Apiden

Each Tablet contains Biperiden (as Hydrochloride) 2 mg.

Pharmacology: Pharmacodynamics: Biperiden is an anticholinergic agent with a marked effect on the central nervous system which is important for its therapeutic application and, unlike atropine, has weak peripheral vegetative effects.
Pharmacokinetics: Biperiden is readily absorbed from the gastro-intestinal tract, but bioavailability is only about 30% suggesting that it undergoes extensive first-pass metabolism.
Biperiden has an elimination half-life of about 20 hours.

Biperiden is used in the symptomatic treatment of parkinsonism, including the alleviation of the extrapyramidal syndrome induced by drugs such as phenothiazines, but is of no value against tardive dyskinesias.

Initial dose is 1 mg twice daily, gradually increased over several days according to the needs of the patient. The usual optimum maintenance dosage varies from 3 to 12 mg daily in divided doses. Initial dose for idiopathic parkinsonism is 2 mg three or four times daily increased according to the needs of the patient to a maximum of 16 mg in 24 hours. The dose for drug-induced extra pyramidal symptoms is 2 mg one to three times daily.

Symptoms: The symptoms of overdose are anticholinergic effects such as mydriasis, dryness of mucous membranes, flushing, rise in heart rate, reduction of bowel motility, reduction in ureter and bladder tone, increased temperature, excitation, confusion, clouding of consciousness and/or hallucinations. In severe overdose, cardiac and respiratory depression may occur.
Treatment: Gastric lavage or emesis should be considered. As antidote, acetylcholinesterase inhibitors are recommended. Vital signs should be closely monitored and appropriate supportive measures taken. Artificial ventilation, reduction of fever and application of a bladder emptying catheter may be necessary.
In the event of cardiac depression, a cardiac stimulant drug, such as dobutamine, may be considered.

Contraindicated in patients who have shown hypersensitivity to Biperiden or any or its ingredients.

Biperiden should only be used during pregnancy or lactation if considered reproductive studies and no reports of use during pregnancy or lactation in man.

Neuromuscular and skeletal: Choreic movements have been reported in a parkinson's disease patient when Biperiden was added to carbidopa/levodopa.
Central Nervous System: Sleep disorder (decreased REM sleep and increased REM latency), drowsiness, euphoria or disorentiation, agitation. At higher doses, disturbed behavior may be seen.
Ocular: Blurred vision.
Gastrointestinal: Dry mouth, constipation.
Genitourinary: A decrease in urinary flow has been noted in a few patients.
Cardiovascular: Postural hypotension, bradycardia.

The administration of Biperiden in combination with other anticholinergic psychotropic drugs, antihistamines, antiparkinsonian drugs and antispasmodics can potentiate the CNS and peripheral side effects. The concomitant intake of quinidine may potentiate the anticholinergic effect (especially AV conduction). The concurrent administration of levodopa and Biperiden may potentiate dyskinesia. Generalised choriec movements have been reported in Parkinson's disease following concurrent administration of carbidopa/levodopa and Biperiden. Tardive dyskinesia induced by presence of existing tardive are occasionally so serious as to mandate continued anticholinergic therapy. The effect of metoclopramide and compounds with similar activity on the gastrointestinal tract is attenuated by anticholinergics such as Biperiden. As with all other drugs acting on the central nervous system, the consumption of alcohol should be avoided under Biperiden therapy.

Store at temperatures not exceeding 30°C.
Protect from light.

Antiparkinsonian Drugs

N04AA02 - biperiden ; Belongs to the class of tertiary amines anticholinergic agents. Used in the management of Parkinson's disease.

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