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Atropine and pralidoxime

Generic name: atropine and pralidoxime [ AT-roe-peen-and-PRAL-i-DOX-eem ]
Brand names: ATNAA, DuoDote
Dosage form: intramuscular solution (2.1 mg/0.7 mL-600 mg/2 mL)
Drug class: Antidotes

Medically reviewed by on Jul 19, 2022. Written by Cerner Multum.

What is atropine and pralidoxime?

Atropine and pralidoxime is a combination medicine used as an antidote to treat poisoning by a pesticide (insect spray) or a chemical that interferes with the central nervous system, such as nerve gas.

atropine and pralidoxime is not effective as an antidote for all types of pesticide poisonings. You may need medications or additional treatments.

Atropine and pralidoxime may also be used for purposes not listed in this medication guide.


In an emergency, you may not be able to tell caregivers about your health conditions. Make sure any doctor caring for you afterward knows you received this medicine.

Before taking this medicine

If possible, before you receive atropine and pralidoxime, tell your doctor if you have ever had:

In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received atropine and pralidoxime.

How is atropine and pralidoxime given?

Atropine and pralidoxime is injected into a muscle in your upper thigh. A healthcare provider will give you this injection.

Atropine and pralidoxime is usually given as soon as possible after the onset of poisoning symptoms. If you still have symptoms after 10 to 15 minutes, you will receive 2 more injections.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely.

You may be watched for up to 72 hours to make sure the medicine has been effective and you no longer have any effects of the poison.

What happens if I miss a dose?

Since atropine and pralidoxime is used when needed, it does not have a daily dosing schedule.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Overdose may occur if you receive atropine and pralidoxime but you have not actually been exposed to the specific poisons this medication is designed to treat. Symptoms may include vision problems, feeling unsteady, loss of balance or coordination, trouble concentrating, fast heart rate, confusion, hallucinations (seeing or hearing things), decreased sweating, hot and dry skin, fainting, weak or shallow breathing, or breathing that stops.

What should I avoid after receiving atropine and pralidoxime?

Avoid becoming overheated or dehydrated during exercise and in hot weather. Atropine can decrease sweating and you may be more prone to heat stroke for a short time after receiving this medication.

Atropine and pralidoxime side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some of the side effects of atropine and pralidoxime may be similar to the symptoms of poisoning. Your caregivers will watch you closely to determine whether your body is responding well to the medication, or if you are having any serious side effects.

Tell your caregivers right away if you have:

  • pounding heartbeats or fluttering in your chest;

  • chest pain spreading to your jaw or shoulder;

  • trouble swallowing;

  • painful or difficult urination;

  • little or no urination;

  • unusual changes in mood or behavior; or

  • blurred vision, tunnel vision, eye pain, or seeing halos around lights.

Side effects may be more likely in older adults.

Common side effects of atropine and pralidoxime may include:

  • trouble breathing;

  • dry mouth;

  • dry eyes, vision changes, increased sensitivity to light;

  • nausea, vomiting;

  • fast heartbeats, increased blood pressure;

  • behavior changes, feeling excited or confused;

  • decreased urination;

  • headache, dizziness, drowsiness;

  • muscle weakness;

  • dry skin, rash; or

  • abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect atropine and pralidoxime?

Other drugs may affect atropine and pralidoxime, including prescription and over-the-counter medicines, vitamins, and herbal products. If possible, before you receive atropine and pralidoxime, tell your doctor about all your current medicines.

Further information

  • Your doctor can provide more information about atropine and pralidoxime.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.