benztropine mesylate

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Related to benztropine mesylate: haloperidol

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.

benztropine mesylate

an anticholinergic and antihistaminic agent.
indications It may be prescribed as adjunctive therapy in the treatment of drug-induced extrapyramidal symptoms and all forms of parkinsonism.
contraindications Known sensitivity to this drug prohibits its use, and it is not administered to children less than 3 years of age.
adverse effects Among the most serious adverse reactions are blurred vision, xerostomia, nausea and vomiting, constipation, depression, and skin rash.

benztropine mesylate

An antiparasympathomimetic agent usually used with other drugs in treating parkinsonism.
References in periodicals archive ?
It was reported yesterday that Fresenius Kabi USA, a business-focused on infusion therapy and clinical nutrition in Europe and in its most important countries of Latin America and Asia Pacific, is recalling four lots of benztropine mesylate injection, USP two mg/two mL (1mg/mL), in two mL single dose vials.
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).