Atropine Sulfate
dl-hyoscyamine (racemic mixture of d-hyoscyamine and l-hyoscyamine)
Also known as: Atroject Β· Atropine SA Β· Atropine L.A. Β· AtroPen Β· Sal-Tropine Β· dl-hyoscyamine Β· atrop. sulph. Β· atropine sulphate Β· atropini sulfas
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
π NA β North Americaπ EU β Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| As a preanesthetic adjuvant (geriatric patients) | 0.01-0.02 mg/kg | IM, IV | once | β | π NA |
| As a preanesthetic adjuvant | 0.074 mg/kg | IV, IM or SC | once | β | π NA |
| As a preanesthetic adjuvant | 0.02-0.04 mg/kg | SC, IM or IV | once | β | π NA |
| During cardiopulmonary cerebral resuscitation (CPCR) efforts | 0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT) | IV, IO, IT | every 3-5 minutes | maximum of 3 doses | π NA |
| Adjunctive treatment of bradycardias, Incomplete AV block, etc. | 0.02-0.04 mg/kg | IV or IM | as needed | β | π NA |
| Atropine Response Test (Rishniw Preference) | 0.04 mg/kg | IV | once | β | π NA |
| Atropine Response Test (Kittleson Preference) | 0.04 mg/kg | SQ | once | β | π NA |
| Treatment of cholinergic toxicity | 0.2-0.5 mg/kg | IV, IM, SC | as needed | β | π NA |
| Treatment of bronchoconstriction | 0.02-0.04 mg/kg | parenteral | as needed | duration of effect 1-1.5 hours | π NA |
- As a preanesthetic adjuvant (geriatric patients): Do not use anticholinergics indiscriminately in geriatric patients.
- During cardiopulmonary cerebral resuscitation (CPCR) efforts: For IT administration: dilute in 5-10 mL of sterile water before administering.
- Atropine Response Test (Rishniw Preference): Wait 15 minutes, record ECG. Persistent sinus tachycardia at >140 bpm expected in vagally-mediated bradycardia.
- Atropine Response Test (Kittleson Preference): Wait 30 minutes, record ECG. Persistent sinus tachycardia at >140 bpm expected in vagally-mediated bradycardia.
- Treatment of cholinergic toxicity: 1/4 of the dose IV and the remainder IM or SC
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| As a preanesthetic adjuvant (geriatric patients) | 0.01-0.02 mg/kg | IM, IV | once | β | π NA |
| As a preanesthetic adjuvant | 0.074 mg/kg | IV, IM or SC | once | β | π NA |
| As a preanesthetic adjuvant | 0.02-0.04 mg/kg | SC, IM or IV | once | β | π NA |
| During cardiopulmonary cerebral resuscitation (CPCR) efforts | 0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT) | IV, IO, IT | every 3-5 minutes | maximum of 3 doses | π NA |
| Treatment of bradycardias | 0.02-0.04 mg/kg | SC, IM or IV | q4-6h | β | π NA |
| Treatment of cholinergic toxicity | 0.2-2 mg/kg | IV, SC, IM | as needed | β | π NA |
- As a preanesthetic adjuvant (geriatric patients): Do not use anticholinergics indiscriminately in geriatric patients.
- During cardiopulmonary cerebral resuscitation (CPCR) efforts: For IT administration: dilute in 5-10 mL of sterile water before administering.
- Treatment of cholinergic toxicity: give 1/4th of the dose IV and the remainder SC or IM
Small Mammals
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| To treat organophosphate toxicity (Rabbits/Rodents) | 10 mg/kg | SC | q20 minutes | β | π NA |
Ferrets
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| As a premed | 0.05 mg/kg | SC or IM | once | β | π NA |
Birds
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Organophosphate poisoning | 0.2 mg/kg | IM | every 3-4 hours as needed | β | π NA |
| To assist in diagnosing organophosphate poisoning | 0.02 mg/kg | IV | once | β | π NA |
| As a preanesthetic | 0.04-0.1 mg/kg | IM or SC | once | β | π NA |
- Organophosphate poisoning: 1/4th the initial dose is administered. Use with pralidoxime (not in raptors) at 10-20 mg/kg IM q8-12h as needed.
- To assist in diagnosing organophosphate poisoning: If bradycardia does not reverse, may consider organophosphate toxicity.
Reptiles
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Organophosphate toxicity in most species | 0.1-0.2 mg/kg | SC or IM | as needed | β | π NA |
| Ptyalism in tortoises | 0.05 mg/kg (50 micrograms/kg) | SC or IM | once daily | β | π NA |
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treatment of bradyarrhythmias due to increased parasympathetic tone | 0.01-0.02 mg/kg | IV | as needed | β | π NA |
| Treatment of bradyarrhythmias due to increased parasympathetic tone | 0.045 mg/kg | parenterally | as needed | β | π NA |
| As a bronchodilator | 5 mg | IV | once | β | π NA |
| As a bronchodilator (rescue medication for severe airway obstruction) | 5-7 mg/kg | IV | single rescue dose | β | π NA |
| Organophosphate poisoning | Approximately 1 mg/kg | IV, SC | may repeat every 1.5-2 hours as required subcutaneously | β | π NA |
| Organophosphate poisoning | 0.22 mg/kg | IV, SC, IM | as needed | β | π NA |
- As a bronchodilator: for a 400-500 kg animal
- As a bronchodilator (rescue medication for severe airway obstruction): for a 450 kg horse. Abbreviated duration (0.5-2 hours). Adverse effects limit use to a single rescue dose.
- Organophosphate poisoning: given to effect, IV (use mydriasis and absence of salivation as therapy endpoints)
- Organophosphate poisoning: 1/4th of the dose administered IV and the remainder SC or IM
Cattle
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| As a preanesthetic | 0.06-0.12 mg/kg | IM | once | β | π NA |
| Adjunctive treatment of bovine hypersensitivity disease | 1 gram per cow once daily followed by 0.5 gram/cow in 2-3 days | not specified | once daily then in 2-3 days | 2-3 days | π NA |
| Treatment of cholinergic toxicity (organophosphates) | 0.5 mg/kg (average dose) | IV, SC, IM | may repeat q3-4h | 1-2 days | π NA |
- As a preanesthetic: Not used routinely as a preoperative agent in ruminants due to lack of extended efficacy and potential adverse reactions.
- Treatment of cholinergic toxicity (organophosphates): give 1/4th of the dose IV and the remainder SC or IM
Swine
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Organophosphate toxicity | Use equine dose | IV, SC, IM | as needed | β | π NA |
| As an adjunctive preanesthetic agent | 0.04 mg/kg | IM | once | β | π NA |
Sheep
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treating organophosphate toxicity | Use the dose for cattle | IV, SC, IM | as needed | β | π NA |
Goats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treating organophosphate toxicity | Use the dose for cattle | IV, SC, IM | as needed | β | π NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Atropine sulfate is a naturally occurring belladonna alkaloid and the prototype βantimuscarinic (anticholinergic)β agent used extensively in veterinary medicine.
Key clinical applications include:
- Emergency Medicine & CPCR: Treatment of hemodynamically significant sinus bradycardia, sinoatrial arrest, and incomplete AV block.
- Anesthesia: Used as a preanesthetic to prevent or reduce respiratory and salivary secretions, and to mitigate vagally-mediated bradycardia.
- Toxicology: Serves as a life-saving antidote for overdoses of cholinergic agents, including organophosphates, carbamates, muscarinic mushrooms, and blue-green algae intoxication.
- Respiratory: Adjunctive treatment for bronchoconstrictive disease.
Clinical Pearl: While highly effective, atropine's use is declining in routine premedication protocols in favor of targeted use or alternatives like glycopyrrolate, which does not cross the blood-brain barrier as readily and has a longer duration of action.
Mechanism of action
Atropine acts as a competitive, reversible antagonist at βmuscarinic acetylcholine receptors (mAChRs)β (M1-M5 subtypes) located at postganglionic parasympathetic neuroeffector sites.
By blocking βacetylcholine (ACh)β binding, it inhibits parasympathetic tone:
- Cardiovascular: Blocks vagal tone at the SA and AV nodes β increases heart rate (positive chronotropy) and improves AV conduction (positive dromotropy).
- Secretions: Inhibits glandular M3 receptors β decreases salivary, bronchial, and gastric secretions.
- Smooth Muscle: Relaxes smooth muscle in the GI, urinary, and biliary tracts β decreases motility and spasm.
- Ocular: Blocks M3 receptors in the pupillary sphincter and ciliary muscle β causes pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia).
Mechanistic Note: At very low doses, atropine can cause a paradoxical, transient bradycardia due to the blockade of presynaptic M1 autoreceptors on vagal postganglionic fibers, which normally inhibit ACh release. High doses may also block nicotinic receptors at autonomic ganglia and the neuromuscular junction.
Safety & warnings
Contraindications
- Narrow-angle glaucoma
- Synechiae (adhesions) between the iris and lens
- Hypersensitivity to anticholinergic drugs
- Tachycardias secondary to thyrotoxicosis or cardiac insufficiency
- Myocardial ischemia
- Unstable cardiac status during acute hemorrhage
- GI obstructive disease or paralytic ileus
- Severe ulcerative colitis
- Obstructive uropathy
- Myasthenia gravis (unless used to reverse adverse muscarinic effects secondary to therapy)
Adverse effects
- Dry mouth (xerostomia)
- Dysphagia
- Constipation
- Vomiting
- Thirst
- Urinary retention or hesitancy
- CNS stimulation, drowsiness, ataxia, seizures, respiratory depression
- Blurred vision, pupil dilation (mydriasis), cycloplegia, photophobia
- Sinus tachycardia (at higher doses)
- Paradoxical bradycardia (initially or at very low doses)
- Hypertension or hypotension
- Arrhythmias (ectopic complexes)
- Decreased gut motility (can induce colic in horses or rumen stasis in cattle)
Precautions
βGeneral Precautions:β
- Use with extreme caution in patients with known or suspected GI infections; decreased motility can prolong retention of causative agents or toxins.
- Use with extreme caution in patients with autonomic neuropathy.
- Use cautiously in patients with hepatic or renal disease, geriatric or pediatric patients, hyperthyroidism, hypertension, CHF, tachyarrhythmias, prostatic hypertrophy, or esophageal reflux.
βSpecies-Specific Warnings:β
- Neonates: Reportedly not effective in treating bradycardias in puppies <14 days old or kittens <11 days old. May damage hypoxic myocardia in neonates.
- Rabbits: Glycopyrrolate is preferred, as ~40% of rabbits possess endogenous atropinesterase, rendering atropine ineffective.
- Horses: Systemic use may decrease gut motility and induce colic. May reduce arrhythmogenic doses of epinephrine.
- Cattle: May result in inappetence and rumen stasis persisting for several days.
- Food Animals: FARAD recommends a 28-day meat and 6-day milk withdrawal time when used at doses up to 0.2 mg/kg.
Drug interactions
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine; do not use in atropine overdose
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
May enhance the activity or toxicity of atropine
Use with alpha-2 blockers may significantly increase arterial blood pressure, heart rates, and the incidence of arrhythmias. Concurrent use is controversial.
Atropine may aggravate signs of amitraz toxicity, leading to hypertension and further inhibition of peristalsis
May decrease PO atropine absorption; give oral atropine at least 1 hour prior to oral antacids
May increase intraocular pressure
Atropine may increase serum digoxin levels; use regular digoxin tablets or oral liquid
Increased gastric pH may decrease GI absorption; administer oral atropine 2 hours after ketoconazole
Atropine and its derivatives may antagonize the actions of metoclopramide
Monitoring
- Heart rate and rhythm
- Thirst and appetite
- Urination and defecation capability
- Mouth and secretions dryness
- Pupillary dilation (mydriasis)
Pharmacokinetics
Absorption
Well absorbed after oral administration, IM injection, inhalation, or endotracheal administration. Peak effects in heart rates occur within 3-4 minutes after IV administration.
Distribution
Well distributed throughout the body. Crosses into the CNS, across the placenta, and can distribute into milk in small quantities.
Metabolism
Metabolized in the liver.
Elimination
Excreted into the urine. Approximately 30-50% of a dose is excreted unchanged into the urine. Plasma half-life in humans is reported to be between 2-3 hours.
Overdose
βSigns of Toxicity:β Extensions of pharmacologic effects: severe dry mouth, dysphagia, extreme thirst, vomiting, urinary retention, CNS signs (extreme agitation, seizures, ataxia, respiratory depression), severe tachycardia, arrhythmias, and circulatory failure.
βTreatment:β
- Decontamination: If recent oral ingestion, empty gut contents and administer activated charcoal and saline cathartics.
- Supportive Care: Treat clinical signs supportively and symptomatically. Fluid therapy and standard treatments for shock may be instituted.
- Contraindications: Do NOT use phenothiazines as they may contribute to anticholinergic effects.
- βAntidote (Physostigmine)β: Controversial. Reserve for extreme agitation/risk of injury or severe/life-threatening supraventricular and sinus tachycardias.
- Human dose: 2 mg IV slowly.
- Pediatric/Small Animal dose: 0.02 mg/kg slow IV (repeat q10 minutes until reversal).
- Note: Physostigmine adverse effects (bronchoconstriction, bradycardia, seizures) may be treated with small doses of IV atropine.
Available products
Formulations
- Injection
- Tablets
- Auto-injectors
- Ophthalmic drops (used off-label buccally)
Veterinary
- Atropine Sulfate for Injection: 0.54 mg/mL (1/120 grain); Atroject (Vetus), Atropine SA (Butler), generic
- Atropine Sulfate for Injection: 15 mg/mL (organophosphate treatment) 100 mL vial; Atropine L.A. (Butler), generic
Human-labeled
- Atropine Sulfate for Injection: 0.05 mg/mL, 0.1 mg/mL, 0.3 mg/mL, 0.4 mg/mL, 0.5 mg/mL, 0.8 mg/mL, 1 mg/mL
- Atropine Sulfate pre-filled auto-injectors: 0.5 mg, 1 mg & 2 mg; AtroPen (Meridian Medical Technologies)
- Atropine Sulfate Tablets: 0.4 mg; Sal-Tropine (Hope)
Regulatory status
No regulatory data for: πΊπΈ US Β· πͺπΊ EU Β· π¬π§ UK Β· ππ° HK Β· πΉπΌ TW Β· π―π΅ JP Β· π°π· KR Β· π¦πΊ AU
Storage & stability
Tablets or soluble tablets should be stored in well-closed containers at room temperature (15-30Β°C). Injection should be stored at room temperature; avoid freezing.
Client information
- Professional Administration: Parenteral atropine administration is best performed by professional veterinary staff in a setting where adequate cardiac monitoring is available.
- Hydration: If your animal is receiving atropine systemically, allow free access to water and encourage drinking, as the medication frequently causes a dry mouth.
- Visual Changes: You may notice your pet's pupils become widely dilated. They may be sensitive to bright lights (photophobia) during this time.
- Monitoring at Home: Watch for signs of constipation or difficulty urinating, and contact your veterinarian if these occur.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturerβs current label.
