Belladonna (Atropa belladonna)

Published November 30, 1985.
List of German Commission E Monographs (Phytotherapy)

Tollkirsche

Name of Drug

Belladonnae folium, belladonna leaf, deadly nightshade leaf.
Belladonnae radix, belladonna root, deadly nightshade root.

Composition of Drug

Belladonna leaf consists of the dried leaves, or the dried leaves together with the flowering branch tips, of Atropa belladonna L. [Fam. Solanaceae], as well as its preparations in effective dosage.

Belladonna root consists of the dried roots and rhizomes of A. belladonna L., as well as its preparations in effective dosage.

The drug contains alkaloids, such as L-hyoscyamine, atropine, and scopolamine, with a total alkaloid content of at least 0.3 percent in the leaves and 0.5 percent in the roots, calculated as hyoscyamine and related to the dried herb.

Uses

Spasms and colic-like pain in the areas of the gastrointestinal tract and bile ducts.

Contraindications

Tachycardiac arrhythmias, prostate adenoma with residual urine formation, narrow-angle glaucoma, acute edema of the lungs, mechanical stenoses of the gastrointestinal tract, megacolon.

Side Effects

Dryness of mouth, decrease in secretion by the perspiration glands, accommodation disturbances, reddening and dryness of skin, hyperthermia, tachycardia, difficulty in micturition (urination), hallucination and spasms (especially with overdosing).

Interactions with Other Drugs

Increase of anticholinergic effect by tricyclic antidepressants, amantadine and quinidine.

Dosage

Unless otherwise prescribed:

Belladonna leaf powder (belladonnae pulvis normatus):
   Average single dosage:

0.05 - 0.1 g;    Maximum single dosage:

0.2 g equivalent to 0.6 mg total alkaloids, calculated as hyoscyamine;    Maximum daily dosage:

0.6 g, equivalent to 1.8 mg total alkaloids, calculated as hyoscyamine. Belladonna root (belladonnae radix):
   Average single dosage:

0.05 g;    Maximum single dosage:

0.1 g equivalent to 0.5 mg total alkaloids, calculated as hyoscyamine;    Maximum daily dosage:

0.3 g equivalent to 1.5 mg total alkaloids, calculated as hyoscyamine. Belladonna extract:
   Average single dosage:

0.01 g;    Maximum single dosage:

0.05 g, equivalent to 0.73 mg total alkaloids, calculated as hyoscyamine;    Maximum daily dosage:

0.15 g, equivalent to 2.2 mg total alkaloids, calculated as hyoscyamine. Mode of Administration As liquid or solid forms of medication for internal use.

Actions

Belladonna preparations act as a parasympatholytic or anticholinergic via a competitive antagonism of the neuromuscular transmitter acetylcholine. This antagonism concerns mainly the muscarine-like effects of acetylcholine and less the nicotine-like effects on the ganglions and the neuromuscular end plate. Belladonna preparations unfold peripheral effects targeted on the vegetative nervous system and the smooth muscle system, as well as the central nervous system. Because of the parasympatholytic properties, the drug can cause relaxation of organs with smooth muscles and relieve spastic conditions, especially in the gastrointestinal tract and bile ducts. Additionally, Belladonna use may result in muscular tremor or rigidity due to effects on the central nervous system. Belladonna preparations have a positive dromotropic as well as a positive chronotropic effect on the heart.