Trade Name:

Generic Name:
Classification:

B & O Suppositories
Belladonna alkaloids and opium
Narcotic analgesic and anti-spasmodic combination
medication
Mechanism:
Belladonna relaxes smooth muscles and stops muscle
spasms. Opium is converted to morphine which is an
opioid pain reliever. Opioids can reduce gastrointestinal
motility, propulsion, secretions, and increase
gastrointestinal muscle tone. Opioids also stimulate
receptors on nerves in the brain to increase the threshold
to pain (increasing the amount of stimulation it takes to
feel pain) and reduce the perception of pain (the
perceived importance of the pain). These effects help in
controlling pain and relieving spasms, especially bladder
spasms. Belladonna/opium is a controlled substance.
Uses:
Treat moderate to severe pain from spasm of the urinary
tract.
Route:
Rectal
Dosage:
Insert 1 suppository rectally once or twice daily. Not to
exceed >4 suppositories/day or as directed by physician.
Side effects
Drowsiness, dizziness, blurred vision, dry mouth, urine
retention, nausea, vomiting, constipation, itching, and
hives.
Adverse
Slow shallow breathing; severe drowsiness or dizziness.
Effects:
Can be habit forming and has abuse potential because of
its opium content.
Contraindicatio Not recommended for children 12 years or younger
ns:
Precautions
Alvimopan (Entereg) increases belladonna and
and
opium levels in the body; opioid must be stopped 7
interactions
days prior to starting Alvimopan.
MAO inhibitors like phenelzine (Nardil), selegiline
(Zelapar, Emsam, Eldepryl), and isocarboxazid
(Marplan) as well as linezolid (Zyvox) antibiotic
may lead to serious changes in blood pressure,
fever, sleepiness, agitation, confusion and in severe
cases, death. Must be stopped or separated by 14
days before administering B&O.
Naltrexone (Revia) decreases levels and
therapeutic effects of B&O, leading to treatment
failure.
Narcotic analgesics increased risks of dizziness,
sedation, and respiratory depression.
Cimetidine, Butorphanol, Nalbuphine, Potassium
tablets, Pramlimtide, Rifampin

Health
Teaching

Development
(lifespan)
Consideration:

Do not stop abruptly as it may cause withdrawal

symptoms.
Do not increase dose.
May cause addiction.
Store at room temperature away from light and
moisture.
Do not refrigerate.
Do not store in the bathroom.
Keep away medications from children and pets.
Do not flush medication in the toilet or pour them
into the drain unless instructed to do so.
Properly discard product when it is expired or no
longer needed.
Consult your pharmacist or local waste disposal for
safe disposal of product.
PREGNANCY: There are no adequate studies done on
belladonna/opium suppositories to determine safe and
effective use in pregnant women. They should be used
only if clearly needed.
NURSING MOTHERS: Opium is converted to morphine.
Morphine is excreted in breast milk, however, the
American Academy of Pediatrics committee states that it
is safe to use while nursing.