In the USA there’s an OTC cold remedy known as Contac, which contains acetominophen and pseudoephedrine. Until sometime in the 1970s it also contained a small amount of atropine, the main active ingredient of belladonna. Atropine has a psychoactive effect so the ingredient was eliminated from the formula, I think mainly in response to teenagers using Contac to get high.
My question is this: What was the atropine there for? What symptom or symptoms was it supposed to treat?
I think it was included as a drying agent – in other words, for its antihistamine properties.
I’m not 100% sure, but atropine is an anticholinergic substance. Possible usefulness in treating colds would be the historical usefulness of anticholinergics in treating things like asthma and bronchitis, and reduction in the production of mucus/saliva.
In addition to potential unwanted side effects and/or abuse, there might be better agents for the purpose, or at least equally effective agents for the purpose, with fewer side effects or abuse potential. Like pseudoephedrine - which, nonetheless, has side effects and can potentially be cooked in meth for recreational/abuse purposes.
As Broomstick already noted, it’s an anticholinergic drug, and helpful for reducing mucus and saliva production in the nose, mouth, respiratory tract, and elsewhere. It also may help speed up a dangerously low heartrate (dependent on what’s causing the slow rate of course). It can be life-saving for certain mushroom and nerve toxin poisoning cases too.
So it’s a pretty potent drug, and frankly using it systemically for annoying nasal congestion can result it a LOT of unintended consequences. Hence it no longer being available in OTC meds.
A version of it for use in a nebulizer can be quite helpful for clearing secretions and helping to reduce bronchospasms in asthmatics and COPDers. Topical drops are useful for certain eye conditions and exams. A nasal spray version is helpful for chronic rhinorrhea (runny nose).
TIL learned a new term that makes me look forward to getting a cold.
It’s can also relieve itchiness and inflammation. If your cold included itchy eyes or nose, or congestion from inflamed nasal passages, as opposed to excess mucous, it would be helpful.
It probably helped a little with pain, which in an aspirin-only world, was important. It also can make you sleepy; if your cold kept you up, it might have knocked you out-- like what doxylamine in Nyquil does now.
Contac used to be made from many tiny, color-coded pills that looked like sprinkles (but more regularly-shaped), inside clear capsules that easily came apart (thanks to the Tylenol poisoner, something you don’t see in OTC meds anymore. I remember the ads, and I remember a friend getting one from her parents’ med closet, and we opened it to watch the tiny pills roll around. We were maybe 7.
Color-coding made it probably easy to decode the color of the atropine and sort it out, if you were a teen, looking to get high.
I think they were made that way to show off the combination of meds, because that may have been an innovation at the time-- why take four different things, when you could take one Contac? I remember it being a selling point in commercials “All these?” [palm showing 4 or 5 pills] “or one Contac.” Something like that.
As an amateur medical historian, it never fails to amaze me what drugs, and combinations thereof, were available, and often OTC no less. Anyway, the atropine would have been put in there to help with “drying up” the nose and eyes.
Assuming, of course, that it actually was atropine. A bit of sleuthing (and these things are harder to find than most laypeople would think) revealed that until ca. 1980, Contac did indeed contain a basically homeopathic amount of belladonna, which can also do many of the same things as atropine but isn’t quite as specific.
(With pseudoephedrine going behind the counter, or even RX only in some areas, many manufacturers have replaced it with phenylephrine, which is very effective when used topically, usually as a spray, but has little effect when taken orally.)
That must be where the term “contac high” comes from.
At one time there was a homeopathic teething formula for babies with Belladonna on the label.
Umm? No. I ain’t giving that to my baby.
If it was homeopathic, then there was not any actual belladonna present in the ‘medication’. Or anything else of significance besides water.
It sat on a table within 3" of a flask of pure distilled belladonna.
I haven’t seen belladonna (or atrophine, which is one of the belladonna alkaloids) in any over-the-counter cold remedy products recently. It’s still a component of some prescription drugs. Donnatal has been prescribed for G.I. complaints for decades and apparently still is used for irritable bowel syndrome. Donnatal contains, in addition to three belladonna alkaloids (hyoscyamine, atropine and scopolamine), phenobarbital, so it sounds like a drug to be administered with caution.
Belladonna is an ingredient in various alternative and homeopathic meds, as proponents claim (with very little evidence) that it’s effective for a wide variety of complaints. While a homeopathic belladonna product advertised as 30C probably would be akin to water, other such homeopathic drugs might contain enough to cause trouble, as in this case.
It is a component in Limotil, where it serves to help paralyze the muscles that perform peristalsis - here we jokingly refer to it as nuclear immodium =) I have a standing scrip from my oncologist for limotil and zofran [and letrozole as a daily pill though that is for the breast cancer to prevent estrogen production as I understand it.]
Lomotil does contain atropine, and it also contains diphenoxylate which is an opioid. So it can be an effective, but more risky combo.
But not as risky as the older diarrhea medicine, paregoric. That was opium dissolved in ethanol. Quite the cocktail.
I’m glad to hear that.
Laudanum? Or was that a brand name?
Paregoric is sometimes confused with Laudanum, because their chemical names are similar: Camphorated Tincture of Opium (Paregoric) vs. Tincture of Opium (Laudanum). However, Laudanum contains 10 milligrams of morphine per milliliter, 25 times more than Paregoric. Confusion between the two drugs has led to overdose and death in patients. Thus the term “Paregoric” should be used instead of “Camphorated Opium Tincture”, since the latter may be confused with Laudanum.
Traditional homeopathic preparations are so diluted that there is often not even one molecule of the putative active ingredient in a dose. However, products labeled as homeopathic belladonna can have physiologically significant doses of atropine. That’s because there is a loophole in the Food, Drug, and Cosmetic Act of 1938 that grandfathered in any substance that is listed in the Homeopathic Pharmacopoeia of the United States. The loophole was inserted into the bill by Royal Copeland, senator from New York who happened to be a homeopath. The law doesn’t specify what concentrations are allowable. So a company that wants to make a few bucks can legally sell belladonna, as long as they label it as a homeopathic treatment. As far as I can tell, they can sell it in any concentration, including concentrations far higher than any practicing homeopath would recommend. Babies have died after using homeopathic teething tablets with belladonna, though I don’t know if atropine was the cause of death.
Good to know, thanks. Yeah, I’m no fan of Senator Copeland.
Yes, that’s it, not paregoric. I know the difference, but my typing fingers didn’t. DavidNRockies is on the money with his post.