benztropine (Cogentin)

Benztropine is an oral and injectable synthetic medication. It is structurally similar to atropine (AtroPen) and diphenhydramine (Benadryl). Benztropine has anticholinergic effects. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter (chemical) that nerves use to communicate with other nerves.

In Parkinson's there is an imbalance between levels of dopamine and acetylcholine neurotransmitters. Benztropine helps restore balance by blocking the action of acetylcholine in the central nervous system (brain and spinal cord). Benztropine may also block the uptake and storage of dopamine in the central nervous system (CNS), resulting in the prolongation of the effects of dopamine. Benztropine was approved by the U.S. Food and Administration (FDA) in 1954.

What brand names are available for benztropine?

Cogentin

Is benztropine available as a generic drug?

Yes

Do I need a prescription for benztropine?

Yes

Side effects associated with benztropine treatment include

• rapid heartbeat,
• confusion,
• depression,
• heat stroke,
• tiredness,
• memory problems,
• nervousness,
• numbness of fingers,
• psychotic symptoms,
• skin rash,
• constipation,
• nausea,
• vomiting,
• dry mouth,
• urinary retention, and
• blurred vision.

: Co-adminstration of benztropine with other anticholinergic agents increases the risk of anticholinergic side effects such as:

• dry mouth,
• dry eyes,
• decreased urination,
• constipation, and
• mental confusion).

Commonly used drugs with moderate to significant anticholinergic effects are:

• amantadine (Symmetral),
• amoxapine, bupropion (Wellbutrin),
• clozapine (Clozaril),
• cyclobenzaprine (Flexeril),
• disopyramide (Norpace),
• maprotiline (Ludiomil),
• olanzapine (Zyprexa),
• orphenadrine (Norflex),
• first generation antihistamines (for example, diphenhydramine),
• phenothiazine, and
• tricyclic anitdepressants.

Benztropine blocks the activity of acetylcholine and can cancel or interfere with the action of drugs that increase gastrointestinal motility (movement of food through the GI tract). Example of such drugs includes:

• metoclopramide (Reglan),
• erythromycin (Erythrocin), and
• tegaserod (Zelnorm).

Umeclidinium (Incruse Ellipta) and tiotropium (Spiriva) may increase the anticholinergic side effects of benztropine. Coadminstration of these agents with benztropine is not recommended.

Benztropine may increase the blood levels of thiazide diuretics. Caution should be used when these agents are used together.

Benztropine may increase the risk of stomach ulcers from using potassium chloride (Klor-Con). Combination treatment with both agents is generally not recommended.

It is not known if benztropine is excreted in breast milk. However, antimuscarinic agents have been reported to suppress lactation in animals and decrease prolactin levels in the blood of nursing mothers. Due to the lack of safety data, benztropine should be used cautiously in females who are breastfeeding or avoided.

What preparations of benztropine are available?

• Tablets: 0.5 mg, 1 mg, 2 mg
• Solution for injection: 1 mg/ 1 ml

How should I keep benztropine stored?

Tablets should be stored at room temperature between 15 C to 30 C (59 F to 86 F). Injection solution should be stored at controlled room temperature between 19.44 C and 25 C (68 F and 77 F).