Generic Name: atropine and pralidoxime (AT roe peen and PRAL i DOX eem)
Brand Name: DuoDote
What is DuoDote (atropine and pralidoxime)?
Atropine blocks the action of chemical called acetylcholine (ah see til KO leen), which may exist in high levels in the body after a poisoning. Atropine also stimulates the heart and reduces the secretions of the nose, mouth, and lungs to improve breathing.
Pralidoxime reverses muscle weakness or paralysis caused by a poison or nerve agent.
The combination of atropine and pralidoxime is 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.
This medication 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.
What is the most important information I should know about DuoDote (atropine and pralidoxime)?
If possible, before you receive atropine and pralidoxime, tell your doctor if you have heart disease, coronary artery disease, a heart rhythm disorder, high blood pressure, narrow-angle glaucoma, kidney disease, enlarged prostate, urination problems, a breathing disorder such as asthma or COPD, if you are allergic to any medication, or if you have recently had a heart attack.
Also tell your doctor if you are pregnant or breast-feeding.
In an emergency situation it may not be possible before you are treated to tell your caregivers about your health conditions or if you are pregnant or breast-feeding. Make sure any doctor caring for you afterward knows that you have received this medication.
What should I discuss with my health care provider before receiving DuoDote (atropine and pralidoxime)?
If possible, before you receive atropine and pralidoxime, tell your doctor if you have:
an allergy to any medication;
heart disease, coronary artery disease;
high blood pressure;
asthma, COPD (chronic obstructive pulmonary disorder), bronchitis, emphysema, or other breathing problem;
a heart rhythm disorder;
an enlarged prostate or urination problems; or
if you have recently had a heart attack.
FDA pregnancy category C. It is not known whether atropine and pralidoxime will harm an unborn baby. Tell your doctor if you are pregnant.
Atropine and pralidoxime can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
In an emergency situation, it may not be possible before you are treated with atropine and pralidoxime 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 this medication.
How is DuoDote (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 while you are receiving this medication.
After treatment with atropine and pralidoxime, 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 given by a healthcare professional in an emergency setting, you are not likely to miss a dose.
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 DuoDote (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.
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
DuoDote (atropine and pralidoxime) side effects
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.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers at once if you have a serious side effect such as:
pounding heartbeats or fluttering in your chest;
painful or difficult urination;
feeling like you might pass out;
loss of movement in any part of your body;
slow heart rate, weak pulse, fainting, slow breathing (breathing may stop); or
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling.
Less serious side effects may include:
dry mouth, dry nose, dry skin;
dry eyes, blurred vision;
increased sensitivity of your eyes to light;
constipation, stomach pain, bloating, nausea, vomiting;
loss of interest in sex, impotence; or
mild skin rash.
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.
See also: Side effects (in more detail)
What other drugs will affect DuoDote (atropine and pralidoxime)?
If possible, before you receive this medication, tell your doctor about all other medicines you use, especially:
aminophylline (Phyllocontin, Truphylline);
morphine (Avinza, Kadian, MS Contin, Oramorph);
theophylline (Elixophyllin, Theo-24, Uniphyl);
a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton); or
a tranquilizer such as chlorpromazine (Thorazine), fluphenazine (Permitil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), or trifluperazine (Stelazine).
This list is not complete and other drugs may interact with atropine and pralidoxime. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Where can I get more information?
- Your doctor or pharmacist 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.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02.
Date modified: January 10, 2017
Last reviewed: December 15, 2010