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Cogentin

Cogentin


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Cogentin Drug Description


COGENTIN®
(benztropine mesylate) Injection

DRUG DESCRIPTION

Benztropine mesylate is a synthetic compound containing structural features found in atropine and diphenhydramine.

It is designated chemically as 8-azabicyclo[3.2.1] octane, 3-(diphenylmethoxy)-,endo, methanesulfonate. Its empirical formula is C21H25NO•CH4O3S, and its structural formula is:

Benztropine mesylate structural formula illustration

Benztropine mesylate is a crystalline white powder, very soluble in water, and has a molecular weight of 403.54. COGENTIN* (Benztropine Mesylate) is supplied as a sterile injection for intravenous and intramuscular use.

Each milliliter of the injection contains:

Benztropine mesylate ..........1 mg
Sodium chloride ...............9 mg
Water for injection q.s. . ....1 mL

 

What are the possible side effects of benztropine (Cogentin)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using benztropine and call your doctor at once if you have a serious side effect such as:

  • high fever;
  • headache, dizziness, weakness, and hot dry skin with no sweating;
  • feeling like you might pass out;
  • severe stomach pain;
  • chest pain, fast or uneven heart rate;
  • painful or difficult swallowing;
  • ...

Read All Potential Side Effects and See Pictures of Cogentin »

 

What are the precautions when taking benztropine mesylate injection (Cogentin)?

Before taking benztropine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain eye problem (narrow-angle glaucoma), blockage of the bladder/esophagus/stomach/intestines (e.g., bowel obstruction), severe ulcerative colitis.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use, breathing problems (e.g., asthma, emphysema), diarrhea caused by an infection, certain eye problem...

 

 

Cogentin


Cogentin Indications & Dosage


INDICATIONS

For use as an adjunct in the therapy of all forms of parkinsonism.

Useful also in the control of extrapyramidal disorders (except tardive dyskinesia — see PRECAUTIONS) due to neuroleptic drugs (e.g., phenothiazines).

DOSAGE AND ADMINISTRATION

Since there is no significant difference in onset of effect after intravenous or intramuscular injection, usually there is no need to use the intravenous route. The drug is quickly effective after either route, with improvement sometimes noticeable a few minutes after injection. In emergency situations, when the condition of the patient is alarming, 1 to 2 mL of the injection normally will provide quick relief. If the parkinsonian effect begins to return, the dose can be repeated.

Because of cumulative action, therapy should be initiated with a low dose which is increased gradually at five or six-day intervals to the smallest amount nec-essary for optimal relief. Increases should be made in increments of 0.5 mg, to a maximum of 6 mg, or until optimal results are obtained without excessive adverse reactions.

Postencephalitic and Idiopathic Parkinsonism —

The usual daily dose is 1 to 2 mg, with a range of 0.5 to 6 mg parenterally.

As with any agent used in parkinsonism, dosage must be individualized according to age and weight, and the type of parkinsonism being treated. Generally, older patients, and thin patients cannot tolerate large doses. Most patients with postencephalitic parkinsonism need fairly large doses and tolerate them well. Patients with a poor mental outlook are usually poor candidates for therapy.

In idiopathic parkinsonism, therapy may be initiated with a single daily dose of 0.5 to 1 mg at bedtime. In some patients, this will be adequate; in others 4 to 6 mg a day may be required.

In postencephalitic parkinsonism, therapy may be initiated in most patients with 2 mg a day in one or more doses. In highly sensitive patients, therapy may be ini-tiated with 0.5 mg at bedtime, and increased as necessary.

Some patients experience greatest relief when given the entire dose at bedtime; others react more favorably to divided doses, two to four times a day. Frequently, one dose a day is sufficient, and divided doses may be unnecessary or undesirable.

The long duration of action of this drug makes it particularly suitable for bedtime medication when its effects may last throughout the night, enabling patients to turn in bed during the night more easily, and to rise in the morning.

When COGENTIN (benztropine mesylate injection) is started, do not terminate therapy with other antiparkinsonian agents abruptly. If the other agents are to be reduced or discontinued, it must be done gradually. Many patients obtain greatest relief with combination therapy.

COGENTIN (benztropine mesylate injection) may be used concomitantly with SINEMET* (Carbidopa-Levodopa), or with levodopa, in which case periodic dosage adjustment may be required in order to maintain optimum response.

Drug-Induced Extrapyramidal Disorders —

In treating extrapyramidal disorders due to neuroleptic drugs (e.g., phenothiazines), the recommended dosage is 1 to 4 mg once or twice a day parenterally. Dosage must be individualized according to the need of the patient. Some patients require more than recommended; others do not need as much.

In acute dystonic reactions, 1 to 2 mL of the injection usually relieves the condition quickly.

When extrapyramidal disorders develop soon after initiation of treatment with neuroleptic drugs (e.g., phenothiazines), they are likely to be transient. One to 2 mg of COGENTIN (benztropine mesylate injection) two or three times a day usually provides relief within one or two days. After one or two weeks, the drug should be withdrawn to determine the continued need for it. If such disorders recur, COGENTIN (benztropine mesylate injection) can be reinstituted.

Certain drug-induced extrapyramidal disorders that develop slowly may not respond to COGENTIN (benztropine mesylate injection) .

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.

HOW SUPPLIED

Injection COGENTIN (benztropine mesylate injection) , 1 mg per mL, is a clear, colorless solution and is supplied in boxes of 5 x 2 mL ampuls.

NDC 67386-611-52

Manufactured by Merck & Co. Inc., Whitehouse Station, NJ 08889, U.S.A. for:OVATION Pharmaceuticals Deerfield, il 60015, u.s.a.
Revised SEPTEMBER 2005
* Registered trademark of Merck & Co., Inc., Whitehouse Station, NJ, U.S.A.
FDA rev date: 5/22/2001

 

Cogentin


Cogentin Side Effects & Drug Interactions


SIDE EFFECTS

The adverse reactions below, most of which are anticholinergic in nature, have been reported and within each category are listed in order of decreasing severity.

Cardiovascular

Tachycardia.

Digestive

Paralytic ileus, constipation, vomiting, nausea, dry mouth.

If dry mouth is so severe that there is difficulty in swallowing or speaking, or loss of appetite and weight, reduce dosage, or discontinue the drug temporarily.

Slight reduction in dosage may control nausea and still give sufficient relief of symptoms. Vomiting may be controlled by temporary discontinuation, followed by resumption at a lower dosage.

Nervous System

Toxic psychosis, including confusion, disorientation, memory impairment, visual hallucinations; exacerbation of pre-existing psychotic symptoms; nervousness; depression; listlessness; numbness of fingers.

Special Senses

Blurred vision, dilated pupils.

Urogenital

Urinary retention, dysuria.

Metabolic/Immune or Skin

Occasionally, an allergic reaction, e.g., skin rash, develops. If this cannot be controlled by dosage reduction, the medication should be discontinued.

Other

Heat stroke, hyperthermia, fever.

DRUG INTERACTIONS

Antipsychotic drugs such as phenothiazines or haloperidol; tricyclic antidepressants (see WARNINGS).

Pediatric use

Because of the atropine-like side effects, COGENTIN (benztropine mesylate injection) should be used with caution in pediatric patients over three years of age (see CONTRAINDICATIONS).

 

Cogentin


 

Cogentin Warnings & Precautions


WARNINGS

Safe use in pregnancy has not been established.

COGENTIN (benztropine mesylate injection) may impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle.

When COGENTIN (benztropine mesylate injection) is given concomitantly with phenothiazines, haloperidol, or other drugs with anticholinergic or antidopaminergic activity, patients should be advised to report gastrointestinal complaints, fever or heat intolerance promptly. Paralytic ileus, hyperthermia and heat stroke, all of which have sometimes been fatal, have occurred in patients taking anticholinergic-type antiparkinsonism drugs, including COGENTIN (benztropine mesylate injection) , in combination with phenothiazines and/or tricyclic antidepressants.

Since COGENTIN (benztropine mesylate injection) contains structural features of atropine, it may produce anhidrosis. For this reason, it should be administered with caution during hot weather, especially when given concomitantly with other atropine-like drugs to the chronically ill, the alcoholic, those who have central nervous system disease, and those who do manual labor in a hot environment. Anhidrosis may occur more readily when some disturbance of sweating already exists. If there is evidence of anhidro-sis, the possibility of hyperthermia should be considered. Dosage should be decreased at the discretion of the physician so that the ability to maintain body heat equilibrium by perspiration is not impaired. Severe anhidrosis and fatal hyperthermia have occurred.

PRECAUTIONS

General

Since COGENTIN (benztropine mesylate injection) has cumulative action, continued supervision is advisable. Patients with a tendency to tachycardia and patients with prostatic hypertrophy should be observed closely during treatment.

Dysuria may occur, but rarely becomes a problem. Urinary retention has been reported with COGENTIN (benztropine mesylate injection) .

The drug may cause complaints of weakness and inability to move particular muscle groups, especially in large doses. For example, if the neck has been rigid and suddenly relaxes, it may feel weak, causing some concern. In this event, dosage adjustment is required.

Mental confusion and excitement may occur with large doses, or in susceptible patients. Visual hallucinations have been reported occasionally. Furthermore, in the treatment of extrapyramidal disorders due to neuroleptic drugs (e.g., phenothiazines), in patients with mental disorders, occasionally there may be intensi-fication of mental symptoms. In such cases, antiparkinsonian drugs can precipitate a toxic psychosis. Patients with mental disorders should be kept under care-ful observation, especially at the beginning of treatment or if dosage is increased.

Tardive dyskinesia may appear in some patients on long-term therapy with phenothiazines and related agents, or may occur after therapy with these drugs has been discontinued. Antiparkinsonism agents do not alleviate the symptoms of tardive dyskinesia, and in some instances may aggravate them. COGENTIN (benztropine mesylate injection) is not recommended for use in patients with tardive dyskinesia.

The physician should be aware of the possible occurrence of glaucoma. Although the drug does not appear to have any adverse effect on simple glaucoma, it probably should not be used in angle-closure glaucoma.

 

 

Cogentin


Cogentin Overdosage & Contraindications


OVERDOSE

Manifestations —

May be any of those seen in atropine poisoning or antihistamine overdosage: CNS depression, preceded or followed by stimulation; confu-sion; nervousness; listlessness; intensification of mental symptoms or toxic psychosis in patients with mental illness being treated with neuroleptic drugs (e.g., phenothiazines); hallucinations (especially visual); dizziness; muscle weakness; ataxia; dry mouth; mydriasis; blurred vision; palpitations; tachycardia; elevat-ed blood pressure; nausea; vomiting; dysuria; numbness of fingers; dysphagia; allergic reactions, e.g., skin rash; headache; hot, dry, flushed skin; delirium; coma; shock; convulsions; respiratory arrest; anhidrosis; hyperthermia; glaucoma; constipation.

Treatment —

Physostigmine salicylate, 1 to 2 mg, SC or IV, reportedly will reverse symptoms of anticholinergic intoxication.** A second injection may be given after 2 hours if required. Otherwise treatment is symptomatic and supportive. Induce emesis or perform gastric lavage (contraindicated in precomatose, convul-sive, or psychotic states). Maintain respiration. A short-acting barbiturate may be used for CNS excitement, but with caution to avoid subsequent depression; supportive care for depression (avoid convulsant stimulants such as picrotoxin, pentylenetetrazol, or bemegride); artificial respiration for severe respiratory depression; a local miotic for mydriasis and cycloplegia; ice bags or other cold applications and alcohol sponges for hyperpyrexia, a vasopressor and fluids for circulatory collapse. Darken room for photophobia.

CONTRAINDICATIONS

Hypersensitivity to any component of COGENTIN (benztropine mesylate injection) injection.

Because of its atropine-like side effects, this drug is contraindicated in pediatric patients under three years of age, and should be used with caution in older pediatric patients.

** Duvoisin, R.C.; Katz, R.J.; Amer. Med. Ass. 206: 1963-1965, Nov. 25, 1968.

 

Cogentin


 

Cogentin Clinical Pharmacology


CLINICAL PHARMACOLOGY

Action

COGENTIN (benztropine mesylate injection) possesses both anticholinergic and antihistaminic effects, although only the former have been established as therapeutically significant in the management of parkinsonism.

In the isolated guinea pig ileum, the anticholinergic activity of this drug is about equal to that of atropine; however, when administered orally to unanesthetized cats, it is only about half as active as atropine.

In laboratory animals, its antihistaminic activity and duration of action approach those of pyrilamine maleate.

 

Cogentin


Cogentin Medication Guide


PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sectrions.

 

Cogentin


Cogentin Consumer

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

 

BENZTROPINE - ORAL

 

(BENZ-troe-peen)

 

USES: Benztropine is used to treat symptoms of Parkinson's disease or involuntary movements due to the side effects of certain psychiatric drugs (antipsychotics such as chlorpromazine/haloperidol). Benztropine belongs to a class of medication called anticholinergics that work by blocking a certain natural substance (acetylcholine). This helps decrease muscle stiffness, sweating, and the production of saliva, and helps improve walking ability in people with Parkinson's disease.

Anticholinergics can stop severe muscle spasms of the back, neck, and eyes that are sometimes caused by psychiatric drugs. It can also decrease other side effects such as muscle stiffness/rigidity (extrapyramidal signs-EPS). It is not helpful in treating movement problems caused by tardive dyskinesia and may worsen them. Benztropine should not be used in children younger than 3 years.

 

HOW TO USE: Take this medication by mouth, usually 2 to 4 times a day with meals and at bedtime, or as a single dose at bedtime, or as directed by your doctor. Your doctor may start you at a low dose and increase your dose slowly to find the best dose for you. The dosage is based on your medical condition and response to therapy.

If you are using the oral solution, measure your dose with a special measuring spoon or device. Do not use a household spoon because it may not provide the correct dose.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day.

Take this medication at least 1 hour before antacids containing magnesium, aluminum, or calcium. Allow at least 1-2 hours between doses of benztropine and certain drugs for diarrhea (adsorbent antidiarrheals such as kaolin, pectin, attapulgite). Take this medication at least 2 hours after ketoconazole. Antacids and some drugs for diarrhea may prevent the full absorption of benztropine, and this product may prevent the complete absorption of ketoconazole when these products are taken together.

If you are taking this medication for side effects from another medication, your doctor may instruct you to take it on a regular schedule or only as needed. If you are taking this medication for Parkinson's disease, your doctor may change the dose of your other medications (e.g., levodopa). Follow your doctor's instructions closely.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Rarely, abnormal drug-seeking behavior (addiction) is possible with this medication. Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.

It may take 2-3 days before the benefit of this drug takes effect. Inform your doctor if your condition persists or worsens.

 

Cogentin


Cogentin Consumer (continued)

SIDE EFFECTS: Drowsiness, dizziness, constipation, flushing, nausea, nervousness, blurred vision, or dry mouth may occur. These effects usually lessen as your body gets used to the medicine. If any of these effects persist or worsen, contact your doctor or pharmacist promptly.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: high fever, decreased sexual ability, severe stomach/abdominal pain, difficult/painful swallowing, difficulty urinating, vision changes, weakness.

Seek immediate medical attention if any of these very unlikely but very serious side effects occur: chest pain, severe dizziness/fainting, fast/irregular/slow heartbeat, mental/mood changes (e.g., confusion, hallucinations, memory problems).

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

 

PRECAUTIONS: Before taking benztropine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain eye problem (narrow-angle glaucoma), blockage of the bladder/esophagus/stomach/intestines (e.g., bowel obstruction), severe ulcerative colitis.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use, breathing problems (e.g., asthma, emphysema), diarrhea caused by an infection, certain eye problem (open-angle glaucoma), heart problems (e.g., angina, heart attack, heart failure, fast/irregular heartbeat), high/low blood pressure, intestinal problems (e.g., chronic constipation, ileus, ulcerative colitis), kidney disease, liver disease, mental/mood problems (e.g., anxiety, dementia, psychosis), certain muscle disease (myasthenia gravis), certain nerve disease (autonomic neuropathy), seizure, stomach problems (e.g., acid reflux, hiatal hernia, ulcer), stroke, overactive thyroid (hyperthyroidism), problems urinating (e.g., due to enlarged prostate, neurogenic bladder).

This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.

To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

This medication decreases saliva production, an effect that can increase gum and tooth problems (e.g., cavities, gum disease). Take special care with your dental hygiene (e.g., brushing, flossing) and have regular dental check-ups.

This drug can cause decreased sweating, which could cause a severe rise in your body temperature (hyperthermia). The risk of this serious side effect is greater in hot weather, during vigorous exercise, and/or if you drink alcohol. Drink plenty of fluids and dress lightly while in hot weather and when exercising. If you experience signs of hyperthermia such as mental/mood changes, headache, or dizziness, promptly seek cool or air-conditioned shelter and/or stop exercising, and seek immediate medical attention. Consult your doctor for more details.

The elderly may be more sensitive to the effects of this drug, especially dizziness, heatstroke, memory problems, and constipation.

Children may be more sensitive to the effects of this drug, especially effects on heart rate.

This drug should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

It is not known if this drug passes into breast milk. Consult your doctor before breast-feeding.

 

Cogentin


Cogentin Consumer (continued)

DRUG INTERACTIONS: Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medication because very serious interactions may occur: pramlintide.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting benztropine.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: anticholinergics/antispasmodics (e.g., belladonna alkaloids, clidinium), amantadine, certain antiarrhythmics (e.g., disopyramide, procainamide, quinidine), cholinesterase inhibitors (e.g., donepezil, galantamine), corticosteroids (e.g., prednisone), monoamine oxidase inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine), motion sickness medication (e.g., meclizine, scopolamine), narcotic pain relievers (e.g., meperidine), potassium tablets/capsules, tricyclic antidepressants (e.g., amitriptyline, doxepin).

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., risperidone, trazodone).

Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain anticholinergics or drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

 

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: unusually fast/slow heartbeat, slow/shallow breathing, unconsciousness, seizures, loss of coordination, fever, hot/dry/flushed skin, widened pupils, change in vision, change in the amount of urine, confusion, hallucinations.

 

NOTES: Do not share this medication with others.

Laboratory and/or medical tests (e.g., eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

People with Parkinson's disease may have an increased risk for developing skin cancer (melanoma). If you are taking this drug to treat Parkinson's disease, tell your doctor promptly if you notice a change in the appearance or size of moles or other unusual skin changes. Ask your doctor if you should have regular skin exams.

 

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

 

STORAGE: Store the United States product at room temperature below 86 degrees F (30 degrees C) away from light and moisture.

Store the Canadian product (solution and tablets) at room temperature between 59-86 degrees F (15-30 degrees C).

Do not store any form of this drug in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

 

Cogentin


Cogentin Patient Information Including Side Effects

Brand Names: Cogentin

Generic Name: benztropine (Pronunciation: BENZ troe peen)

 

  • What is benztropine (Cogentin)?
  • What are the possible side effects of benztropine (Cogentin)?
  • What is the most important information I should know about benztropine (Cogentin)?
  • What should I discuss with my healthcare provider before taking benztropine (Cogentin)?
  • How should I take benztropine (Cogentin)?
  • What happens if I miss a dose (Cogentin)?
  • What happens if I overdose (Cogentin)?
  • What should I avoid while taking benztropine (Cogentin)?
  • What other drugs will affect benztropine (Cogentin)?
  • Where can I get more information?

 

What is benztropine (Cogentin)?

Benztropine reduces the effects of certain chemicals in the body that may become unbalanced as a result of disease (such as Parkinson's), drug therapy, or other causes.

Benztropine is used to treat the symptoms of Parkinson's disease, such as muscle spasms, stiffness, sweating, drooling, and poor muscle control. Benztropine is also used to treat and prevent these symptoms when they are caused by drugs such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), and others.

Benztropine may also be used for other purposes not listed in this medication guide.

Benztropine 1 mg-ROS

elliptical, white, imprinted with 832 BM1

What are the possible side effects of benztropine (Cogentin)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using benztropine and call your doctor at once if you have a serious side effect such as:

  • high fever;
  • headache, dizziness, weakness, and hot dry skin with no sweating;
  • feeling like you might pass out;
  • severe stomach pain;
  • chest pain, fast or uneven heart rate;
  • painful or difficult swallowing;
  • impotence, trouble having an orgasm;
  • urination problems;
  • changes in your vision; or
  • confusion, unusual thoughts or behavior, hallucinations.

Less serious side effects may include:

  • drowsiness, feeling nervous;
  • nausea, vomiting, constipation;
  • dry mouth, nose, or throat, decreased sweating;
  • blurred vision, increased sensitivity to light; or
  • warmth, redness, or tingly feeling under your skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about benztropine (Cogentin)?

You should not take this medication if you are allergic to benztropine, or if you are also taking a medication called pramlintide (Symlin).

Before you take benztropine, tell if you have glaucoma, kidney or liver disease, heart disease, high blood pressure, a history of heart attack or stroke, a breathing disorder, a nerve or muscle disorder, seizures, urination problems, overactive thyroid, mental illness, or a stomach or intestinal disorder.

Avoid taking a diarrhea medication or antacid within 2 hours before or after you take benztropine. Also avoid taking ketoconazole (Nizoral) within 2 hours after you take benztropine.

Benztropine can cause side effects that may impair your vision, thinking, or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Benztropine can decrease perspiration and you may be more prone to heat stroke.

Do not stop taking this medication without first talking to your doctor. Stopping suddenly may make your condition worse. You may need to use less and less before you stop the medication completely.

Related Drug Centers
  • Cogentin

 

Cogentin


Cogentin Patient Information including How Should I Take

In this Article

  • What is benztropine (Cogentin)?
  • What are the possible side effects of benztropine (Cogentin)?
  • What is the most important information I should know about benztropine (Cogentin)?
  • What should I discuss with my healthcare provider before taking benztropine (Cogentin)?
  • How should I take benztropine (Cogentin)?
  • What happens if I miss a dose (Cogentin)?
  • What happens if I overdose (Cogentin)?
  • What should I avoid while taking benztropine (Cogentin)?
  • What other drugs will affect benztropine (Cogentin)?
  • Where can I get more information?

What should I discuss with my healthcare provider before taking benztropine (Cogentin)?

You should not take this medication if you are allergic to benztropine, or if you are also taking a medication called pramlintide (Symlin).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take benztropine, tell your doctor if you have:

  • glaucoma;
  • kidney or liver disease;
  • heart disease, a heart rhythm disorder, or a history of heart attack or stroke;
  • high or low blood pressure;
  • asthma, emphysema, or other breathing disorder;
  • a nerve disorder;
  • a muscle disorder such as myasthenia gravis;
  • seizures;
  • enlarged prostate;
  • overactive thyroid;
  • mental illness or dementia;
  • infectious diarrhea, ulcerative colitis;
  • stomach ulcer, reflux disease, hiatal hernia; or
  • a history of bowel obstruction or other intestinal disorder.

FDA pregnancy category C. It is not known whether benztropine is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether benztropine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

Children may be more likely to have an increased heart rate while taking benztropine.

How should I take benztropine (Cogentin)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Benztropine is sometimes given up to 4 times daily, at meals and at bedtime. If you take benztropine only once per day, it may be best to take the medication at bedtime. Follow your doctor's instructions.

Benztropine can be taken with food to lessen stomach upset.

Your mouth may feel dry while taking benztropine. To prevent or relieve dry mouth, suck on a piece of sugar-free hard candy, chew sugar-free gum, drink water, chew on ice chips, or use a saliva substitute.

Dry mouth may lead to gum disease or cavities. Brush and floss your teeth regularly and see a dentist for routine check-ups while you are taking benztropine.

It may take up to 3 days of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve or if they get worse.

Do not stop taking this medication without first talking to your doctor. Stopping suddenly may make your condition worse. You may need to use less and less before you stop the medication completely.

Store benztropine at room temperature, away from moisture, heat, and light

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Cogentin


Cogentin Patient Information including If I Miss a Dose

In this Article

  • What is benztropine (Cogentin)?
  • What are the possible side effects of benztropine (Cogentin)?
  • What is the most important information I should know about benztropine (Cogentin)?
  • What should I discuss with my healthcare provider before taking benztropine (Cogentin)?
  • How should I take benztropine (Cogentin)?
  • What happens if I miss a dose (Cogentin)?
  • What happens if I overdose (Cogentin)?
  • What should I avoid while taking benztropine (Cogentin)?
  • What other drugs will affect benztropine (Cogentin)?
  • Where can I get more information?

What happens if I miss a dose (Cogentin)?

Benztropine is sometimes taken only when needed, so you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Cogentin)?

Seek emergency medical attention of you think you have used too much of this medicine.

Overdose can cause confusion, hallucinations, loss of balance or coordination, fever, urinating more or less than usual, vision problems, dilated pupils, fast or slow heartbeat, weak or shallow breathing, seizures, and fainting.

What should I avoid while taking benztropine (Cogentin)?

Avoid taking a diarrhea medication (such as Kaopectate, Donnagel, or Rheaban) or an antacid (such as Amphojel, Maalox, Mylanta, Rolaids, Rulox, or Tums) within 2 hours before or after you take benztropine. These medications can make it harder for your body to absorb benztropine, which can make it less effective.

Also avoid taking ketoconazole (Nizoral) within 2 hours after you take benztropine. Benztropine can make it harder for your body to absorb ketoconazole.

Benztropine can cause side effects that may impair your vision, thinking, or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. It can increase some of the side effects of benztropine.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Benztropine can decrease perspiration and you may be more prone to heat stroke.

What other drugs will affect benztropine (Cogentin)?

Before using benztropine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by benztropine.

Tell your doctor about all other medications you use, especially:

  • amantadine (Symmetrel);
  • donepezil (Aricept);
  • galantamine (Razadyne);
  • glycopyrrolate (Robinul);
  • mepenzolate (Cantil);
  • potassium supplements (K-Lyte, K-Dur, Klor-Con, and others);
  • atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), dimenhydrinate (Dramamine), meclizine (Antivert), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
  • an antidepressant;
  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
  • bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
  • a heart rhythm medication such as quinidine (Quinaglute, Quinidex, Quin-Release), procainamide (Procan, Procanbid, Pronestyl), disopyramide (Norpace), propafenone, (Rythmol), and others;
  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine);
  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), risperidone (Risperdal), trazodone (Desyrel), and others;
  • narcotic pain medication; or
  • steroid medicine (prednisone and others).

This list is not complete and there may be other drugs that can interact with benztropine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about benztropine.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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