Formulary
Procyclidine hydrochloride: Indications, Dosing, Side Effects and Interactions
Procyclidine exerts its antiparkinsonian action by reducing the effects of the relative central cholinergic excess that occurs as a result of dopamine...
MedNext Academy | 3 min read
Procyclidine hydrochloride: Indications, Dosing, Side Effects and Interactions
Procyclidine exerts its antiparkinsonian action by reducing the effects of the relative central cholinergic excess that occurs as a result of dopamine...
Drug action
Procyclidine exerts its antiparkinsonian action by reducing the effects of the relative central cholinergic excess that occurs as a result of dopamine deficiency.
Indications and dose
**Parkinsonism**
- **Adult** (By Mouth): 2.5 mg 3 times a day, then increased in steps of 2.5-5 mg daily as required, dose to be increased at 2-3 day intervals, usual maintenance 15-30 mg daily in 2-4 divided doses, maximum daily dose only to be used in exceptional circumstances; maximum 60 mg per day.
- **Elderly** (By Mouth): Lower end of range preferable.
**Drug-induced extrapyramidal symptoms (but not tardive dyskinesia)**
- **Adult** (By Mouth): 2.5 mg 3 times a day, then increased in steps of 2.5 mg daily as required, usual maintenance 10-30 mg daily in 2-3 divided doses.
- **Elderly** (By Mouth): Lower end of range preferable.
**Acute dystonia**
- **Adult** (By Intramuscular Injection, Or By Intravenous Injection): 5-10 mg, occasionally, more than 10 mg, dose usually effective in 5-10 minutes but may need 30 minutes for relief.
- **Elderly** (By Intramuscular Injection, Or By Intravenous Injection): Lower end of range preferable.
**Acute dystonia for procyclidine hydrochloride**
- **Child 1 month-1 year** (By intramuscular injection, or by intravenous injection): 0.5-2 mg for 1 dose, dose usually effective in 5-10 minutes but may need 30 minutes for relief.
- **Child 2-9 years** (By intramuscular injection, or by intravenous injection): 2-5 mg for 1 dose, dose usually effective in 5-10 minutes but may need 30 minutes for relief.
- **Child 10-17 years** (By intramuscular injection, or by intravenous injection): 5-10 mg, occasionally, more than 10 mg, dose usually effective in 5-10 minutes but may need 30 minutes for relief.
**Dystonia for procyclidine hydrochloride**
- **Child 7-11 years** (By mouth): 1.25 mg 3 times a day.
- **Child 12-17 years** (By mouth): 2.5 mg 3 times a day.
Cautions
Cardiovascular disease; elderly; hypertension; liable to abuse; prostatic hypertrophy; psychotic disorders; pyrexia; those susceptible to angle-closure glaucoma
Contraindications
Gastro-intestinal obstruction
Side effects
Common or very common Constipation; dry mouth; urinary retention; vision blurred Uncommon Anxiety; cognitive impairment; confusion; dizziness; gingivitis; hallucination; memory loss; nausea; rash; vomiting Rare or very rare Psychotic disorder
Interactions
**Severe interactions:**
- Daily administration of paroxetine increases significantly the plasma levels of procyclidine.
**Other interactions (5):**
- Monoamine oxidase inhibitors or drugs with anticholinergic properties, such as amantadine, memantine, antihistamines, phenothiazines, tricyclic and related antidepressants, clozapine, disopyramide...
- Anticholinergics, including procyclidine, may reduce the efficacy of levodopa by increasing gastric emptying time, resulting in enhanced gastric degradation.
- The effect of anticholinergics such as procyclidine may antagonise the gastrointestinal effects of cisapride, domperidone and metoclopramide.
- Procyclidine may potentiate the vagolytic effects of quinidine.
- Anticholinergics may reduce the absorption of ketoconazole.
Pregnancy
Use only if potential benefit outweighs risk.
Breast feeding
No information available.
Hepatic impairment
Manufacturer advises caution.
Renal impairment
Use with caution. M
Medicinal forms
Solution,Tablet,Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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