Trihexyphenidyl

What is Trihexyphenidyl

Trihexyphenidyl is an oral synthetic, tertiary antimuscarinic. Its anticholinergic actions are similar to those of atropine. Because it is a tertiary compound, it will penetrate the CNS.

The drug is indicated as an adjunct in the treatment of all forms of parkinsonism (postencephalitic, arteriosclerotic, and idiopathic).

It is often useful as adjuvant therapy when treating these forms of parkinsonism with levodopa.

Additionally, it is indicated for the control of extrapyramidal disorders caused by central nervous system drugs such as the dibenzoxazepines, phenothiazines, thioxanthenes, and butyrophenones.

Trihexyphenidyl was initially marketed for clinical use in 1949.

Brand Name

Artane

Indications

  • drug-induced extrapyramidal symptoms
  • Parkinson’s disease
  • parkinsonism
  • sialorrhea

For the treatment of idiopathic parkinsonism or Parkinson’s disease

Side Effects

  1. agitation
  2. anhidrosis
  3. anxiety
  4. asthenia
  5. blurred vision
  6. confusion
  7. constipation
  8. delirium
  9. depression
  10. dizziness
  11. drowsiness
  12. euphoria
  13. fever
  14. hallucinations
  15. headache
  16. heat intolerance
  17. hyperthermia
  18. ileus
  19. insomnia
  20. memory impairment
  21. myasthenia
  22. mydriasis
  23. nausea
  24. neuroleptic malignant syndrome
  25. ocular hypertension
  26. paranoia
  27. paresthesias
  28. parotitis
  29. psychosis
  30. rash
  31. restlessness
  32. sinus tachycardia
  33. toxic megacolon
  34. urinary retention
  35. vomiting
  36. weakness
  37. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • alcoholism
  • ambient temperature increase
  • anticholinergic medications
  • arteriosclerosis
  • autonomic neuropathy
  • breast-feeding
  • cardiac disease
  • children
  • closed-angle glaucoma
  • contact lenses
  • geriatric
  • GI obstruction
  • hepatic disease
  • hypertension
  • ileus
  • increased intraocular pressure
  • myasthenia gravis
  • neurological disease
  • pregnancy
  • prostatic hypertrophy
  • renal disease
  • renal impairment
  • tardive dyskinesia
  • urinary tract obstruction

Trihexyphenidyl is contraindicated in patients with hypersensitivity to trihexyphenidyl or to any of the tablet or elixir ingredients.

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Aclidinium
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Albuterol; Ipratropium
  • Alfentanil
  • Alosetron
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amantadine
  • Ambenonium Chloride
  • Amoxapine
  • Antacids
  • Anxiolytics; Sedatives; and Hypnotics
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Oxycodone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Botulinum Toxins
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butorphanol
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlorcyclizine
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Cholinergic agonists
  • Cisapride
  • Clemastine
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Crofelemer
  • Cyclizine
  • Cyclobenzaprine
  • Cyproheptadine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Donepezil
  • Donepezil; Memantine
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Droperidol
  • Edrophonium
  • Eluxadoline
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Ethanol
  • Ezogabine
  • Fentanyl
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Fluticasone; Umeclidinium; Vilanterol
  • Galantamine
  • Glucagon
  • Glycopyrronium
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Haloperidol
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Ipratropium
  • Itraconazole
  • Levocetirizine
  • Levodopa
  • Levorphanol
  • Linaclotide
  • Loperamide
  • Loperamide; Simethicone
  • Loxapine
  • Lubiprostone
  • Lurasidone
  • Macimorelin
  • Magnesium Hydroxide
  • Maprotiline
  • Meclizine
  • Memantine
  • Meperidine
  • Meperidine; Promethazine
  • Methacholine
  • Methadone
  • Metoclopramide
  • Mirtazapine
  • Molindone
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Neostigmine
  • Nitrofurantoin
  • Olanzapine
  • Omeprazole; Sodium Bicarbonate
  • Orphenadrine
  • Oxycodone
  • Oxymorphone
  • Paroxetine
  • Pentazocine
  • Pentazocine; Naloxone
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Physostigmine
  • Potassium
  • Pramlintide
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Proton pump inhibitors
  • Pyridostigmine
  • Quetiapine
  • Quinidine
  • Rasagiline
  • Remifentanil
  • Revefenacin
  • Rivastigmine
  • Secretin
  • Sedating H1-blockers
  • Sincalide
  • Sodium Bicarbonate
  • Solifenacin
  • Sufentanil
  • Tacrine
  • Tapentadol
  • Tegaserod
  • Thiazide diuretics
  • Thioridazine
  • Thiothixene
  • Tiotropium
  • Tiotropium; Olodaterol
  • Tolterodine
  • Topiramate
  • Tramadol
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimethobenzamide
  • Triprolidine
  • Trospium
  • Umeclidinium
  • Umeclidinium; Vilanterol
  • Zonisamide
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