Composition:
Each tablet contains 5mg Procyclidine Hydrochloride.
Description:
Procyclidine is a synthetic antispasmodic compound of relatively low toxicity. It has been shown to be useful for the symptomatic treatment of parkinsonism (paralysis agitans) and extrapyramidal dysfunction caused by tranquilizer therapy.
Indications:
- Parklidin is indicated in the treatment of parkinsonism including the postencephalitic, arteriosclerotic, and idiopathic types. Partial control of the parkinsonism symptoms is the usual therapeutic accomplishment.
- Clinical reports indicate that Parklidin often successfully relieves the symptoms of extrapyramidal dysfunction (dystonia, dyskinesia, akathisia, and parkinsonism) which accompany the therapy of mental disorders with phenothiazine and rauwolfia compounds.
- While the drug exerts a mild atropine-like action and therefore causes mydriasis, this may be kept minimal by careful adjustment of the daily dosage.
Contraindications:
Procyclidine hydrochloride should not be used in angle-closure glaucoma although simple type glaucoma does not appear to be adversely affected.
Dosage and Administration:
For Parkinsonism:
The dosage of the drug for the treatment of parkinsonism depends upon the age of the patient, the etiology of the disease, and individual responsiveness. Therefore, the dosage must remain flexible to permit adjustment to the individual tolerance and requirements of each patient. In general, younger and postencephalitic patients require and tolerate a somewhat higher dosage than older patients and those with arteriosclerosis.
For Patients Who Have Received No Other Therapy:
The usual dose of Parklidin for initial treatment is 2.5mg administered three times daily after meals. If well tolerated, this dose may be gradually increased to 5mg three times a day. In some cases, smaller doses may be employed with good therapeutic results.
To Transfer Patients to procyclidine from Other Therapy
Patients who have been receiving other drugs may be transferred to procyclidine hydrochloride. This is accomplished gradually by substituting 2.5mg three times a day for all or part of the original drug. The dose of procyclidine is then increased as required while that of the other drug is correspondingly omitted or decreased until complete replacement is achieved. The total daily dosage may then be adjusted to the level which produces maximum benefit.
For Drug-Induced Extrapyramidal Symptoms:
For treatment of symptoms of extrapyramidal dysfunction induced by tranquilizer drugs during the therapy of mental disorders, the dosage of procyclidine hydrochloride will depend on the severity of side effects associated with tranquilizer administration. In general, the larger the dosage of the tranquilizer, the more severe will be the associated symptoms, including rigidity and tremors. Accordingly, the drug dosage should be adjusted to suit the needs of the individual patient and to provide maximum relief of the induced symptoms. A convenient method to establish the daily dosage of procyclidine is to begin with the administration of 2.5mg three times daily. This may be increased by 2.5mg daily increments until the patient obtains relief of symptoms. In most cases excellent results will be obtained with 10 to 20mg daily.
Geriatric Use:
Clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should start at the low end of the dosing range.
Warnings:
Use in Children: Safety and efficacy have not been established in the pediatric age group; therefore, the use of procyclidine hydrochloride in this age group requires that the potential benefits be weighed against the possible hazards to the child.
Pregnancy Warning: The safe use of this drug in pregnancy has not been established; therefore, the use of procyclidine hydrochloride in pregnancy, lactation, or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.
Precautions:
- Conditions in which inhibition of the parasympathetic nervous system is undesirable, such as tachycardia and urinary retention (such as may occur with marked prostatic hypertrophy), require special care in the administration of the drug.
- Hypotensive patients who receive the drug should be observed closely. Occasionally, particularly in older patients, mental confusion and disorientation may occur with the development of agitation, hallucinations, and psychotic-like symptoms.
- Patients with mental disorders occasionally experience a precipitation of a psychotic episode when the dosage of ant parkinsonism drugs is increased to treat the extrapyramidal side effects of phenothiazine and rauwolfia derivatives.
Side Effects:
The following side effects can occur: dryness of the mouth, mydriasis, blurring of vision, giddiness, lightheadedness, and gastrointestinal disturbances such as nausea, vomiting, epigastric distress, and constipation. Occasionally an allergic reaction such as a skin rash may be encountered.
These symptoms can be avoided by starting with a few doses, then gradually increasing the doses until you reach the appropriate dose and give the medication during or after meals.
Drug Interactions:
No information provided.