BMA Concise Guide to Medicine & Drugs

Procyclidine

Brand names Arpicolin, Kemadrin

Used in the following combined preparations None

QUICK REFERENCE

Drug group Drug for parkinsonism

Overdose danger rating High

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Introduced in the 1950s, procyclidine is an anticholinergic drug that is used to treat Parkinson’s disease. It is especially helpful in the early stages of the disorder for treating muscle rigidity. It also helps to reduce excess salivation. However, the drug has little effect on the shuffling gait and slow muscular movements that characterize Parkinson’s disease.

Procyclidine is also often used to treat parkinsonism resulting from treatment with antipsychotic drugs.

The drug may cause various adverse effects. However, these are rarely serious enough to warrant stopping the treatment.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid, injection.

Frequency and timing of doses 2–3 x daily.

Adult dosage range 7.5–30mg daily, exceptionally up to 60mg daily. Dosage is determined individually in order to find the best balance between effective relief of symptoms and the occurrence of adverse effects.

Onset of effect Within 30 minutes.

Duration of action 8–12 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

OVERDOSE ACTION

Seek immediate medical advice in all cases. Take emergency action if palpitations, seizures, or unconsciousness occur.

POSSIBLE ADVERSE EFFECTS

The adverse effects of procyclidine are mainly the result of its anticholinergic action. Dry mouth, constipation, drowsiness, dizziness, and blurred vision are common. Discuss with your doctor if you have blurred vision or if any of the other symptoms are severe as it may be possible to overcome them by adjusting the drug dosage. Difficulty in passing urine is also common; if it occurs, you should contact your doctor promptly. Nausea, vomiting, nervousness, confusion, or a rash may occasionally occur; if so, discuss with your doctor.

INTERACTIONS

Anticholinergic and antihistamine drugs These drugs may increase the adverse effects of procyclidine.

Tricyclic antidepressants and antipsychotic drugs may increase the side effects of procyclidine.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You suffer from or have a family history of glaucoma.

· You have high blood pressure.

· You suffer from constipation.

· You have prostate problems.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Safety in breast-feeding not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Reduced dose may be necessary.

Driving and hazardous work Avoid such activities until you have learned how procyclidine affects you because the drug can cause drowsiness, blurred vision, and mild confusion.

Alcohol Avoid. Alcohol may increase the sedative effect of this drug.

PROLONGED USE

Prolonged use of this drug may provoke the onset of glaucoma.

Monitoring Periodic eye examinations are usually advised.