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Benztropine

    DEA Class;  Rx

    Common Brand Names; Cogentin

    • Antiparkinson Agents, Anticholinergics

    Synthetic muscarinic-receptor antagonist; structurally similar to atropine and diphenhydramine; has a longer duration of action and may require less frequent dosing than diphenhydramine; produces less CNS stimulation than does trihexyphenidyl and, thus, may be useful in geriatric patients.

    For the treatment of parkinsonism or Parkinson’s disease, including tremor due to the disease.

    For the treatment of drug-induced extrapyramidal symptoms.

    For the treatment of chronic sialorrhea† (chronic drooling) in developmentally-disabled patients.

    Hypersensitivity

    Age <3 years

    • Blurred vision
    • Confusion
    • Constipation
    • Disorientation
    • Dry mouth or throat
    • Hyperthermia
    • Mydriasis
    • Nausea
    • Paralytic ileus
    • Psychosis
    • Tachycardia
    • Urinary retention
    • Visual hallucinations
    • Vomiting

    May cause anhidrosis/hyperthermia, which may become severe; use with catuion in hot weather and during exercise; risk is increased in hot environment; consider lowering the dose to prevent impairing heat equilibrium by perspiration

    May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention)

    At higher doses, may be associated with confusion, visual hallucinations or excitement; intensification of symptoms or toxic psychosis may occur in patients with mental disorders

    May cause CNS depression, which may impair ability to operate heavy machinery and tasks that require mental alertness

    In susceptible patients, large doses may cause weakness and inability to move perticular muscles

    Use caution in patients with GI obstruction, tachycardia, prostatic hyperplasia/urinary stricture, and glaucoma

    Pregnancy

    Use in pregnancy not established; paralytic ileus reported in newborns exposed to a combination of benztropine and chlorpromazine during the second and third trimesters of pregnancy

    Lactation

    Excretion in milk unknown; use with caution

    Adults

    8 mg/day PO, IM, or IV.

    Geriatric

    8 mg/day PO, IM, or IV.

    Adolescents

    Weight-based doses up to 0.05 mg/kg/dose PO, IM or IV, not to exceed adult maximum of 8 mg/day PO, IM or IV, have been reported.

    Children

    3 years and older: Weight-based doses up to 0.05 mg/kg/dose PO, IM or IV, generally not to exceed 1 mg/dose, have been reported.
    Less than 3 years: Contraindicated.

    Infants

    Contraindicated.

    Benztropine mesylate

    Tablet

    • 0.5mg
    • 1mg
    • 2mg

    Injectable solution

    • 1mg/mL