Belladonna / Opium

Trade Names:
B & O Supprettes No. 15A
- Suppositories 16.2 mg powdered belladonna, 30 mg powdered opium

Trade Names:
B & O Supprettes No. 16A
- Suppositories 16.2 mg powdered belladonna, 60 mg powdered opium

Pharmacology

Contains more than a score of alkaloids, including morphine, narcotine, papaverine, and codeine, which act to relax smooth muscle, relieve pain, and cause sedation by depressant effect on cerebral cortex, hypothalamus, and medullary centers.

Indications and Usage

Relief of moderate to severe pain associated with ureteral spasm not responsive to nonnarcotic analgesics and to space intervals between injections of opiates.

Contraindications

Patients with glaucoma, severe hepatic, or renal disease; bronchial asthma; narcotic idiosyncrasies; respiratory depression; convulsive disorders; acute alcoholism; delirium tremens, premature labor; history of hypersensitivity to any component of product.

Dosage and Administration

Rectal 1 or 2 suppositories/day (max, 4 doses/day).

General Advice

• Do not remove suppository from foil pack until immediately prior to insertion.
• Moisten gloved finger and suppository with water before inserting.

Storage/Stability

Store suppositories in foil wrapping at controlled room temperature (59° to 86°F). Do not refrigerate.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Rapid pulse.

CNS

Drowsiness, dizziness.

Dermatologic

Pruritus, urticaria.

EENT

Blurred vision.

GI

Drug mouth; constipation, nausea, vomiting.

Genitourinary

Urinary retention.

Miscellaneous

Photophobia.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Not recommended for use in children.

Special Risk Patients

Use with caution in patients with known idiosyncrasy to atropine or atropine-like compounds, cardiac disease, incipient glaucoma, prostatic hypertrophy, increased intracranial pressure, toxic psychosis, myxedema, and elderly or debilitated patients.

Drug dependence

Has abuse potential and may cause true addiction.

Overdosage

Symptoms

Respiratory depression, pinpoint pupils, coma, hot, dry, flushed skin, dry mouth, and hyperpyrexia.

Patient Information

• Advise patient or caregiver to insert suppository every day to 4 times daily, or as directed by health care provider, as needed for symptoms of ureteral spasm.
• Teach patient or caregiver proper technique for inserting suppository: Use gloves; remove suppository from foil wrap just before insertion; moisten gloved finger and suppository with water; insert suppository rectally with patient lying on side with legs flexed; remove and discard gloves; wash hands.
• Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
• Instruct patient to discontinue use and report any intolerable adverse reactions to health care provider.
• Advise patient that if symptoms are not controlled not to increase the dose of medication but to inform health care provider.

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