Nasal atropine sulfate: efficacy and safety of 0.050% and 0.075% solutions for severe rhinorrhea.

BACKGROUND Anticholinergic agents, specifically the quaternary salt of atropine, are currently being recommended for chronic rhinitis and the common cold. OBJECTIVE To evaluate the efficacy and safety of 50- and 75-microg doses of atropine sulfate as a nasal spray in perennial allergic rhinitis. METHODS A placebo-controlled, double-blind study compared 2 doses of atropine nasal spray given 4 times daily for 2 weeks to 45 patients with perennial allergic rhinitis after a 2-week baseline period. RESULTS Both concentrations of atropine nasal spray improved the severity of rhinorrhea and postnasal drip (P<.001) as reported by patients and physicians. The duration of action in reducing rhinorrhea and postnasal drip for atropine was 2 to 3 hours, compared with less than 1 hour for placebo (P<.01). No difference was noted in efficacy between the 2 atropine doses nor in frequency of adverse events with atropine nasal spray and placebo. CONCLUSIONS Atropine sulfate, 50 or 75 microg 4 times daily, is effective in reducing rhinorrhea and postnasal drip within 2 weeks and may be an alternative therapy for the rhinorrhea component of rhinitis.