from
0.01 to 0.03 mg (0.2 to 0.6 mL of a 0.05 mg/mL solution) per kg of body weight. Atropine is also a
specific antidote for cardiovascular collapse resulting from injudicious administration of choline
ester. When cardiac arrest has occurred, external cardiac massage or other method of resuscitation
is required to distribute the drug after intravenous injection.
In anticholinesterase poisoning from exposure to insecticides, large doses of at least 2 to 3 mg
(20 to 30 mL of a 0.1 mg/mL solution) should be administered parenterally and repeated until signs
of atropine intoxication appear. In the “rapid” type of mushroom poisoning, atropine should be
given in doses sufficient to control parasympathomimetic signs before coma and cardiovascular
collapse supervene.
Parenteral drug products should be inspected visually for particulate matter and discoloration
prior to administration, whenever solution and container permit. See PRECAUTIONS.

No Recall
West-ward Pharmaceutical Corp.

Atropine Sulfate | West-ward Pharmaceutical Corp.

The usual dose of atropine sulfate is 0.4 to 0.6 mg. Suggested dosages for pediatric patients are as follows:
7 - 16 lbs. – 0.1 mg                               40 - 65 lbs. – 0.3 mg
17 - 24 lbs. – 0.15 mg                           65 - 90 lbs. – 0.4 mg
24 - 40 lbs. – 0.2 mg                             Over 90 lbs. – 0.4 to 0.6 mg
Table of Dosage Equivalents Atropine Sulfate Solution (mL required) mg required 1 mg per mL 0.4 mg per mL 1 1 0.80 0.80 0.60 0.60 0.50 0.50 0.40 0.40 1 0.30 0.30 0.75 0.25 0.25 0.63 0.20 0.20 0.50 0.18 0.18 0.45 0.15 0.15 0.38 0.12 0.12 0.30 0.10 0.10 0.25
These doses may be exceeded in certain cases.
For hypotonic radiography of the gastrointestinal tract, the usual adult dose is 1 mg intramuscularly.
Adults suspected of contact with organic phosporous insecticides of the parathion type should be given atropine sulfate 0.8 mg intramuscularly. If an atropine effect is not apparent within 30 minutes or if definite symptoms of the poisoning occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements and excessive sweating, salivation and bronchial secretion), atropine sulfate 2 mg should be given intramuscularly at hourly intervals until signs of atropinization are observed. Up to 2 or 3 times of this dose (4 to 6 mg) may be required in severe cases.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

No Recall
General Injectables & Vaccines, Inc.

Atropine Sulfate | General Injectables & Vaccines, Inc.

Atropine Sulfate Injection, USP in the Ansyr Syringe is intended for intravenous use, but may be administered subcutaneously or intramuscularly. Its use usually requires titration, using heart rate, PR interval, blood pressure and/or patient’s symptoms as a guide for having reached an appropriate dose.

Adults

Initial single doses in adults vary from around 0.5 mg to 1 mg (5-10 mL of the 0.1 mg/mL solution for antisialagogue and other antivagal effects, to 2 to 3 mg (20-30 mL) of the 0.1 mg/mL solution) as an antidote for organophosporous or muscarinic mushroom poisoning. When used as an antidote, the 2 to 3 mg dose should be repeated no less often than every 20 to 30 minutes until the signs of poisoning are sufficiently lessened or signs of atropine poisoning (see ADVERSE REACTIONS and OVERDOSAGE) occur.

When the recurrent use of atropine is essential in patients with coronary artery disease, the total dose should be restricted to 2 to 3 mg (maximum 0.03 to 0.04 mg/kg) to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand. For patients with bradyasystolic cardiac arrest, a 1 mg dose of atropine is administered intravenously and is repeated every 3-5 minutes if asystole persists. Three milligrams (0.04 mg/kg) given I.V. is a fully vagolytic dose in most patients. The administration of this dose of atropine should be reserved for patients with bradyasystolic cardiac arrest. Administration of less than 0.5 mg can produce a paradoxical bradycardia because of the central or peripheral parasympathomimetic effects of low doses in adults.

Endotracheal administration of atropine can be used in patients without I.V. access. The recommended adult dose of atropine for endotracheal administration is 1 to 2 mg diluted to a total not to exceed 10 mL of sterile water or normal saline.

Titration intervals of one or two hours are recommended in circumstances that are not life-threatening.

Pediatrics

Dosing information in pediatric populations has not been well studied. Usage history of initial dose has been in the range of 0.01 to 0.03 mg/kg body weight.

Parenteral drug products should be inspected visually for particulate matter and/or discoloration prior to administration (see PRECAUTIONS).

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual dose of atropine sulfate is 0.4 to 0.6 mg. Suggested dosages for pediatric patients are as follows:

7 - 16 lbs. - 0.1 mg
40 - 65 lbs. - 0.3 mg
17 - 24 lbs. - 0.15 mg
65 - 90 lbs. - 0.4 mg
24 - 40 lbs. - 0.2 mg
Over 90 lbs. - 0.4 to 0.6 mg
Table of Dosage Equivalents
Atropine Sulfate Solution (mL required)

mg required
1 mg per mL
0.4 mg per mL
1
1

0.80
0.80

0.60
0.60

0.50
0.50

0.40
0.40
1
0.30
0.30
0.75
0.25
0.25
0.63
0.20
0.20
0.50
0.18
0.18
0.45
0.15
0.15
0.38
0.12
0.12
0.30
0.10
0.10
0.25
These doses may be exceeded in certain cases.
For hypotonic radiography of the gastrointestinal tract, the usual adult dose is 1 mg intramuscularly.
Adults suspected of contact with organic phosphorous insecticides of the parathion type should be given atropine sulfate 0.8 mg intramuscularly. If an atropine effect is not apparent within 30 minutes or if definite symptoms of the poisoning occur (nausea, vomiting, diarrhea, pupillary constriction, pulmonary edema, fasciculations of eyelids and tongue, jerky ocular movements and excessive sweating, salivation and bronchial secretion), atropine sulfate 2 mg should be given intramuscularly at hourly intervals until signs of atropinization are observed. Up to 2 or 3 times of this dose (4 to 6 mg) may be required in severe cases.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

No Recall
International Medication Systems, Limited

Atropine Sulfate | Procter & Gamble Manufacturing Company

adults and children 2 yrs. & older: brush teeth thoroughly after meals or at least twice a day or use as directed by a dentist do not swallow to minimize swallowing use a pea-sized amount in children under 6 supervise children's brushing until good habits are established children under 2 yrs.: ask a dentist

No Recall
Amphastar Pharmaceuticals, Inc.

Atropine Sulfate | Amphastar Pharmaceuticals, Inc.

Usual adult dosage:
Antimuscarinic: Intramuscular, intravenous, or subcutaneous, 400 to 600 μg (0.4 to 0.6 mg) every four to six hours.
Arrhythmias: Intravenous, 400 μg (0.4 mg) to 1 mg every one to two hours as needed, up to a maximum of 2 mg.
Gastrointestinal radiography: Intramuscular, 1 mg.
Preanesthesia (antisialagogue): Intramuscular, 200 to 600 μg (0.2 to 0.6 mg) one-half to one hour before surgery.
Cholinergic adjunct (curariform block): Intravenous, 600 μg (0.6 mg) to 1.2 mg administered a few minutes before or concurrently with 500 μg (0.5 mg) to 2 mg of neostigmine methylsulfate, using separate syringes.
Antidote (to cholinesterase inhibitors): Intravenous, 2 to 4 mg initially, then 2 mg repeated every five to ten minutes until muscarinic symptoms disappear or signs of atropine toxicity appear.
Antidote (to muscarine in mushroom poisoning): Intramuscular or intravenous, 1 to 2 mg every hour until respiratory effects subside.
Antidote (to organophosphate pesticides): Intramuscular or intravenous 1 to 2 mg, repeated in twenty to thirty minutes as soon as cyanosis has cleared. Continue dosage until definite improvement occurs and is maintained, sometimes for two days or more.
Usual pediatric dosage
Antimuscarinic: Subcutaneous, 10 μg (0.01 mg) per kg of body weight, not to exceed 400 μg (0.4 mg), or 300 μg (0.3 mg) per square meter of body surface, every four to six hours.
    Arrhythmias: Intravenous, 10 to 30 μg (0.01 to 0.03 mg) per kg of body weight.
    Preanesthesia (antisialagogue): or
Preanesthesia (antiarrhythmic): Subcutaneous–
    Children weighing up to 3 kg: 100 μg (0.1 mg).
    Children weighing 7 to 9 kg: 200 μg (0.2 mg).
    Children weighing 12 to 16 kg: 300 μg (0.3 mg).
    Children weighing 20 to 27 kg: 400 μg (0.4 mg).
    Children weighing 32 kg: 500 μg (0.5 mg).
    Children weighing 41 kg; 600 μg (0.6 mg).
Antidote (to cholinesterase inhibitors): Intravenous or intramuscular, 1 mg initially, then 0.5 to 1 mg every five to ten minutes until muscarinic symptoms disappear or signs of atropine toxicity appear.

NOTE: Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

No Recall
Hospira, Inc.

Atropine Sulfate | Hospira, Inc.

Atropine Sulfate Injection, USP may be administered subcutaneously, intramuscularly or intravenously. The average adult dose is 0.5 mg (5 mL of a 0.1 mg/mL solution), range 0.4 to 0.6 mg (4 to 6 mL). As an antisialogogue it is usually injected intramuscularly prior to induction of anesthesia. This produces only minimal blocking of vagal activity. In children, the dosage ranges from 0.1 mg in the newborn to 0.6 mg (6 mL of a 0.1 mg/mL solution) in a child age 12 years, injected subcutaneously 30 minutes before surgery. During surgery, the drug is given intravenously when reduction in pulse rate and cessation of cardiac action are due to increased vagal activity; however, if the anesthetic is cyclopropane, doses less than 0.4 mg should be used and should be given slowly to avoid the possible production of ventricular arrhythmia. Usual doses are used to reduce severe bradycardia and syncope associated with hyperactive carotid sinus reflex. For bradyarrhythmias the usual intravenous adult dosage ranges from 0.4 to 1 mg (4 to 10 mL of a 0.1 mg/mL solution) every one to two hours as needed; larger doses up to a maximum of 2 mg may be required. In children, intravenous dosage ranges from 0.01 to 0.03 mg per kg of body weight. Atropine is also a specific antidote for cardiovascular collapse resulting from injudicious administration of choline ester. When cardiac arrest has occurred, external cardiac massage or other method of resuscitation is required to distribute the drug after intravenous injection.

In anticholinesterase poisoning from exposure to insecticides, large doses of at least 2 to 3 mg (20 to 30 mL of a 0.1 mg/mL solution) should be administered parenterally and repeated until signs of atropine intoxication appear. In the “rapid” type of mushroom poisoning, atropine should be given in doses sufficient to control parasympathomimetic signs before coma and cardiovascular collapse supervene.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. (See PRECAUTIONS.)

No Recall
Cardinal Health

Atropine Sulfate | Cardinal Health

Atropine Sulfate Injection, USP may be administered subcutaneously, intramuscularly or intravenously. The average adult dose is 0.5 mg (5 mL of a 0.1 mg/mL solution), range 0.4 to 0.6 mg (4 to 6 mL). As an antisialogogue it is usually injected intramuscularly prior to induction of anesthesia. This produces only minimal blocking of vagal activity. In children, the dosage ranges from 0.1 mg in the newborn to 0.6 mg (6 mL of a 0.1 mg/mL solution) in a child age 12 years, injected subcutaneously 30 minutes before surgery. During surgery, the drug is given intravenously when reduction in pulse rate and cessation of cardiac action are due to increased vagal activity; however, if the anesthetic is cyclopropane, doses less than 0.4 mg should be used and should be given slowly to avoid the possible production of ventricular arrhythmia. Usual doses are used to reduce severe bradycardia and syncope associated with hyperactive carotid sinus reflex. For bradyarrhythmias the usual intravenous adult dosage ranges from 0.4 to 1 mg (4 to 10 mL of a 0.1 mg/mL solution) every one to two hours as needed; larger doses up to a maximum of 2 mg may be required. In children, intravenous dosage ranges from 0.01 to 0.03 mg per kg of body weight. Atropine is also a specific antidote for cardiovascular collapse resulting from injudicious administration of choline ester. When cardiac arrest has occurred, external cardiac massage or other method of resuscitation is required to distribute the drug after intravenous injection.

In anticholinesterase poisoning from exposure to insecticides, large doses of at least 2 to 3 mg (20 to 30 mL of a 0.1 mg/mL solution) should be administered parenterally and repeated until signs of atropine intoxication appear. In the “rapid” type of mushroom poisoning, atropine should be given in doses sufficient to control parasympathomimetic signs before coma and cardiovascular collapse supervene.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. (See PRECAUTIONS.)

No Recall
General Injectables & Vaccines, Inc

Atropine Sulfate | General Injectables & Vaccines, Inc

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:

7 - 16 pounds     -     0.1 mg

17 - 24 pounds   -     0.15 mg

24 - 40 pounds   -     0.2 mg

40 - 65 pounds   -     0.3 mg

65 - 90 pounds   -     0.4 mg

Over 90 pounds -     0.4 to 0.6 mg

As indicated previously, however, these doses may be considerably exceeded in certain cases.

Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit.

No Recall
Remedyrepack Inc.

Atropine Sulfate | Remedyrepack Inc.

Atropine Sulfate Injection, USP in the Ansyr Syringe is intended for intravenous use, but may be administered subcutaneously or intramuscularly. Its use usually requires titration, using heart rate, PR interval, blood pressure and/or patient’s symptoms as a guide for having reached an appropriate dose.

Adults

Initial single doses in adults vary from around 0.5 mg to 1 mg (5-10 mL of the 0.1 mg/mL solution for antisialagogue and other antivagal effects, to 2 to 3 mg (20-30 mL) of the 0.1 mg/mL solution) as an antidote for organophosporous or muscarinic mushroom poisoning. When used as an antidote, the 2 to 3 mg dose should be repeated no less often than every 20 to 30 minutes until the signs of poisoning are sufficiently lessened or signs of atropine poisoning (see ADVERSE REACTIONS and OVERDOSAGE) occur.

When the recurrent use of atropine is essential in patients with coronary artery disease, the total dose should be restricted to 2 to 3 mg (maximum 0.03 to 0.04 mg/kg) to avoid the detrimental effects of atropine-induced tachycardia on myocardial oxygen demand. For patients with bradyasystolic cardiac arrest, a 1 mg dose of atropine is administered intravenously and is repeated every 3-5 minutes if asystole persists. Three milligrams (0.04 mg/kg) given I.V. is a fully vagolytic dose in most patients. The administration of this dose of atropine should be reserved for patients with bradyasystolic cardiac arrest. Administration of less than 0.5 mg can produce a paradoxical bradycardia because of the central or peripheral parasympathomimetic effects of low doses in adults.

Endotracheal administration of atropine can be used in patients without I.V. access. The recommended adult dose of atropine for endotracheal administration is 1 to 2 mg diluted to a total not to exceed 10 mL of sterile water or normal saline.

Titration intervals of one or two hours are recommended in circumstances that are not life-threatening.

Pediatrics

Dosing information in pediatric populations has not been well studied. Usage history of initial dose has been in the range of 0.01 to 0.03 mg/kg body weight.

Parenteral drug products should be inspected visually for particulate matter and/or discoloration prior to administration (see PRECAUTIONS).

No Recall
Cardinal Health

Atropine Sulfate | Cardinal Health

The usual adult dose of atropine is 0.4 to 0.6 mg. Suggested doses for children are as follows:

7-16 pounds

0.1 mg

17-24 pounds

0.15 mg

24-40 pounds

0.2 mg

40-65 pounds

0.3 mg

65-90 pounds

0.4 mg

Over 90 pounds

0.4 to 0.6 mg

As indicated previously, however, these doses may be considerably exceeded in certain cases. Parenteral drug products should be inspected visually for particulate matter and discoloration,
whenever solution and container permit.

No Recall
Med-pharmex, Inc

Atropine Sulfate | Med-pharmex, Inc

DOSAGE AND ADMINISTRATION:
Dogs and Cats: Inject 1 mL for each 20 lbs. of body weight as a pre-anesthetic adjuvant, or to reduce salivation, bronchial secretions, or internal peristalsis associated with colic or diarrhea.

As an antidote for parasympathomimetic drugs, 1 mL for each 7.5 lbs. of body weight. It is suggested that 1/4 of the dosage be injected intravenous and the remainder intramuscular or subcutaneous.

No Recall