VetSheet

Atropine Sulfate

dl-hyoscyamine (racemic mixture of d-hyoscyamine and l-hyoscyamine)

Anticholinergic / AntimuscarinicIVIMSCPOIOIntratracheal (IT)InhalationDogsCatsSmall MammalsFerretsBirdsReptilesHorsesCattleSwineSheepGoats

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

0.01-0.02 mg/kgIM, IVΒ· once
β€” πŸ•

Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.

Dosing by species

🌎 NA β€” North America🌍 EU β€” Europe

Dogs

IndicationDoseRouteFrequencyDurationRegion
As a preanesthetic adjuvant (geriatric patients)0.01-0.02 mg/kgIM, IVonceβ€”πŸŒŽ NA
As a preanesthetic adjuvant0.074 mg/kgIV, IM or SConceβ€”πŸŒŽ NA
As a preanesthetic adjuvant0.02-0.04 mg/kgSC, IM or IVonceβ€”πŸŒŽ NA
During cardiopulmonary cerebral resuscitation (CPCR) efforts0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT)IV, IO, ITevery 3-5 minutesmaximum of 3 doses🌎 NA
Adjunctive treatment of bradycardias, Incomplete AV block, etc.0.02-0.04 mg/kgIV or IMas neededβ€”πŸŒŽ NA
Atropine Response Test (Rishniw Preference)0.04 mg/kgIVonceβ€”πŸŒŽ NA
Atropine Response Test (Kittleson Preference)0.04 mg/kgSQonceβ€”πŸŒŽ NA
Treatment of cholinergic toxicity0.2-0.5 mg/kgIV, IM, SCas neededβ€”πŸŒŽ NA
Treatment of bronchoconstriction0.02-0.04 mg/kgparenteralas neededduration of effect 1-1.5 hours🌎 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

IndicationDoseRouteFrequencyDurationRegion
As a preanesthetic adjuvant (geriatric patients)0.01-0.02 mg/kgIM, IVonceβ€”πŸŒŽ NA
As a preanesthetic adjuvant0.074 mg/kgIV, IM or SConceβ€”πŸŒŽ NA
As a preanesthetic adjuvant0.02-0.04 mg/kgSC, IM or IVonceβ€”πŸŒŽ NA
During cardiopulmonary cerebral resuscitation (CPCR) efforts0.04 mg/kg (IV or IO); 0.08-0.1 mg/kg (IT)IV, IO, ITevery 3-5 minutesmaximum of 3 doses🌎 NA
Treatment of bradycardias0.02-0.04 mg/kgSC, IM or IVq4-6hβ€”πŸŒŽ NA
Treatment of cholinergic toxicity0.2-2 mg/kgIV, SC, IMas neededβ€”πŸŒŽ 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

IndicationDoseRouteFrequencyDurationRegion
To treat organophosphate toxicity (Rabbits/Rodents)10 mg/kgSCq20 minutesβ€”πŸŒŽ NA

Ferrets

IndicationDoseRouteFrequencyDurationRegion
As a premed0.05 mg/kgSC or IMonceβ€”πŸŒŽ NA

Birds

IndicationDoseRouteFrequencyDurationRegion
Organophosphate poisoning0.2 mg/kgIMevery 3-4 hours as neededβ€”πŸŒŽ NA
To assist in diagnosing organophosphate poisoning0.02 mg/kgIVonceβ€”πŸŒŽ NA
As a preanesthetic0.04-0.1 mg/kgIM or SConceβ€”πŸŒŽ 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

IndicationDoseRouteFrequencyDurationRegion
Organophosphate toxicity in most species0.1-0.2 mg/kgSC or IMas neededβ€”πŸŒŽ NA
Ptyalism in tortoises0.05 mg/kg (50 micrograms/kg)SC or IMonce dailyβ€”πŸŒŽ NA

Horses

IndicationDoseRouteFrequencyDurationRegion
Treatment of bradyarrhythmias due to increased parasympathetic tone0.01-0.02 mg/kgIVas neededβ€”πŸŒŽ NA
Treatment of bradyarrhythmias due to increased parasympathetic tone0.045 mg/kgparenterallyas neededβ€”πŸŒŽ NA
As a bronchodilator5 mgIVonceβ€”πŸŒŽ NA
As a bronchodilator (rescue medication for severe airway obstruction)5-7 mg/kgIVsingle rescue doseβ€”πŸŒŽ NA
Organophosphate poisoningApproximately 1 mg/kgIV, SCmay repeat every 1.5-2 hours as required subcutaneouslyβ€”πŸŒŽ NA
Organophosphate poisoning0.22 mg/kgIV, SC, IMas neededβ€”πŸŒŽ 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

IndicationDoseRouteFrequencyDurationRegion
As a preanesthetic0.06-0.12 mg/kgIMonceβ€”πŸŒŽ NA
Adjunctive treatment of bovine hypersensitivity disease1 gram per cow once daily followed by 0.5 gram/cow in 2-3 daysnot specifiedonce daily then in 2-3 days2-3 days🌎 NA
Treatment of cholinergic toxicity (organophosphates)0.5 mg/kg (average dose)IV, SC, IMmay repeat q3-4h1-2 days🌎 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

IndicationDoseRouteFrequencyDurationRegion
Organophosphate toxicityUse equine doseIV, SC, IMas neededβ€”πŸŒŽ NA
As an adjunctive preanesthetic agent0.04 mg/kgIMonceβ€”πŸŒŽ NA

Sheep

IndicationDoseRouteFrequencyDurationRegion
Treating organophosphate toxicityUse the dose for cattleIV, SC, IMas neededβ€”πŸŒŽ NA

Goats

IndicationDoseRouteFrequencyDurationRegion
Treating organophosphate toxicityUse the dose for cattleIV, SC, IMas neededβ€”πŸŒŽ NA

Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.

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Overview

Atropine sulfate is a naturally occurring belladonna alkaloid and the prototype ​antimuscarinic (anticholinergic)​ 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 ​muscarinic acetylcholine receptors (mAChRs)​ (M1-M5 subtypes) located at postganglionic parasympathetic neuroeffector sites.

By blocking ​acetylcholine (ACh)​ 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

​General Precautions:​

  • 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.

​Species-Specific Warnings:​

  • 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

Amantadine

May enhance the activity or toxicity of atropine

Anticholinergic agents (other)

May enhance the activity or toxicity of atropine

Antihistamines (e.g., diphenhydramine)

May enhance the activity or toxicity of atropine

Disopyramide

May enhance the activity or toxicity of atropine

Meperidine

May enhance the activity or toxicity of atropine

Phenothiazines

May enhance the activity or toxicity of atropine; do not use in atropine overdose

Procainamide

May enhance the activity or toxicity of atropine

Primidone

May enhance the activity or toxicity of atropine

Tricyclic antidepressants (e.g., amitriptyline, clomipramine)

May enhance the activity or toxicity of atropine

Alpha-2 agonists (e.g., dexmedetomidine, medetomidine)

Use with alpha-2 blockers may significantly increase arterial blood pressure, heart rates, and the incidence of arrhythmias. Concurrent use is controversial.

Amitraz

Atropine may aggravate signs of amitraz toxicity, leading to hypertension and further inhibition of peristalsis

Antacids

May decrease PO atropine absorption; give oral atropine at least 1 hour prior to oral antacids

Corticosteroids (long-term use)

May increase intraocular pressure

Digoxin (slow-dissolving)

Atropine may increase serum digoxin levels; use regular digoxin tablets or oral liquid

Ketoconazole

Increased gastric pH may decrease GI absorption; administer oral atropine 2 hours after ketoconazole

Metoclopramide

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

​Signs of Toxicity:​ 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.

​Treatment:​

  • 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.
  • ​Antidote (Physostigmine)​: 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: πŸ‡ΊπŸ‡Έ US Β· πŸ‡ͺπŸ‡Ί EU Β· πŸ‡¬πŸ‡§ UK Β· πŸ‡­πŸ‡° HK Β· πŸ‡ΉπŸ‡Ό TW Β· πŸ‡―πŸ‡΅ JP Β· πŸ‡°πŸ‡· KR Β· πŸ‡¦πŸ‡Ί 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 manufacturer’s current label.