Pronunciation:

BENZ-troe-peen

Brand Names:

• Cogentin

Dosage Forms:

• Tablet

Classifications:

Therapeutic—

Antiparkinsonian

Pharmacologic—

Anticholinergic

Uses of This Medicine:

Benztropine is used with other medicines to treat Parkinson's disease. 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 that are used to treat nervous, mental, and emotional conditions (e.g., phenothiazine medicine such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®).

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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—

Because of benztropine's toxicity, it should be used with caution in children 3 years of age or older. It is not recommended for use in children below 3 years of age.

Older adults—

No information is available on the relationship of age to the effects of benztropine in geriatric patients.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

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

• Potassium Citrate

Using this medicine 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.

• Amantadine
• Buprenorphine
• Clozapine
• Codeine
• Glucagon
• Glycopyrrolate
• Glycopyrronium Tosylate
• Methacholine
• Metoclopramide
• Oxycodone
• Quetiapine
• Revefenacin
• Scopolamine
• Secretin Human
• Tapentadol
• Tiotropium

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Betel Nut
• Chlorpromazine
• Haloperidol

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. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

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

• Enlarged prostate or
• Glaucoma or
• Paralytic ileus (bowel blockage) or
• Psychosis (mental disorder) or
• Tachycardia (fast heartbeat) or
• Urinating problems (e.g., painful or difficult urination, urinary retention)—Use with caution. May make these conditions worse.

• Glaucoma, angle-closure or
• Tardive dyskinesia (movement disorder)—Should not be used in patients with this condition.

Proper Use of This Medicine:

Take this medicine every day exactly as ordered by your doctor in order to improve your condition as much as possible. Do not take more of it or less of it, and do not take it more or less often than your doctor ordered.

It is important to take this medicine together with other medicines for Parkinson's disease. Be sure to take all of the medicines your doctor ordered, and to take them at the right times.

Dosing—

The dose of this medicine 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 this medicine. 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 Idiopathic parkinsonism:
    • Adults—At first, 0.5 to 1 milligram (mg) at bedtime. Your doctor may increase your dose as needed. The dose is usually not more than 6 mg.
    • Children 3 years of age and above—Use and dose must be determined by your doctor.
    • Children below 3 years of age—Use is not recommended.
  • For Parkinson-like symptoms caused by other medicines:
    • Adults—At first, 1 to 4 milligrams (mg) once or twice a day. Your doctor may increase your dose as needed.
    • Children 3 years of age and above—Use and dose must be determined by your doctor.
    • Children below 3 years of age—Use is not recommended.
  • For Postencephalitic parkinsonism:
    • Adults—At first, 0.5 to 2 milligrams (mg) at bedtime. Your doctor may increase your dose as needed. The dose is usually not more than 6 mg.
    • Children 3 years of age and above—Use and dose must be determined by your doctor.
    • Children below 3 years of age—Use is not recommended.

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.

Storage—

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

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is important that your doctor check your progress at regular visits to allow changes in your dose and to check for any unwanted effects.

Benztropine may cause dizziness, trouble in controlling movements, or trouble in thinking or seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely.

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.

This medicine may cause muscle weakness. If you have concerns about this, check with your doctor.

If you develop any unusual or strange thoughts and behavior while receiving benztropine, be sure to discuss it with your doctor. Some changes that have occurred in people receiving this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, worsening of depression, visual hallucinations (seeing things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). 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 medical doctor or dentist before taking any of the above while you are taking this medicine.

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 immediately if any of the following side effects occur:

Incidence not known

Abdominal or stomach cramps or pain

aggressive and violent behavior

being forgetful

bloating

burning while urinating

confusion about identity, place, and time

constipation

decrease in frequency of urination

decrease in urine volume

diarrhea

difficult or painful urination

difficulty in passing urine (dribbling)

difficulty with speaking

difficulty with swallowing

discouragement

dizziness

dry mouth

extremely high fever or body temperature

fast, pounding, or irregular heartbeat or pulse

fast, shallow breathing

fast, weak heartbeat

feeling sad or empty

fever

headache

hot, dry skin

irritability

lack of appetite

lack of sweating

listlessness

loss of interest or pleasure

mood or mental changes

muscle cramps

muscle weakness

nervousness

numbness of the fingers

pale, clammy skin

seeing things that are not there

thirst

tiredness

trouble concentrating

trouble with sleeping

vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Blindness

blurred vision

change in consciousness

cold clammy skin

decreased vision

dizziness

eye pain

holding false beliefs that cannot be changed by fact

lightheadedness

loss of consciousness

muscle weakness

nausea or vomiting

no breathing

nosebleeds

numbness or tingling in the face, arms, or legs

shakiness and unsteady walk

sweating

tearing

unsteadiness, trembling, or other problems with muscle control or coordination

unusual excitement, nervousness, or restlessness

vision problems

wheezing

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:

Incidence not known

Enlarged pupils

loss of appetite

skin rash

weight loss

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

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.