Benztropine

Administration

  • Type: Anticholinergic
  • Dosage Forms: tablet, injectable solution
  • Dosage Strengths: tablet: 0.5, 1, 2mg; injectable solution: 1mg/mL
  • Routes of Administration: IV, IM, oral
  • Common Trade Names: Cogentin

Adult Dosing

  • Extrapyramidal disease: 1-4 mg IV/IM/PO 1-2 times daily
  • Parkinsonism: 0.5 mg IM/IV/PO daily, titrate up in 0.5mg increments

Pediatric Dosing

  • Contraindicated children <3 years old. Otherwise, same as adult dosing

Special Populations

Renal: no adjustment Hepatic: no adjustment

Contraindications

  • Allergy to class/drug
  • Age <3 years

Adverse Reactions

Serious

  • Psychosis, confusion, hallucinations
  • Hyperpyrexia, heat stroke, anhidrosis
  • Paralytic ileus

Common

  • Tachycardia
  • Constipation, nausea, xerostomia
  • Blurry vision
  • Urinary retention

Pharmacology

  • Half-life: duration of action is around 24 hours
  • Metabolism:
  • Excretion:

Mechanism of Action

  • Anticholinergic, reduces imbalance between acetylcholine and dopamine

Comments

See Also

References

  • 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767. [PubMed 30693946]
  • Bellman MH. Treatment of phenothiazine drug intoxication with benztropine. Arch Dis Child.1974;49(8):664-665. [PubMed 4424791]
  • Benztropine tablets [prescribing information]. Livonia, MI: Major Pharmaceuticals; October 2017.
  • Brocks DR. Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective. J Pharm Pharm Sci. 1999;2(2):39-46. [PubMed 10952768]
  • Cogentin (benztropine) injection [prescribing information]. Lake Forest, IL: Akorn Inc; May 2013.
  • Duncan MA, Nikolov NM, and O’Kelly B, “Acute Chorea Due to Ondansetron in an Obstetric Patient,” Int J Obstet Anesth, 2001, 10(4):309-11. [PubMed 15321589]
  • Falterman CG, Richardson CJ. Small left colon syndrome associated with maternal ingestion of psychotropic drugs. J Pediatr. 1980;97(2):308-310. [PubMed 740090]
  • Habre W, Wilson D, Johnson CM. Extrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children. Paediatr Anaesth. 1999;9(4):362-364. [PubMed 10411778]
  • Joseph MM, King WD. Dystonic reaction following recommended use of a cold syrup. Ann Emerg Med. 1995;26(6):749-751. [PubMed 7492048]
  • Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB; Schizophrenia Patient Outcomes Research Team (PORT). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophr Bull. 2010;36(1):94-103. doi: 10.1093/schbul/sbp130. [PubMed 19955388]