belladonna/ergotamine/phenobarbital (Bellergal-S, Spastrin)

Introduction

Tradenames: Bellergal-S, Spastrin. belladonna alkaloids: 0.2 mg, phenobarbital: 40 mg, ergotamine tartrate 0.6 mg.

Indications

• menopausal disorders
• gastrointestinal disorders
• recurrent throbbing headaches

Contraindications

pregnancy category X

Dosage

1 tab PO BID

Adverse effects

• common (> 10%)
  • constipation
  • decreased sweating
  • dry mouth, nose, throat
  • irritation at the site of injection
  • peripheral vascular effects (numbing & tingling of fingers & toes)
  • drowsiness
  • dizziness
  • diarrhea
  • nausea/vomiting
• less common (1-10%)
  • decreased flow of breast milk, difficulty swallowing, increased sensitivity to light, chest pain, transient tachycardia or bradycardia, muscle pains in extremities, leg weakness
• uncommon (< 1%)
  • skin rash, confusion, increased intraocular pain, orthostatic hypotension, bloated feeling, difficulty urinating, blurred vision, drowsiness, headache, loss of memory, fatigue, palpitations, ventricular fibrillation, ataxia

Overdose:

• physostigmine 1-2 mg IV/SC (0.02 mg/kg for children) to reverse effects of belladonna

Drug interactions

• CNS depressants

More general terms

• antispasmodic
• pharmacologic combination

Additional terms

• naloxone (Narcan, Evzio, ReVive)
• physostigmine (Antilirium, Isopto Eserine)

Components

• belladonna alkaloid
• phenobarbital; PB; PHB (Luminal, Barbita, Solfoton)
• ergotamine (Ergostat)