Cogentin (Oral)

Benztropine is used along with other medicines to treat Parkinson's disease. It helps improve muscle control and reduce stiffness, which allows for more normal body movements as the symptoms of the disease decrease. It is also used to manage severe reactions to certain medicines that treat nervous, mental, and emotional conditions (e.g., phenothiazine medicines like prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®).

This medicine is available only with your doctor's prescription.

It is important for your doctor to check your progress at regular visits. This allows for any changes in your dose and helps to monitor for any unwanted effects.

Benztropine may cause dizziness, difficulty controlling movements, or trouble thinking or seeing clearly. Make sure you understand how this medicine affects you before you drive, use machines, or perform tasks that need you to be alert, well-coordinated, or able to think or see well.

Do not stop taking this medicine without first consulting your doctor. Your doctor may want you to gradually reduce your dose before stopping completely.

This medicine may reduce your ability to sweat, which can lead to an increase in your body temperature. Be extra careful to avoid overheating during exercise or in hot weather while taking this medicine, as overheating may lead to heat stroke.

This medicine may cause muscle weakness. If you are concerned about this, talk to your doctor.

If you experience any unusual or strange thoughts and behaviors while taking benztropine, be sure to discuss them with your doctor. Some changes seen in people taking this medicine are similar to those experienced by people who consume excessive alcohol. Other changes may include confusion, worsening depression, visual hallucinations (seeing things that are not there), thoughts of suicide, and unusual excitement, nervousness, or irritability.

This medicine will enhance the effects of alcohol and other CNS depressants (medications that make you drowsy or less alert). Examples of CNS depressants include antihistamines or medications for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medications; prescription pain medications or narcotics; barbiturates; medications for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Consult with your medical doctor or dentist before taking any of these while you are on this medicine.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your health care professional if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Because of the toxicity of benztropine, it should be used cautiously in children 3 years of age or older. It is not recommended for use in children under 3 years of age.

Geriatric

There is no information available on how age affects the effects of benztropine in older patients.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the possible benefits against the possible risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases two different medicines may be used together even if an interaction might happen. In these situations, your doctor may want to adjust the dose, or other precautions may be necessary. When taking this medicine, it is crucial that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been highlighted based on their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Potassium Citrate

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Amantadine
• Buprenorphine
• Clozapine
• Codeine
• Glucagon
• Glycopyrrolate
• Glycopyrronium Tosylate
• Methacholine
• Metoclopramide
• Oxycodone
• Quetiapine
• Revefenacin
• Scopolamine
• Secretin Human
• Tapentadol
• Tiotropium

Using this medicine with any of the following medicines may lead to a higher risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Betel Nut
• Chlorpromazine
• Haloperidol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around mealtime, as interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure to inform your doctor if you have any other medical issues, especially:

• Enlarged prostate or
• Glaucoma or
• Paralytic ileus (bowel blockage) or
• Psychosis (mental disorder) or
• Tachycardia (fast heartbeat) or
• Urinating problems (e.g., painful or difficult urination, urinary retention)—Use with caution. It may worsen these conditions.

• Glaucoma, angle-closure or
• Tardive dyskinesia (movement disorder)—Should not be used in patients with this condition.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may happen, if they do, you may need medical attention.

Check with your doctor right away if any of the following side effects happen:

Incidence not known

• Abdominal or stomach cramps or pain
• aggressive and violent behavior
• being forgetful
• bloating
• burning while urinating
• confusion about identity, place, and time
• constipation
• decrease in frequency of urination
• decrease in urine volume
• diarrhea
• difficult or painful urination
• difficulty in passing urine (dribbling)
• difficulty with speaking
• difficulty with swallowing
• discouragement
• dizziness
• dry mouth
• extremely high fever or body temperature
• fast, pounding, or irregular heartbeat or pulse
• fast, shallow breathing
• fast, weak heartbeat
• feeling sad or empty
• fever
• headache
• hot, dry skin
• irritability
• lack of appetite
• lack of sweating
• listlessness
• loss of interest or pleasure
• mood or mental changes
• muscle cramps
• muscle weakness
• nervousness
• numbness of the fingers
• pale, clammy skin
• seeing things that are not there
• thirst
• tiredness
• trouble concentrating
• trouble with sleeping
• vomiting

Get emergency help right away if any of the following symptoms of overdose happen:

Symptoms of overdose

• Blindness
• blurred vision
• change in consciousness
• cold clammy skin
• decreased vision
• dizziness
• eye pain
• holding false beliefs that cannot be changed by fact
• lightheadedness
• loss of consciousness
• muscle weakness
• nausea or vomiting
• no breathing
• nosebleeds
• numbness or tingling in the face, arms, or legs
• shakiness and unsteady walk
• sweating
• tearing
• unsteadiness, trembling, or other problems with muscle control or coordination
• unusual excitement, nervousness, or restlessness
• vision problems
• wheezing

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also have ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Enlarged pupils
• loss of appetite
• skin rash
• weight loss

Other side effects not listed may also happen in some patients. If you notice any other effects, check with your health care professional.

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

In the U.S.

• Cogentin

Available Dosage Forms:

• Tablet

Therapeutic Class: Antiparkinsonian

Pharmacologic Class: Anticholinergic

Take this medicine every day exactly as ordered by your doctor in order to improve your condition as much as possible. Do not take more of it or less of it, and do not take it more or less often than your doctor ordered.

It is important to take this medicine together with other medicines for Parkinson's disease. Be sure to take all of the medicines your doctor ordered, and to take them at the right times.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets): For Idiopathic parkinsonism: Adults—At first, 0.5 to 1 milligram (mg) at bedtime. Your doctor may increase your dose as needed. The dose is usually not more than 6 mg. Children 3 years of age and above—Use and dose must be determined by your doctor. Children below 3 years of age—Use is not recommended. For Parkinson-like symptoms caused by other medicines: Adults—At first, 1 to 4 milligrams (mg) once or twice a day. Your doctor may increase your dose as needed. Children 3 years of age and above—Use and dose must be determined by your doctor. Children below 3 years of age—Use is not recommended. For Postencephalitic parkinsonism: Adults—At first, 0.5 to 2 milligrams (mg) at bedtime. Your doctor may increase your dose as needed. The dose is usually not more than 6 mg. Children 3 years of age and above—Use and dose must be determined by your doctor. Children below 3 years of age—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.