benztropine (Rx)

Brand and Other Names:Cogentin
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 0.5mg
  • 1mg
  • 2mg

injectable solution

  • 1mg/mL

Parkinsonism

Postencephalitic parkinsonism: 1-2 mg/day (range, 0.5-6 mg/day) PO/IV/IM at bedtime or divided q6-12hr; may consider lower dose or 0.5 mg at bedtime in highly sensitive patients; titrate dose in 0.5-mg increments every 5-6 days (range 0.5-6 mg daily); not to exceed 6 mg/day

Idiopathic parkinsonism: 0.5-1 mg qHS initially; titrate dose in 0.5-mg increments every 5-6 days (range 0.5-6 mg daily; some patients may need 4-6 mg/day); not to exceed 6 mg/day

Drug-Induced Extrapyramidal Disorders

1-2 mg IV/IM/PO q8-12hr; titrate gradually at 0.5 mg increments at 5-6 day intervals based on response and tolerability; not to exceed 6 mg/day; reevaluate after 1-2 weeks; may reinitiate therapy if symptoms recur

Acute dystonia: 1-2 mg IV, then 1-2 mg PO once or twice daily for 7-28 days to prevent recurrence

Dosage Forms & Strengths

tablet

  • 0.5mg
  • 1mg
  • 2mg

injectable solution

  • 1mg/mL

Drug-Induced Extrapyramidal Disorders

<3 years: Not recommended

>3 years: 0.02-0.05 mg/kg IV/IM/PO once daily or q12hr  

Adolescents (off-label): 1-4 mg IV/IM/PO qDay or q12hr

Nonanticholinergic antiparkinson agents should be considered first for treatment of Parkinson disease (Beers criteria)

Not well tolerated in elderly, because of bowel, bladder, and CNS effects; avoid use if possible

Should not be used as prophylaxis against extrapyramidal symptoms in elderly

Parkinsonism

0.5 mg PO once daily or q12hr; titrate dose in 0.5-mg increments every 5-6 days; not to exceed 4 mg/day

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Interactions

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and benztropine

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            Contraindicated (0)

              Serious - Use Alternative (6)

              • glucagon

                glucagon increases toxicity of benztropine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glucagon intranasal

                glucagon intranasal increases toxicity of benztropine by Other (see comment). Avoid or Use Alternate Drug. Comment: Coadministration of anticholinergic drugs and glucagon increase the risk of gastrointestinal adverse reactions due to additive effects on inhibition of gastrointestinal motility. .

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, benztropine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • revefenacin

                revefenacin and benztropine both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

              • secretin

                benztropine decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.

              • umeclidinium bromide/vilanterol inhaled

                benztropine, umeclidinium bromide/vilanterol inhaled. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Concomitant use with other anticholinergic-containing drugs may lead to additive anticholinergic adverse effects.

              Monitor Closely (70)

              • aclidinium

                benztropine and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amantadine

                benztropine, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

              • amitriptyline

                benztropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely. Additive anticholinergic adverse effects may be seen with concurrent use.

              • amoxapine

                benztropine and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos and benztropine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • atropine

                atropine and benztropine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • atropine IV/IM

                atropine IV/IM and benztropine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna alkaloids

                belladonna alkaloids and benztropine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • belladonna and opium

                benztropine and belladonna and opium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • chlorpromazine

                chlorpromazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • clomipramine

                benztropine and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clozapine

                clozapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • cyclizine

                benztropine and cyclizine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • cyclobenzaprine

                benztropine and cyclobenzaprine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • darifenacin

                benztropine and darifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • dicyclomine

                benztropine and dicyclomine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • dimenhydrinate

                dimenhydrinate increases toxicity of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects.

              • diphenhydramine

                benztropine and diphenhydramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • donepezil

                donepezil decreases effects of benztropine by pharmacodynamic antagonism. Use Caution/Monitor.

              • doxepin

                benztropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • droperidol

                droperidol increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • echothiophate iodide

                echothiophate iodide increases and benztropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fesoterodine

                benztropine and fesoterodine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • flavoxate

                benztropine and flavoxate both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • fluphenazine

                fluphenazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • galantamine

                galantamine decreases effects of benztropine by pharmacodynamic antagonism. Use Caution/Monitor.

              • glycopyrrolate inhaled

                benztropine and glycopyrrolate inhaled both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • haloperidol

                haloperidol increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • homatropine

                benztropine and homatropine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • hyoscyamine

                benztropine and hyoscyamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • hyoscyamine spray

                benztropine and hyoscyamine spray both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • imipramine

                benztropine and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • incobotulinumtoxinA

                benztropine, incobotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • ioflupane I 123

                benztropine decreases effects of ioflupane I 123 by receptor binding competition. Use Caution/Monitor. Drugs that bind to dopamine transporter receptor with high affinity may interfere with the image following ioflupane I 123 administration.

              • ipratropium

                benztropine and ipratropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • loxapine

                loxapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • loxapine inhaled

                loxapine inhaled increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                benztropine decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

              • maprotiline

                benztropine and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • meclizine

                benztropine and meclizine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • methscopolamine

                benztropine and methscopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • nortriptyline

                benztropine and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • olanzapine

                olanzapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • oliceridine

                benztropine increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

              • onabotulinumtoxinA

                benztropine and onabotulinumtoxinA both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • orphenadrine

                benztropine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • oxybutynin

                benztropine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • oxybutynin topical

                benztropine and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • oxybutynin transdermal

                benztropine and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • perphenazine

                perphenazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • pimozide

                pimozide increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • pralidoxime

                benztropine and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • pramlintide

                pramlintide, benztropine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Synergistic inhibition of GI motility.

              • prochlorperazine

                prochlorperazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • promethazine

                promethazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • propantheline

                benztropine and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • protriptyline

                benztropine and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • quetiapine

                quetiapine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • rimabotulinumtoxinB

                benztropine and rimabotulinumtoxinB both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • risperidone

                risperidone increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • scopolamine

                benztropine and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • solifenacin

                benztropine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • thioridazine

                thioridazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • thiothixene

                thiothixene increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • tiotropium

                benztropine and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • tolterodine

                benztropine and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • tranylcypromine

                tranylcypromine, benztropine. Other (see comment). Use Caution/Monitor. Comment: Anti-parkinsonism drugs should be used with caution in patients receiving tranylcypromine since severe reactions have been reported.

              • trifluoperazine

                trifluoperazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

              • trihexyphenidyl

                benztropine and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

              • trimipramine

                benztropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • trospium chloride

                benztropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              Minor (3)

              • desipramine

                benztropine and desipramine both decrease cholinergic effects/transmission. Minor/Significance Unknown.

              • levodopa

                benztropine, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

              • trazodone

                benztropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Blurred vision

              Confusion

              Constipation

              Disorientation

              Dry mouth or throat

              Hyperthermia

              Mydriasis

              Nausea

              Paralytic ileus

              Psychosis

              Tachycardia

              Urinary retention

              Visual hallucinations

              Vomiting

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              Warnings

              Contraindications

              Hypersensitivity

              Age <3 years

              Cautions

              May cause anhidrosis/hyperthermia, which may become severe; use with catuion in hot weather and during exercise; risk is increased in hot environment; consider lowering the dose to prevent impairing heat equilibrium by perspiration

              May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention)

              At higher doses, may be associated with confusion, visual hallucinations or excitement; intensification of symptoms or toxic psychosis may occur in patients with mental disorders

              May cause CNS depression, which may impair ability to operate heavy machinery and tasks that require mental alertness

              In susceptible patients, large doses may cause weakness and inability to move perticular muscles

              Use caution in patients with GI obstruction, tachycardia, prostatic hyperplasia/urinary stricture, and glaucoma

              Response in the elderly >65 years of age may be altered; initiate at low doses and increase PRN while monitoring adverse effects

              Use with caution in children >3 years of age due to anticholinergic effects

              Not recommended for patients with tardive dyskinesia; does not relieve symptoms and may potentially exacerbate symptoms

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              Pregnancy & Lactation

              Pregnancy

              Use in pregnancy not established; paralytic ileus reported in newborns exposed to a combination of benztropine and chlorpromazine during the second and third trimesters of pregnancy

              Lactation

              Excretion in milk unknown; use with caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Exerts anticholinergic and antihistaminic effects; may prolong action of dopamine by inhibiting its reuptake and storage

              Absorption

              Bioavailability: 29%

              Onset: PO, 1 hr; parenteral, 15 min

              Duration: 6-48 hr

              Distribution

              Protein bound: 95%

              Elimination

              Trace amounts found unchanged in feces

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              Administration

              IV Incompatibilities

              Syringe: Haloperidol

              IV Compatibilities

              Syringe: Chlorpromazine, fluphenazine, metoclopramide, perphenazine

              Y-site: Tacrolimus, fluconazole

              IV Administration

              IV route rarely necessary; use only when PO and IM routes unavailable

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Cogentin injection
              -
              1 mg/mL solution
              benztropine oral
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              2 mg tablet
              benztropine oral
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              1 mg tablet
              benztropine oral
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              0.5 mg tablet
              benztropine oral
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              0.5 mg tablet
              benztropine oral
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              0.5 mg tablet
              benztropine oral
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              0.5 mg tablet
              benztropine oral
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              1 mg tablet
              benztropine oral
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              1 mg tablet
              benztropine oral
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              2 mg tablet
              benztropine oral
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              2 mg tablet
              benztropine oral
              -
              2 mg tablet
              benztropine oral
              -
              0.5 mg tablet
              benztropine oral
              -
              1 mg tablet
              benztropine oral
              -
              2 mg tablet
              benztropine oral
              -
              2 mg tablet
              benztropine oral
              -
              1 mg tablet
              benztropine oral
              -
              0.5 mg tablet
              benztropine oral
              -
              0.5 mg tablet
              benztropine oral
              -
              2 mg tablet
              benztropine oral
              -
              0.5 mg tablet
              benztropine injection
              -
              1 mg/mL vial
              benztropine injection
              -
              1 mg/mL vial
              benztropine injection
              -
              1 mg/mL solution
              benztropine injection
              -
              1 mg/mL solution

              Copyright © 2010 First DataBank, Inc.

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              benztropine oral

              BENZTROPINE - ORAL

              (BENZ-troe-peen)

              COMMON BRAND NAME(S): Cogentin

              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 by children younger than 3 years.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually 2 to 4 times a day with meals and at bedtime or as a single dose at bedtime. 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, age, 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 (such as levodopa). Follow your doctor's instructions closely.When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Do not increase your dose, use it more often, 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 suddenly stopped. Your dose may need to be gradually decreased.It may take 2-3 days before the benefit of this drug takes effect. Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Drowsiness, dizziness, constipation, flushing, nausea, nervousness, blurred vision, or dry mouth may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.To relieve dry mouth, suck (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 right away if you have any serious side effects, including: high fever, decreased sexual ability, severe stomach/abdominal pain, difficult/painful swallowing, difficulty urinating, weakness.Get medical help right away if you have any very serious side effects, including: chest pain, severe dizziness/fainting, fast/irregular/slow heartbeat, mental/mood changes (such as confusion, hallucinations, memory problems), eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: 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 or at www.fda.gov/medwatch.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.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of glaucoma (angle-closure type), breathing problems (such as asthma, emphysema), diarrhea caused by an infection, heart problems (such as angina, heart attack, heart failure, fast/irregular heartbeat), high/low blood pressure, intestinal problems (such as chronic constipation, ileus, ulcerative colitis, bowel obstruction), blockage of the bladder/esophagus/stomach/intestines, kidney disease, liver disease, mental/mood problems (such as anxiety, dementia, psychosis), a certain muscle disease (myasthenia gravis), a certain nerve disease (autonomic neuropathy), seizure, stomach problems (such as acid reflux, hiatal hernia, ulcer), stroke, overactive thyroid (hyperthyroidism), problems urinating (for example, due to enlarged prostate, neurogenic bladder), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication decreases saliva production, an effect that can increase gum and tooth problems (such as cavities, gum disease). Take special care with your dental hygiene (such as brushing, flossing) and have regular dental check-ups.Benztropine may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially dizziness, drowsiness, heatstroke, memory problems, difficulty urinating, and constipation. Dizziness and drowsiness can increase the risk of falling.Children may be more sensitive to the side effects of this drug, especially effects on heart rate.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: potassium tablets/capsules, pramlintide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This medication may interfere with certain medical/lab tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. 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.Lab and/or medical tests (such as eye exams) should be done while you are taking this medication. Keep all medical and lab appointments. 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. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications 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.

              Information last revised November 2019. Copyright(c) 2021 First Databank, Inc.

              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.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.