Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
ONLS
АТХ:N.04.A.A.01 Trihexyphenidyl
Pharmacodynamics:Oppression of central m-cholinergic receptors, normalization of the balance of cholinergic and dopaminergic processes in the basal nuclei.
Pharmacokinetics:After oral administration, it is quickly and sufficiently absorbed from the digestive tract. Easily penetrates the blood-brain barrier. Quickly leaves the body, appears mostly unchanged. Do not cumulate.
Indications:Parkinsonism (idiopathic, postencephalitic, atherosclerotic, due to side effects of drugs, as monotherapy and in combination with levodopa), Parkinson's disease, Little's disease, spastic paralysis associated with lesions of the extrapyramidal system.
VI.G20-G26.G20 Parkinson's disease
VI.G20-G26.G21 Secondary Parkinsonism
VI.G80-G83.G80 Cerebral palsy
VI.G80-G83.G81 Hemiplegia
VI.G80-G83.G82.1 Spastic paraplegia
VI.G80-G83.G82.4 Spasmodic tetraplegia
Contraindications:Hypersensitivity; mechanical stenosis of the gastrointestinal tract, megacolon, angle-closure glaucoma, urinary retention, prostatic hyperplasia (with residual residual urine); pregnancy (I trimester), pulmonary edema, dementia.
Carefully:Decompensated diseases of the heart, kidney or liver, tachycardia, tachyarrhythmia, hypertension, psychosis, acute myocardial infarction, advanced age.
Pregnancy and lactation:Adequate and well-controlled studies in humans and animals have not been conducted. There is no information on the penetration into breast milk. Do not apply! Perhaps oppression of lactation. Do not apply!
Recommendations for FDA - Category C.
Dosing and Administration:The initial dose is 0.5-1 mg per day. Then, if necessary, every 3-5 days, the dose is gradually increased by 1-2 mg until the optimal therapeutic effect is achieved; the frequency of reception is 3-5 times a day.
When hypersalivation before treatment trihexyphenidyl should be taken after meals. With the development during the treatment of dryness of the oral mucosa trihexyphenidyl appoint before meals (if this does not cause nausea).
Maximum doses: when taken orally, a single dose of 10 mg, daily - 20 mg.
Side effects:From the side CNS: headache, irritability, delirium, hallucinations, mental disorientation (mainly in patients with atherosclerosis).
Effects due to anticholinergic activity: dryness of the oral mucosa, visual impairment, increased intraocular pressure, constipation, difficulty urinating, tachycardia.
Allergic reactions: skin rash.
Other: purulent parotitis (due to xerostomia).
Overdose:Pronounced anticholinergic effects.
Treatment: cholinesterase inhibitors, pilocarpine, symptomatic and supportive therapy.
Interaction:Alcohol and other drugs that depress the central nervous system together with trihexyphenidyl increase the inhibitory effect.
Holin blockers and other preparations possessing anticholinergic activity, together with trihexyphenidyl potentiate anticholinergic effects.
Special instructions:The drug is more effective (in comparison with placebo) to improve motor disorders (monotherapy or in combination with levodopa).Like other anticholinergics, it causes neuropsychiatric and cognitive impairment. The results of studies of the effects on tremor in Parkinsonian syndrome are contradictory. Data is not enough to compare with the efficacy or tolerability of other anticholinergic drugs.
There is no evidence of efficacy in acute akathisia (versus placebo), potential benefits and the risk of side effects should be weighed.
Patients over 60 years of age prescribe the drug with extreme caution because of increased sensitivity to it, possible deterioration of memory and thinking.
With prolonged treatment, the severity of side effects due to anticholinergic action decreases.