This medication is used to treat nerve agent poisoning by certain chemicals known as anticholinesterase agents (e.g., carbamate/organophosphate insecticides such as parathion, "nerve gas" such as sarin, other nerve agents such as VX). Pralidoxime is used with atropine for certain organophosphate poisonings but not carbamate poisonings. Atropine works by blocking the activity of a certain natural substance (acetylcholine) that is increased in poisoning. Symptoms of nerve agent/insecticide poisoning may include trouble breathing, headache, runny nose, drooling, vision changes, sweating, abdominal cramps, nausea, vomiting, diarrhea, muscle twitching/jerking, drowsiness, confusion, and seizures.

Atropine treats symptoms of poisoning such as wheezing, increased sweating/saliva, abdominal cramps, vomiting, and diarrhea. Another drug (pralidoxime) works mostly on the muscles (including breathing muscles) to decrease twitching, cramping, weakness, and paralysis in organophosphate poisoning.

Talk with your doctor about when you should use this product. Know the symptoms of nerve agent poisoning. (See also Uses section.)

Learn how to properly inject this medication in advance so you will be prepared when you actually need to use it. Also teach another person what to do in case you cannot inject the medication yourself. When treating another person, use their auto-injector if possible. Try to avoid using your own injectors on someone else so that you have an antidote available if needed for self-aid.

This medication is given by injection into the muscle of the outer thigh, through clothing if necessary, as soon as possible after exposure. Hold the injector firmly in place for 10 seconds. Massage the area of injection.

To prevent further exposure to poison, leave the contaminated area. The victim (and any others who treat or have contact with the victim) must immediately put on protective equipment (e.g., breathing mask, protective clothing) and perform rapid decontamination procedures (e.g., removing contaminated clothing, washing skin and hair with sodium bicarbonate or alcohol).

Give atropine as soon as you notice symptoms of poisoning (e.g., severely watering eyes, drooling, difficulty breathing, muscle spasms). If needed, another drug (pralidoxime) may be injected after the atropine. For mild symptoms (watering eyes, increased saliva, wheezing, mild muscle twitching), use 1 injection. If severe symptoms of poisoning are still present 10 minutes after the first injection, give 2 more doses of atropine in a row into the muscle of the outer thigh or buttock. You should give only the first dose to yourself. Try to find someone else to give you any further injections. If the victim is unconscious or symptoms are severe (e.g., strange/confused behavior, severe difficulty breathing, seizures, loss of bladder or bowel control), and no atropine has been given, give 3 injections in a row into the muscle of the outer thigh or buttock.

After using this medication, seek immediate medical attention for follow-up treatment. Do not give more than 3 injections unless directed by a doctor.

Dosage of atropine is based on your age, weight, medical condition, and poisoning symptoms. Check the dose of your auto-injector to make sure it is the right dose for you. Auto-injectors are color-coded for dose.

From time to time, check this product visually for particles or discoloration. If either is present, do not use the liquid. Obtain a new injector.

Dizziness, drowsiness, or pain at the injection site may occur. Normal effects from atropine include flushing, fever, large pupils, fast heartbeat, and dryness of the mouth and nose. If any of these effects persist or worsen, tell your doctor, pharmacist, or other medical professional promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the life-saving benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

If atropine is given without exposure to poison, serious side effects may occur. These effects are very similar to the effects of poisoning. Seek immediate medical attention if any of the following symptoms occur: chest pain, confusion/hallucinations, inability to walk, severe vision problems.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), worsening dizziness, worsening trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Severe nerve agent poisoning is life-threatening and requires quick treatment. Treatment of severe poisoning should not be delayed. Discuss your medical history with your doctor before treatment is needed. Be sure you understand when to self-treat, what dose to use, and how many doses to give.

Before using atropine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Before you need to use this medication, tell your doctor or pharmacist your medical history, especially of: a certain eye condition (narrow-angle glaucoma), blockage in the stomach/intestines (pyloric stenosis), heart problems (e.g., recent heart attack, irregular heartbeat), kidney disease, prostate problems (prostatic hypertrophy).

This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.

This medication can decrease sweating. To prevent heatstroke, avoid becoming overheated in hot weather, saunas, or during exercise/other strenuous activities.

Caution is advised when using this drug in children because they may be more sensitive to the effects of the drug. Dosage is based on weight in children.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug may pass into breast milk. Consult your doctor before breast-feeding.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Tell your doctor that you have been given this medication. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Do not use the following drugs in patients who have been poisoned with an organophosphate/carbamate nerve agent/insecticide: morphine, aminophylline/theophylline, succinylcholine, reserpine, phenothiazines (e.g., chlorpromazine, prochlorperazine).

Nerve agents may increase the effect of the following medications: barbiturates (e.g., phenobarbital).

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, or if this drug is injected accidentally without exposure to a nerve agent, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. In people with overdose and people not exposed to poison, symptoms of overdose may include: restlessness, shakiness (tremor), difficulty walking, confusion, hallucinations.

After first-aid treatment and decontamination, additional treatment in a hospital is usually needed. Consult your doctor for more details.

Not applicable.

Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not freeze. Do not store in the bathroom. Keep all medicines away from children and pets.

From time to time, check the expiration date, and also check this product visually for particles or discoloration. Replace the unit before it expires or if particles/discoloration are present.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this medication when it is expired, used, or no longer needed. Consult your pharmacist or local waste disposal provider for more details about how to safely discard your medication.

Information last revised July 2009 Copyright(c) 2009 First DataBank, Inc.