Atropine for drooling

What is atropine?

Atropine eye drops can be given under the tongue to treat drooling. Drooling can be caused by problems keeping saliva in the mouth, problems with swallowing, or by making too much saliva. Atropine decreases the amount of saliva made in the mouth. Atropine belongs to a class of medicines called anticholinergics.

Before giving atropine to your child

Tell your child's doctor if your child has:

• A history of allergic reaction to atropine or other anticholinergics (glycopyrrolate, scopolamine, hyoscine, belladonna, and other medicines used to treat bowel spasms and urine incontinence)
• Narrow-angle glaucoma
• Blockage in the intestines
• Myasthenia gravis
• Ulcerative colitis

Talk with your child's doctor or pharmacist if your child has any of the following conditions. Your child may be more sensitive to the side effects of this medicine if your child has:

• Severe liver or kidney disease
• Heart rhythm abnormalities (heart block, fast or irregular heart rate)
• Heart failure
• High blood pressure
• Narrowing of the lower part of the stomach (pyloric stenosis)
• Heartburn
• High thyroid hormone
• Urinary retention
• Constipation
• Nerve damage that affects your child's ability to control temperature, blood pressure, heart rate, and bowel and bladder emptying

How should you give your child atropine?

• Wipe away any excess saliva or secretions
• Give this medicine by placing the prescribed number of drops under the tongue
• Take steps to avoid giving too large of a dose:

1. Turn the bottle upside down.
2. Squeeze the bottle lightly and allow the drop to fall under the tongue. Do not give more than one drop with each squeeze of the bottle.
3. Repeat for the prescribed number of drops.

• Do not give this drug by any other method than by placing the drops under the tongue. The medicine will not work as well if they are swallowed. Your child may also experience more side effects if the drops are swallowed.
• Avoid contact between the bottle and surfaces of the mouth.
• If 2 drops are prescribed, attempt to deliver one on each side of the tongue as this may result in better drooling management.

How long does atropine take to work?

Atropine will start to reduce the amount of saliva within 5 to 30 minutes, and the effect will last approximately 4 to 6 hours.

What are the possible side effects of atropine?

Even though atropine is meant to act locally within the mouth, side effects throughout the body can still occur. Side effects to atropine occur more frequently with higher doses. Children may be more sensitive to high doses of this medicine.

Your child may have some of these side effects while they take atropine. Check with your child's doctor if your child continues to have any of these side effects, if they do not go away, or if they bother your child:

• Facial flushing
• Excessive dry mouth/mucous membranes or skin
• Blurred vision
• Eyes are sensitive to light
• Drowsiness
• Upset stomach
• Difficulty urinating
• Constipation

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency Department if your child has any of these side effects:

• Rash
• Fast and/or irregular heart rate
• Severe abdominal pain
• Fever
• Confusion
• Excitement, irritability, behaviour changes
• Hallucinations
• Difficulty breathing

What safety measures should you take when your child is using atropine?

There are some medicines that should not be taken together with atropine or in some cases the dose of atropine or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medicines (prescription, over the counter or herbal) including:

• Antidepressants, antipsychotics, or medicines used to treat anxiety.
• Antihistamines (diphenhydramine, chlorpheniramine, cyproheptadine, hydroxyzine)
• Muscle relaxants
• Antinauseants (prochlorperazine, dimenhydrinate)
• Drugs used to treat urinary incontinence (oxybutynin, tolteridine, and others)
• Diphenoxylate atropine (Lomotil?)
• Ipratropium (Atrovent?)

What other important information should you know about atropine?

• Keep a list of all medicines your child is on and show the list to the doctor or pharmacist
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child
• Keep atropine at room temperature in a cool, dry place away from sunlight. Keep tightly closed. Do NOT store it in the bathroom or kitchen
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines
  

Keep atropine for drooling out of your child’s sight and reach and locked up in a safe place. If your child takes too much atropine for drooling, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.