Dosing and uses of Belladonna and opium (B and O Suppositories)
Adult dosage forms and strengths
suppository: Schedule II
- 16.2mg/30mg
- 16.2mg/60mg
Ureteral Spasm Pain
Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
1 suppository PR qDay or q12hr
Not to exceed 4 doses/day
Pediatric dosage forms and strengths
suppository: Schedule II
- 16.2mg/30mg
- 16.2mg/60mg
Ureteral Spasm Pain
<12 years
- Not recommended
>12 years
- Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
- 1 suppository PR qDay or q12hr
- Not to exceed 4 doses/day
Geriatric dosage forms and strengths
Ureteral Spasm Pain
Indicated for severe pain associated with ureteral spasm unresponsive to nonnarcotic analgesics or to space intervals between opiate injections
1 suppository PR qDay or q12hr
Not to exceed 4 doses/day
Belladonna and opium (B and O Suppositories) adverse (side) effects
Frequency not defined
Pruritus
Urticaria
Nausea
Vomiting
Photophobia
Anticholinergic
- Dizziness
- Sedation
- Urticaria
- Constipation
- Dry mouth
- Blurred vision
- Urinary retention
Warnings
Contraindications
Hypersensitivity
Respiratory disease/depression, pseudomembranous colitis, severe hepatic dz, convulsive disorders, GI obstruction, myasthenia gravis, angle-closure glaucoma, obstructive uropathy, paralytic ileus, intestinal atony of elderly or debilitated pt, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis, toxic megacolon, tachycardia secondary to cardiac insufficiency or thyrotoxicosis
Cautions
Asthma, BPH, hepatic dz, history of opioid dependence, reflux esophagitis, hiatal hernia, mitral stenosis, pts who are concurrently on CNS depressant
Pregnancy and lactation
Pregnancy category: C
Lactation: excretion in milk unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Belladonna and opium (B and O Suppositories)
Mechanism of action
Opium: analgesic, antispasmodic, antimuscarinic; because of its morphine content, inhibits GI motility and propulsion, diminishes digestive secretion
Belladonna: anticholinergic alkaloids; competitively inhibit Ach actions at muscarinic receptors
Pharmacokinetics
Onset: Opium: 30 min, Belladonna: 1-2 hr
Metabolism: opium: extensively in liver, undergoes conjugation with glucuronic acid; belladonna: no data
Metabolites: opium: morphine-3-glucuronide, morphine-3-6-diglucuronide; belladonna: no data
Excretion: opium: mainly by kidney, little amount in bile; belladonna: urine
