Biperiden

What is Biperiden?

• Biperiden (Akineton) is an oral anticholinergic agent used predominantly in the symptomatic therapy of Parkinson disease and movement disorders.

Biperiden structure

Biperiden-3D-sticks

Biperiden

What are the uses of this medicine?

• Biperiden (Akineton) is used to treat Parkinson disease and certain drug-induced movement disorders.

Limitations of use:

• It is not recommended for tardive dyskinesias.

How does this medicine work?

• Biperiden (bye per' i den) is an anticholinergic agent that blocks the central cholinergic receptors, helping to balance cholinergic transmission in the basal ganglia.
• Biperiden may also block dopamine reuptake and storage in central sites thus increasing dopaminergic activity.
• The exact mechanism(s) by which the anticholinergic agents are beneficial for symptoms of Parkinson disease is unknown.
• They are used largely in early Parkinsonism and as adjunctive therapy with levodopa or more potent antiParkinson disease agents.

Who Should Not Use this medicine ?

This medicine cannot be used in patients with:

• Hypersensitivity to biperiden
• Narrow angle glaucoma
• Ileus

• Use with Caution in People with obstructive diseases of the urogenital tract, people with a known history of seizures and those with potentially dangerous tachycardia.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Be sure to mention any of the following:

• Other anticholinergic drugs
• Quinidine
• Antipsychotics
• Pethidine
• Metoclopramide
• Alcohol

Is this medicine FDA approved?

• Biperiden was approved for use in the United States in 1959 and has been in use since.

How should this medicine be used?

Recommended dosage:

• The recommended dose is 2 mg three to four times daily.

Administration:

• It is taken by mouth, injection into a vein, or muscle.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As tablets of 2 mg

This medicine is available in fallowing brand namesː

• Akineton

What side effects can this medication cause?

The most common side effects of this medicine include:

• nervousness, drowsiness, confusion, tachycardia, blurred vision, constipation, dry mouth, nausea and urinary retention

Biperiden may cause serious side effects which may include:

• CNS : Drowsiness, vertigo, headache, and dizziness are frequent. With high doses nervousness, agitation, anxiety, delirium, and confusion are noted. Biperiden may be abused due to a short acting mood-elevating and euphoriant effect. The normal sleep architecture may be altered (REM sleep depression). Biperiden may lower the seizure-threshold. Some instances of dementia have been noted to correlate with chronic administration of anticholinergic medications such as Biperiden for Parkinson's disease.
• Peripheral side effects : Blurred vision, dry mouth, impaired sweating, abdominal discomfort, and obstipation are frequent. Tachycardia may be noted. Allergic skin reactions may occur. Parenteral use may cause orthostatic hypotension.
• Eyes : Biperiden causes mydriasis with or without photophobia. It may precipitate narrow angle glaucoma.

What special precautions should I follow?

• Biperiden has not been associated with serum enzyme elevations during treatment and must be a very rare cause of clinically apparent acute liver injury, if it occurs at all.
• Isolated instances of mental confusion, euphoria, agitation and disturbed behavior have been reported in susceptible patients.
• Caution should be observed in patients with manifest glaucoma, though no prohibitive rise in intraocular pressure has been noted following either oral or parenteral administration.
• Patients with prostatism, epilepsy or cardiac arrhythmia should be given this drug with caution.
• Occasionally, drowsiness may occur, and patients who drive a car or operate any other potentially dangerous machinery should be warned of this possibility.
• As with other drugs action on the central nervous system, the consumption of alcohol should be avoided during Akineton therapy.
• It is not known whether biperiden is distributed into milk. Because many drugs are distributed into milk, biperiden should be used with caution in nursing women.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• dilated and sluggish pupils, warm, dry skin, facial flushing, decreased secretions of the mouth, pharynx, nose, and bronchi, foul-smelling breath, elevated temperature, tachycardia, cardiac arrhythmias, decreased bowel sounds, urinary retention, delirium, disorientation, anxiety, hallucinations, illusions, confusion, incoherence, agitation, hyperactivity, ataxia, loss of memory, paranoia, combativeness, and seizures.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• Maintain an open airway and assist ventilation if needed.
• Treat hyperthermia, coma, rhabdomyolysis, and seizures if they occur.
• A small dose of physostigmine can be given to patients with severe toxicity (e.g., hyperthermia, severe delirium, or tachycardia).
• Administer activated charcoal orally if conditions are appropriate. Gastric lavage is not necessary after small to moderate ingestions if activated charcoal can be given promptly.
• Hemodialysis, hemoperfusion, peritoneal dialysis, and repeat-dose charcoal are not effective in removing anticholinergic agents.

Can this medicine be used in pregnancy?

• There is no sufficient clinical data on pregnant women.
• The drug should therefore be used cautiously during pregnancy.

Can this medicine be used in children?

• Children and adolescents aged 1 year and older may be treated.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• Biperiden hydrochloride

Inactive ingredients:

Who manufactures and distributes this medicine?

• manufactured / distrubuted by abbvie inc.

What should I know about storage and disposal of this medication?

• Biperiden tablets should be stored in tight, light-resistant containers at 15-30 °C.

• Dailymed label info on Biperiden
• FDA Biperiden