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trademark for preparations of benztropine mesylate, an antidyskinetic.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

benztropine mesylate

Apo-Benztropine (CA), Cogentin, PMS Benztropine (CA)

Pharmacologic class: Anticholinergic

Therapeutic class: Antiparkinsonian

Pregnancy risk category C


Inhibits cholinergic excitatory pathways and restores balance of dopamine and acetylcholine in CNS, thereby decreasing excess salivation, rigidity, and tremors (parkinsonian symptoms)


Injection: 1 mg/ml in 2-ml ampules

Tablets: 0.5 mg, 1 mg, 2 mg

Indications and dosages


Adults: Initially, 1 to 2 mg/day P.O. or I.M. at bedtime or in two or four divided doses. Dosage range is 0.5 to 6 mg/day.

Acute dystonic reactions

Adults: Initially, 1 to 2 mg I.M. or I.V., then 1 to 2 mg P.O. b.i.d.

Drug-induced extrapyramidal reactions (except tardive dyskinesia)

Adults: 1 to 4 mg P.O. or I.M. once or twice daily

Dosage adjustment

• Elderly patients

Off-label uses

• Excessive salivation


• Hypersensitivity to drug

• Angle-closure glaucoma

• Tardive dyskinesia

• Children younger than age 3


Use cautiously in:

• seizure disorders, arrhythmias, tachycardia, hypertension, hypotension, hepatic or renal dysfunction, alcoholism, prostatic hypertrophy

• elderly patients

• pregnant or breastfeeding patients.


• Give after meals to prevent GI upset.

• Crush tablets if patient has difficulty swallowing them.

• Know that I.V. route is seldom used.

• Be aware that entire dose may be given at bedtime. (Drug has long duration of action.)

Adverse reactions

CNS: confusion, depression, dizziness, hallucinations, headache, weakness, memory impairment, nervousness, delusions, euphoria, paresthesia, sensation of heaviness in limbs, toxic psychosis

CV: hypotension, palpitations, tachycardia, arrhythmias

EENT: blurred vision, diplopia, mydriasis, angle-closure glaucoma

GI: nausea, constipation, dry mouth, ileus

GU: urinary hesitancy or retention, dysuria, difficulty maintaining erection

Musculoskeletal: paratonia, muscle weakness and cramps

Skin: rash, urticaria, decreased sweating, dermatoses


Drug-drug. Antacids, antidiarrheals: decreased benztropine absorption

Antihistamines, bethanechol, disopyramide, phenothiazines, quinidine, tricyclic antidepressants: additive anticholinergic effects

Drug-herbs. Angel's trumpet, jimsonweed, scopolia: increased anticholinergic effects

Drug-behaviors. Alcohol use: increased sedation

Patient monitoring

• Monitor blood pressure closely, especially in elderly patients.

• Monitor fluid intake and output; check for urinary retention.

• Assess for signs and symptoms of ileus, including constipation and abdominal distention.

Patient teaching

• Advise patient to use caution during activities that require physical or mental alertness, because drug causes sedation.

• Tell patient to avoid increased heat exposure.

Caution patient not to stop therapy abruptly.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


An anticholinergic used to manage parkinsonism, Parkinson’s disease and dystonia.
Adverse effects
In high doses can cause nervousness, impaired memory, numbness, listlessness, depression, confusion, excitement, and hallucinations; GI symptoms include dry mouth, constipation, nausea, vomiting, blurred vision, mydriasis, hyperthermia, anhidrosis, urinary retention, dysuria, weakness, rash and tachycardia.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


A brand name for BENZTROPINE (benzatropine).
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
P.S.: I'm also on perphenazine and Cogentin. This combination really works for me.
Upon discharge, Andrea has prescriptions for 150 mg of Wellbutrin twice daily, 75 mg of Effexor twice daily, 2 mg of Cogentin once daily, and 5 mg of Haldol once daily.
Two were prescribed both Haldol and Cogentin (along with either Prozac or clonidine).
To combat these effects, patients often are given anticholinergic medication such as benztropine (Cogentin) or diphenhydramine (Benadryl).
Other drugs available for Parkinson's disease include Eldepryl (selegiline), Tasmar (tolcapone), Symmetrel (amantadine), and the anticholinergics Artane (trihexyphenidyl) and Cogentin (benztropine).
Antiparkinsonism Agents -- L-DOPA, Sinemet, Symmetrel, Cogentin, Artane, Kemadrin, Benadryl, Akineton, Parlodel, Permax, Eldepryl
Both dystonia and akathisia are reversible when antipsychotic medication is lowered or stopped, and both can be treated with anticholinergic medications such as benztropine mesylate (Cogentin) and trihexyphenidyl (Artane).
"From two anti-parkinsonian agents -- Cogentin and Artane -- I got partially paralyzed eye muscles.
(Mirapex) Anticholinergics, amantadine and deprenyl Trihexyphenidyl (Artane) May help reduce tremor and to a Apo-trihex lesser extent, bradykinesia and Benztropine (Cogentin) rigidity.
"These patients truly like Cogentin and the other anticholinergics, and they will abuse them.
Cogentin (benztropine) .5mg, 1 mg, 2 mg tabs .5 mg bid, max 4 mg bid Parsidol (ethopropazine) 10 mg tid, max 30 mg tid Artane (trihexyphenidyl) tabs 2mg & 5 mg, elixir 2 mg/5ml, timed release 5 mg 2mg tid-qid, max 5mg tid-qid Kemadrin (Procyclidine HCI) Tablets: 5 mg 2.5 mg tid after meals increase gradually to 5 mg tid.