Generic
Procyclidine Hydrochloride
10 brands available in the market
At a glance
Procyclidine Hydrochloride is an antimuscarinic antiparkinsonian agent used for adjunctive treatment of all forms of parkinsonian syndrome and for controlling troublesome extrapyramidal symptoms including pseudoparkinsonian, acute dystonic reactions, and akathisia induced by neuroleptic drugs such as phenothiazine derivatives.
Description
Procyclidine hydrochloride is an antimuscarinic antiparkinsonian agent of relatively low toxicity. It exerts its antiparkinsonian effect by correcting the relative cholinergic excess thought to occur in parkinsonian as a result of dopamine deficiency. It blocks excess acetylcholine at cerebral synapses and exhibits direct antispasmodic effect on smooth muscle.
Indications
- Parkinsonian syndrome (idiopathic, postencephalitic, and arteriosclerotic)
- Neuroleptic-induced extrapyramidal symptoms (pseudoparkinsonian, acute dystonic reactions, akathisia)
Therapeutic class
Antiparkinson drugs
Pharmacological class
Antimuscarinic (Anticholinergic)
Pharmacology
Procyclidine hydrochloride is an antimuscarinic agent that corrects the relative cholinergic excess in parkinsonian states due to dopamine deficiency. It blocks excess acetylcholine at cerebral synapses and exhibits direct antispasmodic effect on smooth muscle.
Mechanism of action
Improves muscle control and reduces stiffness by blocking excess acetylcholine.
Dosage
Adult Dose (Oral):
- Parkinsonism and drug-induced extrapyramidal syndrome: Initial 2.5 mg three times daily; increase by 2.5-5 mg every 2-3 days if needed; maintenance 10-30 mg/day in 3-4 divided doses; up to 60 mg/day in some cases
- Elderly: Lower doses required
Parenteral Dose:
- Parkinsonism/drug-induced extrapyramidal syndrome (emergency): IV: 5-10 mg; IM: 5-10 mg single dose, repeat after 20 min if needed, max 20 mg/day
Pediatric Dose (Oral):
- Dystonia (7-12 years): 1.25 mg three times daily; (12-18 years): 2.5 mg three times daily
- Emergency (IM/IV): <2 years: 0.5-2 mg; 2-10 years: 2-5 mg; 10-18 years: 5-10 mg
Administration
- Take with food (to reduce side effects)
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Dry mouth (most common)
- Mydriasis
- Blurred vision
- Nausea
- Vomiting
- Epigastric distress
- Constipation
- Dizziness
- Urinary retention
- High doses: Vertigo, confusion, hallucinations
Precautions & warnings
- May affect driving ability; do not drive if drowsy or dizzy
- Caution in glaucoma, prostatic hypertrophy, urinary retention, cardiovascular disease
- Do not stop abruptly (rebound Parkinsonism symptoms may occur)
- Psychotic patients may experience precipitation of psychotic episode
Contraindications
- Urinary outflow obstruction
- Prostatic hypertrophy
- Narrow-angle glaucoma
- Paralytic ileus
- Pyloric stenosis
Drug interactions
- Amantadine: Increased anticholinergic activity
- Paroxetine: Increased plasma concentrations
- MAOIs and other anticholinergic drugs: Enhanced anticholinergic action
- Cholinergic drugs: Reduced therapeutic effect
- Levodopa: May reduce efficacy
- Ketoconazole: May reduce absorption
Food interactions
Alcohol with Procyclidine Hydrochloride may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Caution; breastfeeding should be held until treatment is completed and drug is eliminated from the body.
Pediatric use
Pediatric dose based on age and weight; consult your doctor.
Geriatric use
Elderly patients require lower doses; caution required.
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; consult your doctor.
Overdose effects
No overdose information available; consult your doctor if taken in excess.
Storage conditions
Protect from light and moisture, store below 25°C; keep out of reach of children.
Chemical structure
Procyclidine Hydrochloride