Benzatropine mesilate

CLINICAL USE

Parkinson’s disease

Drug-induced extrapyramidal side effects

DOSE IN NORMAL RENAL FUNCTION

IV/IM (emergency use): 1–2 mg

PHARMACOKINETICS

Molecular weight :403.5

%Protein binding :95

%Excreted unchanged in urine : Majority (as unchanged drug and metabolites)

Volume of distribution (L/kg) :

half-life – normal/ESRD (hrs) :

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Start with low doses and adjust according to response

10 to 20 : Start with low doses and adjust according to response

<10 : Start with low doses and adjust according to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsPhenothiazines and tricyclic anti- depressants: may cause paralytic ileus which can be fatal

ADMINISTRATION

Reconstition

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Route

IV, IM

Rate of Administration

–

Comments

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OTHER INFORMATION

Benzatropine pharmacokinetics are not well studied, but the drug apparently is hepatically metabolised to conjugates and may undergo entero-hepatic recycling

Benzatropine has a cumulative effect and a prolonged duration of action; therefore, treatment should commence with the lowest possible dosage and be titrated according to response

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