Belladonna

Belladonna/Drug Interactions:

  • AlcoholAlcohol: Concomitant use of alcohol with belladonna may theoretically result in additive CNS depression.
  • Alkaloid agentsAlkaloid agents: Doses of belladonna are generally calculated by milligrams of total alkaloids. Atropa belladonna contains up to 20 different tropane alkaloid compounds (17). Concomitant use of belladonna with other alkaloid agents, such as hyoscyamine, apoatropine, 3?-phenylacetoxytropane, cuscohygrine, and scopolamine, may result in additive effects.
  • AntiandrogensAntiandrogens: Based on secondary reports, belladonna may interact with antiandrogens.
  • Antiarrhythmic agentsAntiarrhythmic agents: Administering belladonna with procainamide may result in additive anti-vagal effects on atrioventricular nodal conduction.
  • AnticholinergicsAnticholinergics: Numerous drugs and drug classes may interact with anticholinergic agents. Belladonna taken with other anticholinergics may cause additive anticholinergic effects including severe dry mouth, decreased urination, blurred vision, excessive sedation, and constipation. Examples include: acetophenenazine, amantadine, amitriptyline, atropine, benztropine, bethanechol, biperiden, brompheniramine, carbinoxamine, chlorpromazine, clemastine, clindinium, clozapine, cyclopentolate, cyproheptadine, dicyclomine, diphenhydramine, dixyrazine, ethopropazine, fenotherol, fluphenazine, haloperidol, homatropine, hyosciamine, ipratropium, loxapine, mesoridazine, methdilazine, methotrimeprazine, olanzapine, oxybutynin, perazine, periciazine, perphenazine, pimozide, pipotiazine, prochlorperazine, procyclidine, promazine, promethazine, propiomazine, quinidine, scopolamine, thiethylperazine, thioridazine, thiothixene, trifluoperazine, triflupromazine, trihexyphenidyl, trimeprazine, triprolidine.
  • Antidepressant agents, tricyclic (TCAs)Antidepressant agents, tricyclic (TCAs): Due to the anticholinergic properties of belladonna, additive anticholinergic effects may occur with tricyclic antidepressant drugs.
  • AntiestrogensAntiestrogens: Based on secondary reports, belladonna may interact with antiestrogens.
  • AntihistaminesAntihistamines: Theoretically, excessive anticholinergic activity may occur when belladonna is combined with other anticholinergic agents like antihistamines.
  • AtropineAtropine: Theoretically, combined use of the belladonna alkaloid, atropine, with belladonna may cause additive anticholinergic effects including severe dry mouth, decreased urination, blurred vision, excessive sedation, and constipation. Additionally, drugs that interact with atropine may also interact with belladonna because atropine is a constituent of belladonna. Examples include: ambenonium, arbutamine, belladonna, cisapride, cromolyn, halothane, methacholine, procainamide.
  • CisaprideCisapride: Atropine, a constituent of belladonna, has been reported to block the effects of cisapride on peristaltic contractions (55): When atropine was administered before cisapride, the effects of cisapride on lower esophageal sphincter pressure were antagonized. The effect did not occur when atropine was administered after cisapride.
  • Ergot derivativesErgot derivatives: Based on secondary sources, belladonna used in combination with ergotamine tartrate and phenobartbital may reduce menopausal hot flashes; however, there is limited suggestion of efficacy for this agent (56; 57).
  • Estrogen and progestin combinationEstrogen and progestin combination: Based on secondary reports, belladonna may interact with hormone replacement therapy.
  • EstrogensEstrogens: Based on secondary reports, belladonna may interact with hormone replacement therapy.
  • Hormonal agentsHormonal agents: Based on secondary reports, belladonna may interact with hormonal herbs and supplements.
  • Muscarinic antagonistsMuscarinic antagonists: Belladonna alkaloids are competitive inhibitors of the muscarinic actions of acetylcholine, acting at receptors located in exocrine glands, smooth and cardiac muscle, and intramural neurons.
  • PhenobarbitalPhenobarbital: Based on secondary sources, belladonna used in combination with ergotamine tartrate and phenobartbital may reduce menopausal hot flashes; however, there is limited suggestion of efficacy for this agent (56; 57).
  • PhenothiazinesPhenothiazines: Theoretically, excessive anticholinergic activity may occur when belladonna is combined with other anticholinergic agents like phenothiazines.
  • Photosensitizing agentsPhotosensitizing agents: Based on secondary reports, belladonna may interact with photosensitizers.
  • Renally eliminated agentsRenally eliminated agents: Atropine is primarily renally excreted. Renal clearance of atropine following ingestion of raw or cooked belladonna berries is variable, depending on the form ingested, but may be as high as 3.6mg/24 hours (18).
  • ScopolamineScopolamine: Scopolamine, an alkaloid of belladonna, when used in combination with belladonna itself may cause additive anticholinergic effects including severe dry mouth, decreased urination, blurred vision, excessive sedation, and constipation.
  • TacrineTacrine: In mice, cognitive deficits associated with belladonna alkaloid administration are attenuated by tacrine (58).

    • Belladonna/Herb/Supplement Interactions:

  • Alkaloid agentsAlkaloid agents: Doses of belladonna are generally calculated by milligrams of total alkaloids. Atropa belladonna contains up to 20 different tropane alkaloid compounds (17). Concomitant use of belladonna with other alkaloid agents, such as hyoscyamine, apoatropine, 3?-phenylacetoxytropane, cuscohygrine, and scopolamine, may result in additive effects.
  • AntiandrogensAntiandrogens: Based on secondary reports, belladonna may interact with antiandrogens.
  • Anticholinergic herbsAnticholinergic herbs: Combination use of belladonna with anticholinergic agents may potentiate its therapeutic and adverse effects. Examples of anticholinergic herbs include bittersweet (Solanum dulcamara), henbane (Hyoscyamus niger), and Jimson weed (Datura stramonium).
  • AntiestrogensAntiestrogens: Based on secondary reports, belladonna may interact with antiestrogens.
  • AntihistaminesAntihistamines: Theoretically, excessive anticholinergic activity may occur when belladonna is combined with other anticholinergic agents like antihistamines.
  • ErgotErgot: Based on secondary sources, belladonna used in combination with ergotamine tartrate and phenobartbital may reduce menopausal hot flashes; however, there is limited suggestion of efficacy for this agent (56; 57).
  • Hormonal herbs and supplementsHormonal herbs and supplements: Based on secondary reports, belladonna may interact with hormonal herbs and supplements.
  • Hormone replacement therapy (HRTHormone replacement therapy (HRT) : Based on secondary reports, belladonna may interact with hormone replacement therapy.
  • Muscarinic antagonistsMuscarinic antagonists: Belladonna alkaloids are competitive inhibitors of the muscarinic actions of acetylcholine, acting at receptors located in exocrine glands, smooth and cardiac muscle, and intramural neurons.
  • PhotosensitizersPhotosensitizers: Based on secondary reports, belladonna may interact with photosensitizers.
  • Renally eliminated herbs and supplementsRenally eliminated herbs and supplements: Atropine is primarily renally excreted. Renal clearance of atropine following ingestion of raw or cooked belladonna berries is variable, depending on the form ingested, but may be as high as 3.6mg/24 hours (18).

    • Belladonna/Food Interactions:

  • Insufficient available evidence.

    • Belladonna/Lab Interactions:

  • Insufficient available evidence.