Patient w/ arteriosclerosis, history of drug idiosyncrasy. CV disease, glaucoma, GI obstruction, prostatic hyperplasia and/or urinary stricture. Not intended for treatment of tardive dyskinesia. Avoid abrupt withdrawal. Hepatic and renal impairment. Elderly. Pregnancy and lactation. Patient Counselling May impair mental or physical abilities e.g. operating machinery or driving. Monitoring Parameters Perform gonioscopic examination prior to initiation of therapy. Monitor intraocular pressure at regular intervals during prolonged treatment.
Patients with closed-angle glaucoma, chronic pulmonary disease, sick sinus syndrome, thyrotoxicosis, cardiac failure with tachycardia.
Dose
N/A
Side Effect
>10%
Anticholinergic side effects (30-50%), Rash
<1%
Suppurative parotitis,Hallucination,Paralytic ileus
Pregnancy Category
Name :
C
Description
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Trihexyphenidyl HCl is a tertiary amine antimuscarinic which exerts a direct inhibitory effect on the parasympathetic nervous system. It also exhibits a direct spasmolytic action on smooth muscle, weak mydriatic, antisialagogue and cardiovagal blocking effects.
Interaction
Increased antimuscarinic side effects w/ phenothiazines, clozapine, antihistamines, disopyramide, nefopam and amantadine. Synergistic effect when concomitantly used w/ TCAs. Concurrent admin w/ MAOIs may cause dry mouth, blurred vision, urinary hesitancy or retention and constipation. May antagonise effect of metoclopramide and domperidone on GI function. Reduced absorption of levodopa. May antagonise effect of parasympathomimetics.
Pregnancy Category Note
Pregnancy Category: C
Lactation: no data; may inhibit lactation
Adult Dose
Oral
Drug-induced extrapyramidal symptoms
Adult: 5-15 mg/day PO divided q6-8hr
Parkinson Disease
Adult: Initially, 1 mg daily, gradually increased at intervals of 3-5 days by increments of 2 mg until 6-10 mg daily in 3-4 divided doses.
Maintenance: 5-15 mg/day PO divided q6-8hr
Parkinsonism
Adult: 5-15 mg/day PO divided q6-8hr
Elderly: May require lower doses.
Child Dose
Safety and efficacy not established
Renal Dose
N/A
Administration
Should be taken with food. Best taken w/ meals. Take before meals if dry mouth occurs, after meals if drooling/nausea occurs. Take at the same time each day.
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