Atropine ophthalmic Side Effects

Not all side effects for atropine ophthalmic may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to atropine ophthalmic: ophthalmic ointment, ophthalmic solution

Side effects include:

Elevated IOP. With prolonged administration, local irritation, hyperemia, edema, exudate, follicular conjunctivitis, dermatitis.

For Healthcare Professionals

Applies to atropine ophthalmic: ophthalmic ointment, ophthalmic solution


Atropine toxicity (anticholinergic side effects) may occur after ocular administration and often presents as fever, agitation, and dry skin/mucous membranes.


Cardiovascular side effects have included flushing, hypotension, tachycardia, arrhythmias, atrial fibrillation, supraventricular tachycardia, coma, and death after ocular atropine.

Nervous system

If delirium due to atropine develops and there are no contraindications, many experts recommend the use of 2 mg of physostigmine IM or IV once or twice (as needed) as an effective antidote. Repeated doses may be necessary. Diazepam has been useful for the treatment of convulsions secondary to atropine poisoning.

Nervous system side effects have included lethargy and somnolence. Systemic atropine toxicity may result in hallucinosis, loss of neuromuscular coordination, seizures, and agitation. The elderly and very young appear to be more prone to the anticholinergic effects of atropine on the CNS.


Ocular side effects have included inhibition of the iris sphincter muscle (resulting in mydriasis), blurry vision, inhibition of the ciliary muscle (which can interfere with near vision in up to 23% of patients), increased intraocular pressure and precipitation of acute narrow angle glaucoma. Prolonged use may result in local irritation (follicular conjunctivitis, vascular congestion, edema, exudate, and eczematoid dermatitis),


Gastrointestinal side effects have included abdominal distention (in infants), decreased gastrointestinal motility, and salivation.


Hypersensitivity reactions have rarely included systemic reactions, manifested by urticaria, eczema, papillary hyperplasia, mucopurulent discharge, eosinophilia, pruritus, edema, hypotension, abdominal pain, tachypnea, nausea and vomiting. Contact dermatitis has rarely been associated with atropine ophthalmic preparations.


Respiratory side effects associated with severe reactions have included progressive respiratory depression.


Dermatologic side effects have included rash (a possible sign of atropine toxicity).

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