Brand Names:

• Akineton
• Artane
• Azilect
• Comtan
• Dostinex
• Eldepryl
• Kemadrin
• Lodosyn
• Mirapex
• Parlodel
• Permax
• Requip
• Sinemet 10-100
• Stalevo 100
• Symmetrel
• Tasmar
• Pms-Procyclidine
• Pms-Trihexyphenidyl

Dosage Forms:

• Tablet
• Tablet, Extended Release
• Capsule
• Capsule, Extended Release
• Syrup
• Elixir
• Tablet, Disintegrating
• Capsule, Liquid Filled
• Solution

Uses of This Medicine:

Antidyskinetics are used to treat Parkinson's disease, sometimes referred to as "shaking palsy." By improving muscle control and reducing stiffness, this medicine allows more normal movements of the body as the disease symptoms are reduced. It is also used to control severe reactions to certain medicines such as reserpine (e.g., Serpasil) (medicine to control high blood pressure) or phenothiazines, chlorprothixene (e.g., Taractan), thiothixene (e.g., Navane), loxapine (e.g., Loxitane), and haloperidol (e.g., Haldol) (medicines for nervous, mental, and emotional conditions).

Antidyskinetics may also be used for other conditions as determined by your doctor.

These medicines are available only with your doctor's prescription.

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Children may be especially sensitive to the effects of antidyskinetics. This may increase the chance of side effects during treatment.

Older adults

Agitation, confusion, disorientation, hallucinations, memory loss, and mental changes are more likely to occur in elderly patients, who are usually more sensitive to the effects of antidyskinetics.

Pregnancy

Studies on effects in pregnancy have not been done in either humans or animals. However, antidyskinetics have not been shown to cause problems in humans.

Breast-feeding

It is not known if antidyskinetics pass into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking these medicines and who wish to breast-feed should discuss this with their doctor.

Since antidyskinetics tend to decrease the secretions of the body, it is possible that the flow of breast milk may be reduced in some patients.

Other medicines

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Amphetamine
• Clorgyline
• Cyclobenzaprine
• Desvenlafaxine
• Dextromethorphan
• Ephedrine
• Fluvoxamine
• Furazolidone
• Iproniazid
• Isocarboxazid
• Linezolid
• Lisdexamfetamine
• Meperidine
• Methadone
• Milnacipran
• Mirtazapine
• Moclobemide
• Morphine
• Morphine Sulfate Liposome
• Nialamide
• Pargyline
• Phenelzine
• Phenylephrine
• Phenylpropanolamine
• Procarbazine
• Propoxyphene
• Pseudoephedrine
• Selegiline
• St John's Wort
• Tapentadol
• Tetrabenazine
• Toloxatone
• Tramadol
• Tranylcypromine

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Amitriptyline
• Amoxapine
• Apomorphine
• Bitolterol
• Citalopram
• Clomipramine
• Desipramine
• Difenoxin
• Diphenoxylate
• Dobutamine
• Dopamine
• Dothiepin
• Doxepin
• Duloxetine
• Epinephrine
• Escitalopram
• Fentanyl
• Fluoxetine
• Imipramine
• Iproniazid
• Isocarboxazid
• Isoetharine
• Isoniazid
• Isoproterenol
• Lofepramine
• Maprotiline
• Methyldopa
• Moclobemide
• Nefazodone
• Nialamide
• Norepinephrine
• Nortriptyline
• Pargyline
• Paroxetine
• Phenelzine
• Procarbazine
• Protriptyline
• Sertraline
• Sibutramine
• Tranylcypromine
• Trimipramine
• Venlafaxine

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use your medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Tyramine Containing Food

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Difficult urination or
• Enlarged prostate or
• Glaucoma or
• Heart or blood vessel disease or
• High blood pressure or
• Intestinal blockage or
• Myasthenia gravis or
• Uncontrolled movements of hands, mouth, or tongue Antidyskinetics may make the condition worse.

• Kidney disease or
• Liver disease Higher blood levels of the antidyskinetics may result, increasing the chance of side effects.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer period of time than your doctor ordered. To do so may increase the chance of side effects.

To lessen stomach upset, take this medicine with meals or immediately after meals, unless otherwise directed by your doctor.

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults To start, 0.5 to 4 milligrams (mg) a day, depending on your condition. Your doctor will adjust your dose as needed; however, the dose is usually not more than 6 mg a day.
    • Children Use and dose must be determined by your doctor.
• For injection dosage form:
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults 1 to 4 mg a day, depending on your condition. Your doctor will adjust your dose as needed; however, the dose is usually not more than 6 mg a day.
    • Children Use and dose must be determined by your doctor.

• For oral dosage form (tablets):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults 2 mg up to four times a day. Your doctor will adjust your dose, depending on your condition; however, the dose is usually not more than 16 mg a day.
    • Children Use and dose must be determined by your doctor.
• For injection dosage form:
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults 2 mg, injected into a muscle or vein. The dose may be repeated if needed; however, the dose is usually not given more than four times a day.
    • Children Use and dose is based on body weight and must be determined by your doctor.

• For oral dosage form (tablets):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults 50 mg one or two times a day. Your doctor will adjust your dose as needed; however, the dose is usually not more than 600 mg a day.
    • Children Use and dose must be determined by your doctor.

• For oral dosage forms (elixir and tablets):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults To start, 2.5 mg three times a day after meals. Your doctor may need to adjust your dose, depending on your condition.
    • Children Use and dose must be determined by your doctor.

• For extended-release oral dosage form (extended-release capsules):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults 5 mg after breakfast. Your doctor may add another 5 mg dose to be taken twelve hours later, depending on your condition.
    • Children Use and dose must be determined by your doctor.
• For other oral dosage forms (elixir or tablets):
  • For Parkinson's disease or certain severe side effects caused by some other medicines:
    • Adults To start, 1 to 2 mg a day. Your doctor may adjust your dose as needed; however, the dose is usually not more than 15 mg a day.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of this medicine, take it as soon as possible. However, if it is within 2 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Keep the liquid form of this medicine from freezing.

Precautions While Using This Medicine:

Your doctor should check your progress at regular visits, especially for the first few months you take this medicine. This will allow your dosage to be changed as necessary to meet your needs.

Your doctor may want you to have your eyes examined by an ophthalmologist (eye doctor) before and also sometime later during treatment.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely, to prevent side effects or the worsening of your condition.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine

Do not take this medicine within 1 hour of taking medicine for diarrhea. Taking these medicines too close together will make this medicine less effective.

If you think you or anyone else has taken an overdose of this medicine, get emergency help at once. Taking an overdose of this medicine may lead to unconsciousness. Some signs of an overdose are clumsiness or unsteadiness; seizures; severe drowsiness; severe dryness of mouth, nose and throat; fast heartbeat; hallucinations (seeing, hearing, or feeling things that are not there); mood or mental changes; shortness of breath or troubled breathing; trouble in sleeping; and unusual warmth, dryness, and flushing of skin.

This medicine may cause your eyes to become more sensitive to light than they are normally. Wearing sunglasses and avoiding too much exposure to bright light may help lessen the discomfort.

This medicine may cause some people to have blurred vision or to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert or able to see well.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from lying or sitting. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

This medicine may make you sweat less, causing your body temperature to increase. Use extra care to avoid becoming overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke. Also, hot baths or saunas may make you feel dizzy or faint while you are taking this medicine.

This medicine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Rare

Confusion (more common in the elderly or with high doses)

eye pain

skin rash

Symptoms of overdose

Clumsiness or unsteadiness

drowsiness (severe)

dryness of mouth, nose, or throat (severe)

fast heartbeat

hallucinations (seeing, hearing, or feeling things that are not there)

mood or mental changes

seizures

shortness of breath or troubled breathing

trouble in sleeping

warmth, dryness, and flushing of skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Blurred vision

constipation

decreased sweating

difficult or painful urination (especially in older men)

drowsiness

dryness of mouth, nose, or throat

increased sensitivity of eyes to light

nausea or vomiting

Less common or rare

Dizziness or lightheadedness when getting up from a lying or sitting position

false sense of well-being (especially in the elderly or with high doses)

headache

loss of memory (especially in the elderly)

muscle cramps

nervousness

numbness or weakness in hands or feet

soreness of mouth and tongue

stomach upset or pain

unusual excitement (more common with large doses of trihexyphenidyl)

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Anxiety

difficulty in speaking or swallowing

dizziness or lightheadedness when getting up from a lying or sitting position

fast heartbeat

loss of balance control

mask-like face

muscle spasms, especially of face, neck, and back

restlessness or desire to keep moving

shuffling walk

stiffness of arms or legs

trembling and shaking of hands and fingers

trouble in sleeping

twisting movements of body

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.