MedChoice CNS Pharma
Full Prescribing Info
Biperiden hydrochloride.
Each tablet contains: Biperiden HCl, USP 2 mg.
Pharmacology: Pharmacodynamics: Biperiden HCl (Akidin) is a centrally acting anticholinergic drug responsible for its therapeutic effect and has weak peripheral effects compared to Atropine.
Pharmacokinetics: Biperiden is readily absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism, hence its bioavailability is only 30%. Its elimination half-life is about 20 hours.
Biperiden HCl (Akidin) is used in the management of Parkinsonian syndromes, including rigidity and tremor. It is also used for extrapyramidal symptoms such as dyskinesia, akathisia and parkinsonism caused by neuroleptics and similarly acting drugs.
Dosage/Direction for Use
Treatment of Biperiden HCl (Akidin) is usually given with small incremental doses, depending on the therapeutic effect and side effects. Cautious dosing is necessary in elderly patients, especially those with symptoms of organic brain disease. There have been limited experience in pediatric use of the drug product.
Parkinsonism: Adults: The initial dose is 1 mg (1/2 tablet) in two divided dose. The dose may be adjusted to 2 mg (1 tablet) daily up to a maximum dose of 16 mg (8 tablets) daily. The total daily dose must be given evenly throughout the day.
Drug-induced Extrapyramidal Symptoms: Adults: 1 to 4 mg may be given to patient in one to four divided doses concomitantly given with neuroleptics depending on the severity of the symptoms.
Children 3-15 years of age: 1 to 2 mg may be given to patient in one to three divided doses.
Or as prescribed by a physician.
Anticholinergic effects are the symptoms of overdosage of Biperiden HCl (Akidin). These includes dryness of mucous membranes, flushing, mydriasis, tachycardia, constipation, urinary retention, increased temperature, excitation, confusion, and hallucinations. In severe cases of overdosage, cardiac and respiratory depression may occur.
Gastric lavage and emesis should be considered. Acetylcholinesterase inhibitors are the recommended antidote. Vital signs should be closely monitored and appropriate supportive measures should be taken. Artificial ventilation, reduction of fever, and application of bladder emptying catheter may be necessary. In the event of cardiac depression, a cardiac stimulant drug, such as Dobutamine, may be considered.
This product is contraindicated in patients with prostatic enlargement, in whom it may lead to urinary retention, those with paralytic ileus or pyloric stenosis and ulcerative colitis. It should not be given to patients with narrow-angle glaucoma and myasthenia gravis. It is contraindicated to patients with diseases that may lead to perilous tachycardia.
Special Precautions
Biperiden HCl (Akidin) should be used with caution in children and elderly, and in patients with diarrhea, thyrotoxicosis, heart failure, tachycardia, prostatic adenoma, and to those with high risk of convulsions.
Increases in dosage and transfer to other forms of treatment should be gradual and should not be withdrawn abruptly.
Effects on Ability to Drive and Use Machines: Biperiden HCl (Akidin) may cause drowsiness; thus, patients are not recommended to drive or use machines.
Use In Pregnancy & Lactation
There are no controlled studies in humans and animals regarding pregnancy and lactation, thus, the use of Biperiden HCl (Akidin) is not recommended during pregnancy unless necessary and advised by a physician.
Adverse Reactions
Psychiatric disorders: anxiety, euphoric mood, agitation, confusion, delirium, and hallucinations.
Nervous System disorders: dizziness, fatigue, ataxia, memory impairment, and dyskinesia.
Eye disorders: mydriasis, cyclopegia, photophobia.
Skin disorder: dryness of skin.
Immune System disorder: hypersensitivity.
Cardiac disorders: tachycardia, bradycardia.
Gastrointestinal disorders: constipation, dry mouth.
Renal and Urinary disorders: urinary retention.
Drug Interactions
Concomitant use of Biperiden HCl (Akidin) with other anticholinergic psychotropic drugs, antihistamines, antiparkinsonian drugs and antispasmodics increases the CNS and peripheral side effects. Anticholinergic effect is enhanced when it is administered with Quinidine.
Concomitant use of Levodopa with Biperiden HCl (Akidin) may exacerbate parkinsonian symptoms including dyskinesia. Administration of neuroleptic drugs with Biperiden HCl (Akidin) may intensify tardive dyskinesia. Parkinsonian symptoms in the presence of existing tardive dyskinesia are occasionally so serious as to mandate continued anticholinergic therapy.
Anticholinergics, such as Biperiden HCl (Akidin), reduce the effect of Metoclopramide and compounds with similar activity on the gastrointestinal tract.
Alcohol intake should be avoided when taking Biperiden HCl (Akidin).
Store at temperature not exceeding 30°C.
ATC Classification
N04AA02 - biperiden ; Belongs to the class of tertiary amines anticholinergic agents. Used in the management of Parkinson's disease.
Tab 2 mg (white, oval-shaped with score on one side and plain on the other) x 100's.
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