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NERVOUS SYSTEM › ANTI-PARKINSON DRUGS › ANTICHOLINERGIC AGENTS › Tertiary amines
biperiden
N04AA02
Forms & Strengths
- Tablet: 2 mg
- Solution for injection: 5 mg/mL (1 mL ampoules)
Adult Dosing
- Parkinsonism: Oral 2 mg 1 to 4 times daily; maximum 16 mg/day.
- Extrapyramidal symptoms (acute): IM or IV 2.5 to 5 mg, repeated every 30 minutes if needed; maximum 4 doses per 24 hours.
Pediatric Dosing
- Safety and efficacy in pediatric patients not established.
- Use in children is generally off-label and limited to acute dystonic reactions.
Indications
- Idiopathic Parkinson's disease
- Post-encephalitic parkinsonism
- Control of extrapyramidal symptoms induced by neuroleptics (e.g., acute dystonia, akathisia)
Mechanism of Action
- Central anticholinergic and antispasmodic agent.
- Competitively blocks acetylcholine receptors in the central nervous system, helping to balance cholinergic and dopaminergic activity in the basal ganglia.
Contraindications
- Hypersensitivity to biperiden
- Narrow-angle glaucoma
- Gastrointestinal obstruction, ileus, or megacolon
- Prostatic hypertrophy or urinary retention
Adverse Reactions
- Dry mouth, blurred vision, constipation, urinary retention
- Tachycardia, palpitations
- Drowsiness, dizziness, confusion, memory impairment, hallucinations (especially in elderly)
- Reduced sweating and heat intolerance
Drug Interactions
- Other anticholinergics (e.g., tricyclic antidepressants, antihistamines): potentiates anticholinergic adverse effects.
- Levodopa: may enhance parkinsonism symptom control but can increase dyskinesias or anticholinergic toxicity.
- Alcohol and CNS depressants: may cause additive sedation and cognitive impairment.
- Metoclopramide: antagonistic effects on gastrointestinal motility.
Curated Content: Needs Vetting Before Put to Clinical Use