benztropine mesylate
Benztropine is an add-on medication used for the treatment of Parkinson's disease. It's also used for movement problems that are side effects from other medications, such as antipsychotics. It's no longer available as the brand name Cogentin, but still sold as the generic name benztropine. Dry mouth, trouble sweating, nausea, and fast heartbeat are some possible side effects of benztropine.
What is Benztropine?
What is Benztropine used for?
- Parkinson's disease (add-on medication)
- Movement problems (extrapyramidal symptoms, or EPS) caused by antipsychotic medications
How Benztropine works
Benztropine is an anticholinergic medication. It blocks chemicals that are thought to cause muscle spasms and tremors.
Drug facts
Side effects of Benztropine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dry mouth
- Nausea and vomiting
- Constipation
- Slowed gut movement
- Fast heartbeat
Less Common Side Effects
- Blurry vision
- Confusion
- Memory problems
- Fever
- Discomfort while urinating
Benztropine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Overheating: high body temperature, reduced sweating, confusion
More on Benztropine side effects
The following Benztropine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach cramps or pain
aggressive and violent behavior
being forgetful
burning while urinating
confusion about identity, place, and time
decrease in frequency of urination
decrease in urine volume
difficult or painful urination
difficulty in passing urine (dribbling)
difficulty with speaking
difficulty with swallowing
discouragement
dizziness
extremely high fever or body temperature
fast, pounding, or irregular heartbeat or pulse
fast, shallow breathing
fast, weak heartbeat
feeling sad or empty
headache
hot, dry skin
irritability
lack of appetite
lack of sweating
listlessness
loss of interest or pleasure
mood or mental changes
muscle cramps
muscle weakness
nervousness
numbness of the fingers
pale, clammy skin
seeing things that are not there
thirst
tiredness
trouble concentrating
trouble with sleeping
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blindness
blurred vision
change in consciousness
cold clammy skin
decreased vision
dizziness
holding false beliefs that cannot be changed by fact
lightheadedness
loss of consciousness
muscle weakness
nausea or vomiting
no breathing
nosebleeds
numbness or tingling in the face, arms, or legs
shakiness and unsteady walk
sweating
tearing
unsteadiness, trembling, or other problems with muscle control or coordination
unusual excitement, nervousness, or restlessness
vision problems
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Benztropine
Pros
- Dose can be easily adjusted based on your symptoms and side effects
- Works together with other anti-parkinson medications
- Available as a lower-cost generic medication
Cons
- Can cause severe dry mouth that can make it difficult to eat and speak
- Not a good option for young children and older adults
- Interacts with certain antipsychotics and tricyclic antidepressants (TCAs)
Pharmacist tips for Benztropine
- Work closely with your provider, especially in the beginning, to find the right dose of medication for you. Your dose will likely start small and become larger over time.
- You can take benztropine with or without food. If the medication makes your mouth dry, try to avoid dry or salty foods
- Benztropine can cause dry mouth. Drinking water, chewing gum, and sucking on hard candy can help with dry mouth. Let your provider know if your dry mouth makes it hard to speak, eat, or swallow. They might be able to lower your dose.
- Let your provider know all the medications that you take, especially if you take medications for mental health conditions. Benztropine can interact with certain antipsychotics and antidepressants, or make mental disorders worse.
- Artificial tears and lubricating eye drops can relieve dry eyes you may get while taking benztropine. Talk to your provider if you start to have blurry vision. They might want you to get your eyes checked by a specialist.
- If you have conditions that make urinating more difficult (e.g., enlarged prostate), benztropine can make your symptoms worse. Let your provider know if this happens.
- Talk to your provider if you're pregnant or thinking of becoming pregnant. It isn't known if benztropine is safe to take during pregnancy.
Common questions about Benztropine
If you're taking benztropine to help with movement problems from antipsychotics, you might notice improvements in symptoms within 1 or 2 days. The injectable forms of benztropine work faster than the tablets.
No benztropine isn't FDA-approved for tardive dyskinesia (TD). TD is a very rare form of movement problems (EPS) that can be caused by antipsychotic medications. Compared to other EPS movement problems, TD more so involves uncontrolled movement of the face, rather than arms or legs. If you have medication-related movement problems, your provider will evaluate you to see if benztropine is an appropriate medication for you.
No, benztropine isn't approved for treating anxiety. If you've symptoms of anxiety, talk to your provider about treatment options that can help.
Memory problems are listed as a side effect of benztropine by the manufacturers. Benztropine is an anticholinergic medication and this class of medication is known to cause memory problems and confusion. In one small study, people taking benztropine had problems remembering things. If this is concerning to you, speak with your provider.
No, benztropine isn't an antipsychotic medication. However, it can be used to treat movement problems that are a side effect of antipsychotic medications.
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Risks and warnings for Benztropine
Benztropine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Trouble thinking clearly
Some people have trouble thinking clearly or feel confused when they take benztropine. If you're starting this medication for the first time or if your provider raises your dose, don't drive or do any activity that requires a lot of focus until you know how benztropine makes you feel
Slowed gut movement
- Risk factors: Taking tricyclic antidepressants, phenothiazines, or haloperidol
Before taking benztropine, let your provider know if you're taking tricyclic antidepressants, phenothiazines, haloperidol, or other anticholinergics. These medications can interact with benztropine and cause your gut movement to slow down or stop (paralytic ileus). This can lead to serious problems. Let your provider know if you experience stomach pain or discomfort.
Heat stroke
- Risk factors: Dehydration | Hot weather | Chronic alcohol use | Manual labor
Benztropine makes it harder for your body to sweat and cool itself down. This can put you at risk for heat stroke. Make sure you stay hydrated and out of the sun, especially if it's really hot out. Let your provider right away if you have a fever or feel very hot, but aren't able to sweat.
Muscle weakness
- Risk factors: Taking large doses
Some people taking large doses of benztropine have reported muscle weakness. It might feel like muscle tension (like a stiff neck), followed by sudden relaxation and weakness. Let your provider know if this happens to you as they might need to lower your dose.
Mental health effects
- Risk factors: Older adults | Having a history of mental health conditions | Taking larger doses of benztropine
Some people can have confusion or excitement with large doses of benztropine. In some rare cases, some people experience psychoactive effects, including hallucinations (seeing or hearing things that aren't there). Let your provider know if you have a history of mental health conditions. They might want to monitor you closely when you first start the medication.
Benztropine dosage
Typical dosage for Benztropine
- Parkinson's disease: The typical starting dose ranges from 0.5 mg to 1 mg by mouth daily. The typical maintenance dose ranges from 0.5 mg to 6 mg daily, taken once daily or in smaller doses throughout the day.
- Movement problems: The typical dose ranges from 1 mg to 4 mg by mouth once or twice daily.
Benztropine is also available as an injection that's given by a trained healthcare provider.
Interactions between Benztropine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Potassium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Clozapine
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Methacholine
- Metoclopramide
- Quetiapine
- Revefenacin
- Scopolamine
- Secretin Human
- Tiotropium
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Betel Nut
- Chlorpromazine
- Haloperidol
How much does Benztropine cost?
Benztropine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Benztropine will not be safe for you to take.
- Children younger than 3 years old
What are alternatives to Benztropine?
News about Benztropine
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