By Mark Land, AAHP president
September 1, 2017

Belladonna, more commonly known as deadly nightshade, Atropa belladonna, devil’s cherries, devil’s herb, divale, dwale, dwayberry, great morel, naughty man’s cherries, and poison black cherry, is a perennial herb that has been valued for its medicinal properties for more than five centuries. Belladonna is a member of the Solanaceae (nightshade) family, which also includes potatoes and tomatoes.

Galen of Pergamon, the father of pharmacy, is the first author who refers to the mydriatic action of species of Solanaceae in the second century. By the 17th century, mydriatic action was confirmed by many authors. In the late 18th and early 19th centuries, apothecaries had begun to isolate specific alkaloids from belladonna extracts. Belladonna alkaloids were widely used as an antispasmodics, sedatives, and anticholenergics. Today, belladonna alkaloid preparations are used in ophthalmology, anesthesia, and cold preparations. As one of the most widely used homeopathic medicines, the belladonna symptom picture is nearly identical to the intoxicating effects of its main alkaloid constituents.

Belladonna preparation begins with the harvesting of wild or cultivated Atropa belladonna plant material. Under cultivated conditions the plant is generally harvested after its second year. Most official texts (Table 1) refer to use of the whole plant in flower. The United States Pharmacopoeia specifies leaf only. Although part of plant used is important (Table 2), the amount of total alkaloid is generally the specification of reference. In general, most official pharmacopoeias specify between 0.015 to 0.05% total belladonna alkaloids.

Table 1:

Reference Monograph title Part of plant Specifications
Homeopathic Pharmacopoeia of the United States Belladonna Whole plant at the beginning of flowering Contains not less than 0.02% w/w and not more than 0.05% w/w of total non-volatile alkaloids calculated as hyoscyamine (C17H23NO3; m.w. 289.4).
European Pharmacopoeia Belladonna for homeopathic preparations Whole, fresh, flowering plant of Atropa belladonna L., harvested at the end of flowering, with the ligneous base of the stems removed. Content: 0.020% w/w to 0.050% w/w of hyoscyamine (C17H23NO3; Mr 289.4).
United States Pharmacopoeia Belladonna tincture Belladonna leaf coarsely ground Belladonna tincture yields not less than 27 mg and not more than 33 mg of the alkaloids of belladonna leaf.
German Homeopathic Pharmacopoeia Atropa bella-donna (belladonna) Whole, fresh, flowering plant of Atropa belladonna L., harvested at the end of flowering, with the ligneous base of the stems removed. Contains not less than 0.020% and not more than 0.05% total alkaloids calculated as of atropine (C12H23NO3; Mr 289.4). The total alkaloid shall not contain more than 5% hyoscine (C17H21NO4; Mr 300.3).
French Pharmacopoeia Belladonna for homeopathic preparations Whole, fresh, flowering plant of Atropa belladonna L., Content: 0.015% w/w to 0.025 per cent w/w of hyoscyamine (C17H23NO3; Mr 289.4).

Extraction of belladonna plant material is most often accomplished by maceration of the plant material in a solution of water and alcohol. Extracts destined for dry preparations may use percolation, a process aided by gravity and prolonged contact between the menstruum and the plant material. Extraction of belladonna alkaloids from tinctures or other extracts is often based on manipulation of pressure gradients between membranes with pH adjustment.

Solid belladonna preparations include powdered leaf and powdered extracts. Powdered leaf preparations are simple mixtures of suitably ground leaf material and a carrier substance. The ground leaf is standardized to a certain total alkaloid concentration, usually through adjustment of the quantity of carrier substance added. Powdered extracts are prepared by drying liquid extracts, which are subsequently powdered to a suitable fineness. Purified belladonna alkaloids that are crystalline may also be prepared into powders, tablets, or injections for medicinal use.

Alkaloid content can vary by part of plant and origin (Table 2).

Table 2:

Leaves Root Stem Stem
Wild harvested 2.88% 8.06% 1.42%
Cultivated 1.76% 3.3% 1.42% 4.8%

In this article, belladonna refers to several substances with more or less therapeutic effect (Table 3). Atropine and hyoscamine are the most medically important of the belladonna alkaloids. Scopolamine, however, is important against vertigo.

Table 3:

Alkaloids of Belladonna
Atropine (C17H23NO3) ͠  90%
Hyoscyamine (C17H23NO3)
Apoatropine (C17H21NO2) 7%
Scopolamine 2%
Others 1%

Homeopathic preparations of belladonna are generally prepared via the maceration extraction method. The extract is then deconcentrated (attenuated) using successive dilution steps followed by agitation in a liquid vehicle (succussion) to the desired attenuation level. The liquid homeopathic preparation is then applied to the final dosage form directly or to an unformed diluent for blending or compression in the case of tablets. The liquid attenuations can also be used without application to a carrier dosage form. Belladonna alkaloids are mostly soluble but liquid extracts may be subject to precipitation when transitioned to an aqueous vehicle in high concentration.

The Homeopathic Pharmacopoeia of the United States has established 3X as the first safe OTC dilution for adults and children. See the companion article to this by Dr. Todd Hover on the clinical uses of homeopathic belladonna.

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