Adult Dosing
Parkinsonism
- 1-2 mg PO qd, range 0.5-6 mg/day
Idiopathic parkinsonism
- Start 0.5-1 mg PO qhs; may require 4-6 mg/day
Postencephalitic parkinsonism
- Start 2 mg/day PO in one or more doses
- Highly sensitive patients: Start 0.5 mg PO qhs, increase as required
Drug-induced extrapyramidal disorders
- 1-4 mg PO qd/bid
- If extrapyramidal disorders develop soon after initiation of therapy with neuroleptic drugs, give 1-2 mg bid-tid x1-2 days; discontinue benztropine therapy after 1-2 wks
Note:
- It should be given to patients who are able to take oral medication
- Start the therapy at lowest effective dose, then increase gradually at 5- or 6-day intervals to achieve optimal relief
- Increase the dose in increments of 0.5 mg to a max of 6 mg or until optimal results are achieved without excessive adverse reactions
Pediatric Dosing
- Safety and effectiveness in pediatric patients <3 yrs of age have not been established
- Should be used with extreme caution in children >3 yrs of age because of the drug's adverse anticholinergic effects
[Outline]
- Caution should be exercised while driving vehicle or operating a machinery because benztropine may impair mental and physical abilities
- Co-administration of phenothiazines, haloperidol, or other drugs with anticholinergic or antidopaminergic activity may cause GI complaints, fever or heat intolerance; patients should be advised to promptly report such events
- Fatal hyperthermia, paralytic ileus, and heat stroke may occur. Severe anhidrosis may be produced; use with caution during hot weather, especially when used with other atropine-like drugs in patients who are chronically ill, alcoholic, or those with CNS disease. Dose should be decreased so that the ability to maintain body heat equilibrium by perspiration is not impaired
- Urinary retention, dysuria, visual hallucinations, and glaucoma may occur
- Large doses may cause muscle weakness and/or inability to move particular muscle groups; adjust dosage as required
- Patients with mental disorders should be kept under careful observation, especially at the beginning of treatment or if dosage is increased
- Tardive dyskinesia may occur during or after discontinuation of long-term therapy with phenothiazines and related agents; benztropine is contraindicated in patients with tardive dyskinesia as it may aggravate these symptoms
Cautions: Use cautiously in
- Pediatric patients >3 yrs of age
- Cardiovascular disease
- Obstructive uropathy
- Benign prostatic hypertrophy
- Pregnancy
- Elderly patients
Pregnancy Category:C
Breastfeeding: No information is available; prolonged use may reduce milk production. Monitor for signs of decreased lactation. Single dose is not likely to interfere with breastfeeding. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 3 March 2011).
