phenobarbital / hyoscyamine / atropine / scopolamine
Donnatal is a prescription medication that's added alongside other treatments to help manage stomach problems, such as irritable bowel syndrome (IBS), enterocolitis (inflammation in the intestines), and duodenal ulcers. It contains a combination of four active ingredients: a barbiturate (phenobarbital) and three anticholinergic medications (hyoscyamine, atropine, and scopolamine). This combination of medications is also available as a lower-cost generic and under the brand name Phenohytro. Typically, the tablets and elixir (liquid) are taken by mouth 3 to 4 times per day. Side effects include sleepiness, dizziness, blurry vision, and dry mouth.
What is Donnatal?
What is Donnatal used for?
Add-on therapy to treat:
- Irritable bowel syndrome (IBS)
- Short term enterocolitis (inflammation in the intestines)
- Duodenal ulcer
How Donnatal works
Donnatal is a combination of four medications that work together to treat stomach problems:
- Phenobarbital is a barbiturate. It causes changes in the brain to produce a mild calming effect.
- Hyoscyamine, atropine, and scopolamine are all anticholinergic medications. They work by blocking a chemical called acetylcholine from attaching to receptors in your body. This helps relax stomach muscles, slow down gut movement, and reduce stomach secretions to help treat a variety of stomach problems.
Drug facts
Side effects of Donnatal
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dry mouth
- Dizziness
- Blurred vision
- Constipation
- Sweating less
- Difficulty passing urine
- Fast heartbeat
Less Common Side Effects
- Headache
- Nervousness
- Bloating
- Nausea
- Vomiting
- Muscle pain
- Weakness
- Loss of taste
- Trouble sleeping
- Eye problems
Donnatal serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: swelling of eyelids, cheeks, or lips
- Serious skin reaction: rash, severe skin redness, peeling of the skin, painful blisters, fever, confusion
The following Donnatal side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Fever that does not go away, decreased sweating
- Trouble passing urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Blurry vision
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Headache
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Pros and cons of Donnatal
Pros
- Available in both tablet and elixir (liquid) form
- Can be used in both children and adults
- Can treat many stomach conditions
Cons
- Rated by the FDA to be "possibly" effective
- Needs to be taken multiple times a day
- Could be habit-forming because it contains phenobarbital
Pharmacist tips for Donnatal
- You can take Donnatal with or without food, but if it upsets your stomach, try taking it with food to help.
- Donnatal can make you sleepy and dizzy, which can raise your risk for falls. Avoid alcohol, driving, or activities that need focus until you know how this medication affects you. Tell your prescriber if you're taking benzodiazepines, anxiety medications, or muscle relaxants, as these can worsen these effects.
- Donnatal might affect how well certain blood thinners work. If you're also taking anticoagulants, your prescriber might have to raise your anticoagulant dose. When Donnatal is stopped, your prescriber might have to lower your anticoagulant dose.
- Donnatal can cause your mouth to feel dry because it causes your body to make less saliva. Be sure to drink enough water when you're taking this medication.
- Donnatal can cause you to sweat less. Be careful in hot weather or during exercise, as this can lead to a fever and overheating.
- Don't change your dose or stop taking Donnatal without talking to your prescriber first. Stopping suddenly can cause withdrawal symptoms, like seizures and confusion. If you need to stop, follow your prescriber's instructions to gradually reduce your dose.
- Let your prescriber know if you experience diarrhea with Donnatal, especially if you have surgical openings in the stomach like an ileostomy or colostomy. Diarrhea could be a sign of a partial stomach blockage, which could be harmful, so you'll need to be seen right away.
More tips for the liquid:
- Store the bottle at room temperature and keep it in the original bottle to protect from light.
- Make sure to only use a medication dose cup, syringe, or dropper from the pharmacy to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
Common questions about Donnatal
No, brand and generic versions of Donnatal are still available, including both the tablets and elixir.
No, Donnatal is only available by a prescription from a healthcare professional.
Although phenobarbital, an ingredient in Donnatal, is a Schedule IV controlled substance on its own, federal law allows Donnatal to be labeled as a non-controlled medication because it contains only a small amount of phenobarbital mixed with three other non-controlled ingredients. But, some states, like California, might classify Donnatal as a controlled substance. Donnatal can still cause misuse and dependence, leading to addiction. To lower this risk, take the medication only as directed by your prescriber.
The time it takes for each active ingredient of Donnatal to leave your system differs. After a single dose in adults, it takes about a month for phenobarbital, 8 to 18 hours for hyoscyamine, 10 to 12 hours for atropine, and 18 to 23 hours for scopolamine. These time frames are estimated based on the half-life of each active ingredient in Donnatal. It can differ from person to person depending on other factors, such as your age and whether you have kidney or liver problems. Talk to your prescriber if you have more questions on how long Donnatal stays in your system.
No, Donnatal isn't a narcotic because it's not an opioid medication. Donnatal is a combination product containing a barbiturate and three anticholinergic medications.
Both Phenohytro and Donnatal are brands that contain the same 4 active ingredients: phenobarbital, hyoscyamine, atropine, and scopolamine. The major difference between them is that Phenohytro is an elixir (liquid) whereas Donnatal is available as both an elixir and a tablet taken by mouth.
Yes, both Donnatal tablets and elixir (liquid) are available as generic medications.
Donnatal has been available since the 1940s when the FDA approved medications only based on safety, and not how well it works. In 1962, the law was changed and new medications were only approved if they were found to be safe and effective. Because Donnatal was on the market before this change in the law, it's not FDA approved. Donnatal is allowed to be on the market, but it's part of the FDA's list that requires further studies to determine how well it works. That's why the FDA rates Donnatal as "possibly effective".
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Risks and warnings for Donnatal
Donnatal can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to your unborn baby
It's strongly recommended to avoid using Donnatal while pregnant unless a healthcare professional determines the benefits outweigh the risks. Donnatal hasn’t been studied in pregnancy, and the phenobarbital in it can cause withdrawal symptoms in babies, like weakness and trouble sleeping. If you're pregnant or are planning on becoming pregnant, let your care team know right away.
Fever and heatstroke
Donnatal can reduce your ability to sweat. This can make your body overheat more easily, leading to a higher risk of fever or heatstroke in hot temperatures. Make sure to drink enough water and stay hydrated while taking this medication.
Dependence and withdrawal
- Risk factors: History of substance use disorder | History of mental health problems | Using higher doses of Donnatal for a long time | Stopping Donnatal suddenly
Phenobarbital in Donnatal can lead to dependence, where your body needs the medication to function normally. Take the medication exactly as prescribed and don't change the dose without talking to your prescriber first.
If you need to stop taking Donnatal, talk to your prescriber about a way to safely do so. Stopping the medication too suddenly can lead to life-threatening withdrawal symptoms, such as seizures and confusion.
Donnatal dosage
Typical dosage for Donnatal
-
Donnatal tablets and generics: Each tablet contains 16.2 mg of phenobarbital, 0.1037 mg of hyoscyamine, 0.0194 mg of atropine, and 0.0065 mg of scopolamine.
- Adults: The typical dose is 1 to 2 tablets by mouth 3 or 4 times a day.
-
Donnatal elixir, Phenohytro elixir, and generics : Each teaspoonful (5 mL) contains 16.2 mg of phenobarbital, 0.1037 mg of hyoscyamine, 0.0194 mg of atropine, and 0.0065 mg of scopolamine.
- Adults: The typical dose is 1 to 2 teaspoonfuls (5 mL to 10 mL) by mouth 3 to 4 times a day.
- Children: The dose is calculated based on your child’s weight. In general, the dose ranges from 0.5 mL to 5 mL by mouth every 4 hours, or 0.75 mL to 7.5 mL every 6 hours.
How much does Donnatal cost?
Donnatal contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Donnatal will not be safe for you to take.
- Glaucoma
- Urinary tract blockage
- Stomach or intestinal blockage
- Long-term constipation
- Unstable heart or bleeding problems
- Severe ulcerative colitis with toxic megacolon
- Myasthenia gravis
- Hiatal hernia with acid reflux
- Acute intermittent porphyria
- People who get restless and/or excited from phenobarbital
What are alternatives to Donnatal?
Donnatal images
