Procyclidine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Drug-induced extrapyramidal symptoms; Parkinsonism Initial: 2.5 mg tid, increased gradually if needed. Maintenance: 10-30 mg/day in 3-4 divided doses. Max: 60 mg/day. IV/IM Drug-induced extrapyramidal symptoms; Parkinsonism Emergency: 5-10 mg IV inj; 5-10 mg as a single IM dose, may repeat after 20 min if needed. Max: 20 mg/day.
Dosage Details
Oral
Drug-induced extrapyramidal symptoms, Parkinsonism
Adult: Initially, 2.5 mg tid, increased gradually by 2.5-5 mg every 2-3 days if required or by 2.5 mg daily for drug-induced extrapyramidal symptoms. Maintenance: 10-30 mg daily in 3-4 divided doses. Up to 60 mg daily may be required in some cases.
Elderly: Lower doses are required.

Parenteral
Drug-induced extrapyramidal symptoms, Parkinsonism
Adult: Emergency cases: IV: 5-10 mg, higher doses may be needed; IM: 5-10 mg as a single dose, may repeat after 20 min if needed. Max: 20 mg/day.
Elderly: Lower doses are required.
Contraindications
Patient w/ myasthenia gravis, untreated urinary retention, closed angle glaucoma, GI obstruction.
Special Precautions
Patient w/ mental disorders, CV disease (e.g. tachycardia, cardiac arrhythmias, hypertension, hypotension). Hepatic and renal impairment. Avoid abrupt withdrawal. Elderly. Pregnancy and lactation.
Adverse Reactions
Dry mouth, mydriasis, blurred vision, lightheadedness, giddiness, disorientation, GI effects (e.g. nausea, vomiting, epigastric distress, constipation), allergic reaction (e.g. rash), muscular weakness; vertigo, confusion, hallucinations at high doses; tremor, acute suppurative parotitis.
Patient Counseling Information
This drug may cause blurred vision, dizziness, confusion or disorientation, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor symptoms of extrapyramydal syndrome or Parkinson's disease, pulse, anticholinergic effects (e.g. CNS, bowel and bladder function).
Overdosage
Symptoms: Stimulant effects (e.g. agitation, restlessness, confusion, sleeplessness lasting up to ≥24 hr; euphoria, anxiety, aggressive behaviour; dilated pupils that are nonreactive to light; disorientation (lasting for 1-4 days); CNS depression (e.g. somnolence, reduced consciousness, and occasionally coma); tachycardia. Management: Use activated charcoal to reduce absorption w/in 1-2 hr of ingestion (or possibly longer in view of its likely effects on gastric motility). Consider gastric lavage only if clinically appropriate. May give diazepam inj if convulsions occur.
Drug Interactions
Increased plasma concentrations w/ paroxetine. Enhanced anticholinergic action w/ MAOIs and other anticholinergic drugs. Reduced therapeutic effect w/ cholinergic drugs. May antagonise the effect of parasympathomimetic agents. May reduce the absorption and therapeutic effect of sublingual or buccal nitrate tab. May reduce the efficacy of levodopa. May antagonise the GI effects of cisapride, domperidone and metoclopramide. May potentiate the vagolytic effects of quinidine. May reduce the absorption of ketoconazole.
Food Interaction
Alcohol may potentiate the CNS effects of procyclidine.
Action
Description: Procyclidine is postulated to act by blocking excess acetylcholine at the muscarinic receptor; many of its effects are due to its pharmacologic similarities w/ atropine.
Onset: W/in 5-20 min (IV).
Duration: Up to 4 hr (IV).
Pharmacokinetics:
Absorption: Adequately absorbed from the GI tract. Bioavailability: 75% (oral). Time to peak plasma concentration: Approx 1 hr.
Distribution: Disappears rapidly from the tissues. Volume of distribution: 1 L/kg.
Metabolism: Undergoes hepatic metabolism (approx one-fifth of oral dose) by CYP450 isoenzymes, then conjugated w/ glucuronic acid.
Excretion: Via urine as unchanged drug (small amounts). Plasma elimination half-life: Approx 12 hr (oral/IV).
Chemical Structure

Click on icon to see table/diagram/image
Storage
Store between 15-30°C. Protect from moisture.
Disclaimer: This information is independently developed by MIMS based on Procyclidine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in