From the Guidelines
Atropine should be administered at a dose of 0.02 mg/kg IV/IO, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg for a child and 1.0 mg for an adolescent, to manage hyper saliva. This dosage is based on the most recent and highest quality study available, which provides guidelines for pediatric emergency drugs 1. The dose may be repeated every 5 minutes to a maximum total dose of 1 mg for a child and 2 mg for an adolescent or adult.
Key Considerations
- The dose for children is 0.02 mg/kg IV/IO, which is the recommended dosage for managing hyper saliva in pediatric patients 1.
- The minimum single dose is 0.1 mg, and the maximum single dose is 0.5 mg for a child and 1.0 mg for an adolescent 1.
- The dose may be repeated every 5 minutes, with a maximum total dose of 1 mg for a child and 2 mg for an adolescent or adult 1.
Administration and Monitoring
- Atropine may be administered via IV/IO or IM routes, with dosages of 0.02–0.04 mg/kg for IM administration 1.
- Patients should be monitored for common anticholinergic side effects, including dry mouth, blurred vision, urinary retention, constipation, and confusion.
- Atropine is contraindicated in patients with narrow-angle glaucoma, prostatic hypertrophy, and certain cardiac conditions.
Special Populations
- For children, the dose is typically 0.02 mg/kg IV/IO, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg 1.
- In elderly patients, the dose should be adjusted carefully due to increased sensitivity to anticholinergic effects.
From the FDA Drug Label
Adult dosage Antisialagogue or for antivagal effects: Initial single dose of 0. 5 to 1 mg. The recommended dose of atropine for hyper saliva is an initial single dose of 0.5 to 1 mg administered intravenously, as it is used as an antisialagogue. 2
From the Research
Atropine Dose for Hyper Saliva
- The optimal dose of atropine for managing hyper saliva is not explicitly stated in the provided studies 3, 4, 5, 6.
- However, atropine is mentioned as a potential treatment option for hyper saliva in several studies 3, 5, 6.
- A systematic review and meta-analysis found that atropine is efficacious in managing sialorrhea in most disease states, with sublingual administration being superior to other routes of administration 6.
- The study suggests that the route of atropine administration, rather than the dose, may be a crucial factor in its effectiveness in reducing salivary flow 6.
- Other studies discuss the use of anticholinergic medications, including atropine, in managing sialorrhea, but do not provide specific dosage information 3, 4, 5.