Trihexyphenidil
Trihexyphenidil: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Trihexyphenidyl
ATX code: N04AA01
Active ingredient: trihexyphenidyl (Trihexyphenidyl)
Manufacturer: Federal State Unitary Enterprise "Moscow Endocrine Plant" (Russia); Usolye-Sibirskiy Khimfarmzavod JSC (Russia)
Description and photo update: 2020-20-02
Prices in pharmacies: from 33 rubles.
Buy
Trihexyphenidil is a central anticholinergic antagonist that is highly effective in parkinsonism.
Release form and composition
Dosage form - tablets: biconvex, round, white (in a cardboard box 1, 2, 3, 4 or 5 packs of cell contour, containing 10 tablets, and instructions for the use of Trihexyphenidil).
Composition of 1 tablet:
- active substance: trihexyphenidyl hydrochloride - 2 mg;
- auxiliary components: polyplasdone XL-10 (crospovidone) - 2 mg; calcium stearate monohydrate - 1 mg; low molecular weight medical polyvinylpyrrolidone (povidone) - 0.8 mg; potato starch - 15.8 mg; white sugar (sucrose) - 78.4 mg.
Pharmacological properties
Pharmacodynamics
Trihexyphenidil is an antiparkinsonian drug of central and peripheral action, with an anticholinergic and muscle relaxant effect. Due to competition with the neurotransmitter acetylcholine, the mechanism of action of the substance is implemented on the postsynaptic membrane.
The drug reduces tremor, has less effect on hypokinesia and rigidity, has peripheral M-anticholinergic properties, which is manifested by a decrease in the secretion of the sebaceous glands, salivation and, to a lesser extent, sweating.
Pharmacokinetics
After oral administration, trihexyphenidil is rapidly and completely absorbed from the digestive tract.
The substance is characterized by high lipotropy, good permeability through the blood-brain and placental barrier. It is excreted in breast milk, and when exposed to nonspecific esterases, it is hydrolyzed.
Excretion is carried out by the kidneys mainly in the form of metabolites and only in small quantities in an unchanged form. The half-life of the drug from plasma varies from 5 to 10 hours.
Indications for use
- parkinsonism of various origins;
- movement disorders associated with damage to the extrapyramidal system.
Contraindications
Absolute:
- dementia;
- megacolon;
- pulmonary edema;
- angle-closure glaucoma;
- hyperplasia of the prostate (with residual urine);
- retention of urine;
- mechanical stenosis of the gastrointestinal tract;
- age up to 12 years;
- pregnancy;
- lactation period;
- established hypersensitivity to the components of the drug.
Relative (taking Trihexyphenidil requires special care and careful medical supervision):
- tachyarrhythmia;
- acute myocardial infarction;
- arterial hypertension;
- decompensated pathologies of the liver, kidneys or heart;
- psychosis;
- elderly age.
Trihexyphenidil, instructions for use: method and dosage
Trihexyphenidil tablets are intended for oral administration.
A single dose should be taken before or with meals. Therapy begins with a dose of ¼ – ½ tablet per day. It is gradually increased by ½ – 1 tablet every 3–5 days.
The usual maintenance daily dose is 3–5 tablets, divided into 3–4 doses. If necessary, in severe cases, it is allowed to increase the daily dose to 6-8 tablets, divided into 3-4 doses.
The maximum single dose is 5 tablets, the daily dose is 8.
Side effects
When taking Trihexyphenidil tablets, the following negative reactions from systems and organs may develop:
- nervous system: decreased concentration, dizziness, increased fatigue, irritability, headache, hallucinations, psychosis, delirium;
- digestive system: vomiting, nausea;
- allergic reactions: skin rash;
- others: decreased muscle tone, flushing of the skin, purulent parotitis (due to xerostomia), drug dependence may occur.
Possible development of undesirable phenomena due to anticholinergic activity: decreased sweating, tachycardia, urinary retention (including with prostate adenoma), constipation, dryness of the oral mucosa, increased intraocular pressure, paresis of accommodation.
Overdose
Taking higher doses of trihexyphenidil leads to blockade of the postganglionic endings of the parasympathetic nervous system. In this case, the picture of intoxication is similar to that of atropine poisoning. Possible symptoms: fever, intestinal and biliary tract atony, tachycardia, dryness of the mucous membranes of the oral cavity, mydriasis, disorders of the central nervous system (motor and mental agitation, paralysis of the respiratory center, coma).
The therapy is symptomatic, there is no specific antidote. First aid measures include gastric lavage and the appointment of activated charcoal.
special instructions
The use of Trihexyphenidil should not be stopped suddenly. In cases of dry mouth during treatment, the tablets should be taken before meals to avoid nausea.
It is important to gradually reduce the dose of the drug at the end of its use, as well as when starting alternative therapy.
Elderly patients (over the age of 60) are prescribed the drug with extreme caution, since, due to sensitivity to its action, their thinking and memory may deteriorate.
Treatment with the drug in patients with predisposing factors (advanced age, atherosclerosis, earlier development of idiosyncrasy for any drug), as well as its use in high doses, may be accompanied by vomiting, nausea, or mental disorders (increased irritability, agitation, unnatural mood elevation). In such cases, it is necessary to cancel therapy.
With prolonged use of the drug, the severity of adverse events associated with its anticholinergic effect decreases. Periodic monitoring of eye pressure is recommended.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy with Trihexyphenidil, it is forbidden to drive vehicles, as well as perform other work associated with increased attention.
Application during pregnancy and lactation
During pregnancy and during breastfeeding, Trihexyphenidil is not prescribed.
Pediatric use
The drug is not used in children under 12 years of age.
With impaired renal function
Decompensated kidney disease is a relative contraindication to the use of the drug.
For violations of liver function
Trihexyphenidil is prescribed with caution in patients with decompensated liver pathologies.
Use in the elderly
In elderly patients, treatment is recommended with extreme caution due to the possible impairment of thinking and memory due to sensitivity to the drug.
Drug interactions
Combinations of trihexyphenidil and other substances / drugs that are recommended to be taken into account:
- tricyclic antidepressants, phenothiazine derivatives, HI-histamine blockers: the severity of peripheral anticholinergic effects increases;
- chlorpromazine: a decrease in its content in blood plasma is possible;
- reserpine: its antiparkinsonian effect decreases (cholinergic neurons are activated, dopamine reserves are depleted);
- levodopa: its antiparkinsonian activity increases. Combination therapy requires lower doses of drugs. In such cases, 1.5–3 tablets of Trihexyphenidil per day, divided into 2 doses, are usually sufficient;
- monoamine oxidase inhibitors: the anticholinergic effect of anticholinergics prescribed for parkinsonism may be enhanced;
- nitrates used sublingually: due to the use of trihexyphenidil, dry mouth develops, due to which the effect of such drugs decreases;
- alcohol, drugs that affect the central nervous system: their depressive effect may increase.
Analogs
Analogs of Trihexyphenidil are: Akineton, Mendilex, Trihexyphenidil-Pharmstandard, Parkopan, Cyclodol, Trihexyphenidil Organics, etc.
Terms and conditions of storage
Store at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 5 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Trihexyphenidil
There are few reviews of Trihexyphenidil, indicating its effectiveness.
Price for Trihexyphenidil in pharmacies
The approximate price for Trihexyphenidil, 2 mg tablets (50 pieces per package) - 77 rubles.
Trihexyphenidil: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Trihexyphenidil Organic 2 mg tablets 50 pcs. RUB 33 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
