Atropine and 2 side effects: what 1,487 FDA adverse event reports show
Drug class
Anticholinergic, Cholinergic Muscarinic Antagonist
Label matched
Atropine (Atropen Auto-Injector)
Who reports
1,487 reports · 94% serious · 391 with death outcome · 57% female
Used for
ATROPEN is indicated for the treatment of poisoning by susceptible organophosphorus nerve agents having cholinesterase activity as well as organophosphorus or carbamate insecticides in adult and pediatric patients. ATROPEN is a cholinergic muscarinic a.
What it is
Each prefilled ATROPEN single-dose autoinjector provides an intramuscular dose of atropine, a cholinergic muscarinic antagonist in a self-contained unit, designed for self- or caregiver-administration.
Boxed warning
None in the current label
Causality screen of the 13 strongest signals
What the badges mean
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Outcome field, not a reaction Death is a report outcome, not a reaction term. It is dominated by the underlying illness; see the seriousness profile and the boxed warning instead.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 6 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Therapy interrupted | 158 | 32.4 27.9–37.5ROR 36.1 · χ² 4,776 / p <1e-300 | 32.2 EB05 28.2 · IC025 +4.6 3/3 methods agree | Reporting / coding artifact | serious PRR 43.6 · 97% clinician | no trial data cached |
| Therapy cessation | 113 | 31.3 26.2–37.3ROR 33.7 · χ² 3,280 / p <1e-300 | 31.0 EB05 26.5 · IC025 +4.5 3/3 methods agree | Reporting / coding artifact | serious PRR 42.2 | no trial data cached |
| Spinal operation | 16 | 18.7 11.5–30.4ROR 18.9 · χ² 250 / p 1e-56 | 18.1 EB05 11.4 · IC025 +2.8 3/3 methods agree | Reporting / coding artifact | serious PRR 11.7 | no trial data cached |
| Surgery | 72 | 17.5 14.0–22.0ROR 18.4 · χ² 1,108 / p 3e-243 | 17.4 EB05 14.3 · IC025 +3.6 3/3 methods agree | Reporting / coding artifact | serious PRR 12.2 · 96% clinician | no trial data cached |
| Knee operation | 9 | 13.1 6.8–25.1ROR 13.2 · χ² 89 / p 2e-21 | 10.8 EB05 5.2 · IC025 +1.9 3/3 methods agree | Reporting / coding artifact | serious PRR 8.9 | no trial data cached |
| Knee arthroplasty | 15 | 10.2 6.1–16.8ROR 10.2 · χ² 115 / p 4e-27 | 8.8 EB05 5.3 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 6.1 | no trial data cached |
| Intentional dose omission | 18 | 9.3 5.9–14.7ROR 9.4 · χ² 125 / p 3e-29 | 8.1 EB05 5.2 · IC025 +2.1 3/3 methods agree | Reporting / coding artifact | serious PRR 11.7 | no trial data cached |
| Hospitalisation | 95 | 8.8 7.2–10.7ROR 9.3 · χ² 653 / p 2e-144 | 8.6 EB05 7.2 · IC025 +2.7 3/3 methods agree | Reporting / coding artifact | serious PRR 5.4 | no trial data cached |
| Hip arthroplasty | 7 | 6.5 3.1–13.6ROR 6.5 · χ² 27 / p 9e-8 | 4.8 EB05 2.5 · IC025 +0.9 3/3 methods agree | Not in label — unassessed | serious PRR 4.1 | no trial data cached |
| Pregnancy | 9 | 6.3 3.3–12.0ROR 6.3 · χ² 35 / p 2e-9 | 4.9 EB05 2.8 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious PRR 5.0 | no trial data cached |
| Death | 346 | 5.7 5.2–6.2ROR 7.1 · χ² 1,381 / p <1e-300 | 5.6 EB05 5.1 · IC025 +2.3 3/3 methods agree | Outcome field, not a reaction | serious PRR 3.5 · 96% clinician | no trial data cached |
| Dialysis | 5 | 5.0 2.1–11.9ROR 5.0 · χ² 12 / p 3e-4 | 3.6 EB05 1.7 · IC025 +0.3 | Not in label — unassessed | serious PRR 3.2 | no trial data cached |
| Skin cancer | 5 | 3.3 1.4–7.9ROR 3.3 · χ² 6 / p 0.008 | 2.7 EB05 1.3 · IC025 -0.1 PRR-only: not supported by EBGM or IC | Not in label — unassessed | serious PRR 2.1 | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Death | 346 | 5.7 5.2–6.2ROR 7.1 · χ² 1,381 / p <1e-300 | 5.6 EB05 5.1 · IC025 +2.3 3/3 methods agree | Outcome field, not a reaction | serious PRR 3.5 · 96% clinician | no trial data cached |
| Therapy interrupted | 158 | 32.4 27.9–37.5ROR 36.1 · χ² 4,776 / p <1e-300 | 32.2 EB05 28.2 · IC025 +4.6 3/3 methods agree | Reporting / coding artifact | serious PRR 43.6 · 97% clinician | no trial data cached |
| Therapy cessation | 113 | 31.3 26.2–37.3ROR 33.7 · χ² 3,280 / p <1e-300 | 31.0 EB05 26.5 · IC025 +4.5 3/3 methods agree | Reporting / coding artifact | serious PRR 42.2 | no trial data cached |
| Hospitalisation | 95 | 8.8 7.2–10.7ROR 9.3 · χ² 653 / p 2e-144 | 8.6 EB05 7.2 · IC025 +2.7 3/3 methods agree | Reporting / coding artifact | serious PRR 5.4 | no trial data cached |
| Surgery | 72 | 17.5 14.0–22.0ROR 18.4 · χ² 1,108 / p 3e-243 | 17.4 EB05 14.3 · IC025 +3.6 3/3 methods agree | Reporting / coding artifact | serious PRR 12.2 · 96% clinician | no trial data cached |
| Intentional dose omission | 18 | 9.3 5.9–14.7ROR 9.4 · χ² 125 / p 3e-29 | 8.1 EB05 5.2 · IC025 +2.1 3/3 methods agree | Reporting / coding artifact | serious PRR 11.7 | no trial data cached |
| Spinal operation | 16 | 18.7 11.5–30.4ROR 18.9 · χ² 250 / p 1e-56 | 18.1 EB05 11.4 · IC025 +2.8 3/3 methods agree | Reporting / coding artifact | serious PRR 11.7 | no trial data cached |
| Knee arthroplasty | 15 | 10.2 6.1–16.8ROR 10.2 · χ² 115 / p 4e-27 | 8.8 EB05 5.3 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 6.1 | no trial data cached |
| Pregnancy | 9 | 6.3 3.3–12.0ROR 6.3 · χ² 35 / p 2e-9 | 4.9 EB05 2.8 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious PRR 5.0 | no trial data cached |
| Knee operation | 9 | 13.1 6.8–25.1ROR 13.2 · χ² 89 / p 2e-21 | 10.8 EB05 5.2 · IC025 +1.9 3/3 methods agree | Reporting / coding artifact | serious PRR 8.9 | no trial data cached |
| Hip arthroplasty | 7 | 6.5 3.1–13.6ROR 6.5 · χ² 27 / p 9e-8 | 4.8 EB05 2.5 · IC025 +0.9 3/3 methods agree | Not in label — unassessed | serious PRR 4.1 | no trial data cached |
| Skin cancer | 5 | 3.3 1.4–7.9ROR 3.3 · χ² 6 / p 0.008 | 2.7 EB05 1.3 · IC025 -0.1 PRR-only: not supported by EBGM or IC | Not in label — unassessed | serious PRR 2.1 | no trial data cached |
| Dialysis | 5 | 5.0 2.1–11.9ROR 5.0 · χ² 12 / p 3e-4 | 3.6 EB05 1.7 · IC025 +0.3 | Not in label — unassessed | serious PRR 3.2 | no trial data cached |
| Neurotoxicity | 4 | 3.2 1.2–8.6ROR 3.3 · χ² 4 / p 0.020 | 2.6 EB05 1.2 · IC025 -0.4 PRR-only: not supported by EBGM or IC | Not in label — unassessed | serious PRR 2.0 | no trial data cached |
| Hospice care | 4 | 5.7 2.2–15.2ROR 5.7 · χ² 11 / p 4e-4 | 3.8 EB05 1.6 · IC025 +0.1 | Not in label — unassessed | serious PRR 5.1 | no trial data cached |
Unlabeled candidate signals
Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Atropine and 2?
In FDA FAERS, the most frequently co-reported reaction terms for Atropine and 2 are knee arthroplasty, pregnancy, hip arthroplasty, skin cancer, dialysis, neurotoxicity. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Atropine and 2 have an FDA boxed warning?
No. The FDA label retrieved for Atropine and 2 has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Atropine and 2 causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID e2d4307d-da8f-49f5-aac0-02355dd9ffb7, effective 20220915; matched on
openfda.generic_name.exact:"ATROPINE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 19 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.