بیپریدین
Biperiden (Akineton)
بیپریدین

نام ژنریک

Biperiden

شکل دارویی

اشكال دارويي:


Injection: 5mg/ml


Tablet: 2mg


Tablet, Extended Release: 4mg

موارد مصرف

موارد و مقدار مصرف


الف) اختلالات اكستراپيراميدال.


بزرگسالان: از راه خوراكي، مقدار mg/day 6-2 در مقادير منقسم (دو يا سه بار) برحسب شدت بيماري، تجويز مي‌شود. مقدار مصرف معمول اين دارو mg/day 2، يا 2 ميلي گرم از طريق تزريق عضلاني يا وريدي هر نيم ساعت است و مقدار مصرف نبايد از 4 نوبت يا 8 ميلي گرم در روز تجاوز كند.


ب) پاركينسونيسم.


بزرگسالان: از راه خوراكي، مقدار دو ميلي گرم سه يا چهار بار در روز مصرف مي‌شود.


پ) درمان اختلالات اسپاستيك غيرمرتبط مانند آسيب به نخاع.


بزرگسالان- از راه خوراكي mg 2 دو يا سه بار در روز مصرف مي‌ شود.


مكانيسم اثر


اثر ضد پاركينسون: بي پريدن با انسداد گيرنده‌هاي مركزي كولينرژيك، به ايجاد تعادل در فعاليت كولينرژيك در گانگليونهاي قاعدهاي مغز كمك مي‌كند. اين دارو ممكن است با مهار برداشت مجدد دوپامين و ذخيره آن در محلهاي گيرنده مركزي، اثرات دوپاميني را نيز طولاني كند.

موارد منع مصرف

تداخل دارويي


مصرف همزمان با آمانتادين، ممكن است عوارض آنتيكولينرژيك بي‌پريدن، مانند اغتشاش شعور و توهم، را تشديد كند. مقدار مصرف بي‌پريدن قبل از مصرف آمانتادين بايد كاهش يابد.


مصرف همزمان آنتياسيدها و ضداسهالها با اين دارو ممکن است جذب بيپريدن را کاهش دهد. بنابراين بي پريدن با يد حداقل يک ساعت قبل از اين داروها مصرف شود.


مصرف همزمان با هالوپريدول و فنوتيازينها ممكن است اثر ضد سايكوز اين داروها را، احتمالاً با آنتاگونيسم مستقيم در CNS كاهش دهد. مصرف همزمان با فنوتيازينها خطر بروز عوارض آنتي كولينرژيك را افزايش مي‌دهد.


فرآورده‌هاي حاوي الكل و ساير داروهاي مضعف CNS اثر تسكين‌بخش بي‌پريدن را افزايش مي‌دهند.

موارد قابل توجه

-

تداخل دارویی

عوارض جانبي


اعصاب مركزي: سردرد، از دست رفتن حس جهتيابي، سرخوشي موقت، بي‌قراري، خواب‌آلودگي، اغتشاش شعور و هيجان (در سالخوردگان)، سرگيجه، سايكوز گذرا، آشفتگي، رفتار غير طبيعي.


قلبي- عروقي: كاهش فشار خون وضعيتي گذرا.


چشم: تاري ديد ، افزايش فشار داخل كره چشم.


دستگاه گوارش: يبوست، خشكي دهان، ‌تهوع، استفراغ، ديسترس در ناحيه سر دل، اتساع شكم.


ادراري- تناسلي: احتباس ادرار.


توجه: مصرف دارو در صورت بروز حساسيت مفرط ، احتباس ادرار، اغتشاش شعور، تهوع، گشادي و ثابت ماندن مردمك چشم و خشكي و برافروختگي پوست بايد قطع شود.


مسموميت و درمان


تظاهرات باليني: تحريك مركزي و به دنبال آن ، افسردگي و علائم سايكوز، مانند از دست رفتن حس جهت‌يابي، اغتشاش شعور، توهم، آشفتگي، اضطراب، بي‌قراري. اثرات محيطي مصرف بيش از حد دارو عبارت‌اند از گشادي و ثابت ماندن مردمك چشم، تاري ديد، خشكي و برافروختگي پوست، خشكي سطوح مخاطي، اشكال در بلع، كاهش يا حذف صداهاي روده ، ‌احتباس ادرار، افزايش غير طبيعي حرارت بدن، سردرد، تاكيكاردي، زيادي فشار خون و افزايش سرعت تنفس.


درمان: در صورت نياز، عمدتاً انجام اقدامات حمايتي و علامتي است. راه تنفسي بيمار بايد باز باشد. در صورت هوشيار بودن بيمار ، با واداشتن او به استفراغ (يا شستشوي معده) و بعد از آن با ذغال فعال و مسهل نمكي ، مي‌توان از جذب بيشتر شكل خوراكي دارو جلوگيري كرد. در موارد شديد، مي‌توان فيزوستيگمين را براي خنثي كردن اثرات ضد موسكاريني بي‌پريدن به كار برد. تأمين مايعات بدن براي درمان شوك لازم است. ديازپام براي كنترل علائم سايكوز و قطرة چشمي پيلوكارپين براي كاهش گشادي مردمك چشم مصرف مي‌شوند. در صورت احتباس ادرار ، ممكن است سوندگذاري لازم باشد.


مکانیزم اثر

عوارض جانبي


اعصاب مركزي: سردرد، از دست رفتن حس جهتيابي، سرخوشي موقت، بي‌قراري، خواب‌آلودگي، اغتشاش شعور و هيجان (در سالخوردگان)، سرگيجه، سايكوز گذرا، آشفتگي، رفتار غير طبيعي.


قلبي- عروقي: كاهش فشار خون وضعيتي گذرا.


چشم: تاري ديد ، افزايش فشار داخل كره چشم.


دستگاه گوارش: يبوست، خشكي دهان، ‌تهوع، استفراغ، ديسترس در ناحيه سر دل، اتساع شكم.


ادراري- تناسلي: احتباس ادرار.


توجه: مصرف دارو در صورت بروز حساسيت مفرط ، احتباس ادرار، اغتشاش شعور، تهوع، گشادي و ثابت ماندن مردمك چشم و خشكي و برافروختگي پوست بايد قطع شود.


مسموميت و درمان


تظاهرات باليني: تحريك مركزي و به دنبال آن ، افسردگي و علائم سايكوز، مانند از دست رفتن حس جهت‌يابي، اغتشاش شعور، توهم، آشفتگي، اضطراب، بي‌قراري. اثرات محيطي مصرف بيش از حد دارو عبارت‌اند از گشادي و ثابت ماندن مردمك چشم، تاري ديد، خشكي و برافروختگي پوست، خشكي سطوح مخاطي، اشكال در بلع، كاهش يا حذف صداهاي روده ، ‌احتباس ادرار، افزايش غير طبيعي حرارت بدن، سردرد، تاكيكاردي، زيادي فشار خون و افزايش سرعت تنفس.


درمان: در صورت نياز، عمدتاً انجام اقدامات حمايتي و علامتي است. راه تنفسي بيمار بايد باز باشد. در صورت هوشيار بودن بيمار ، با واداشتن او به استفراغ (يا شستشوي معده) و بعد از آن با ذغال فعال و مسهل نمكي ، مي‌توان از جذب بيشتر شكل خوراكي دارو جلوگيري كرد. در موارد شديد، مي‌توان فيزوستيگمين را براي خنثي كردن اثرات ضد موسكاريني بي‌پريدن به كار برد. تأمين مايعات بدن براي درمان شوك لازم است. ديازپام براي كنترل علائم سايكوز و قطرة چشمي پيلوكارپين براي كاهش گشادي مردمك چشم مصرف مي‌شوند. در صورت احتباس ادرار ، ممكن است سوندگذاري لازم باشد.


فارماكوكینتیك

موارد منع مصرف و احتياط


موارد احتياط: هيپرتروفي پروستات (ممكن است احتباس ادرار را وخيم تر كند)، آريتمي قلبي (ممكن است از مهار مركز ضربان ساز گره سينوسي- دهليزي به وسيله عصب واگ جلوگيري كند)، گلوكوم با زاويه باريك (سيكلوپلژي و گشادي مردمك چشم ناشي از مصرف دارو ممكن است فشار داخل كره چشم را افزايش دهد.)


در بيماران با هيپرپلازي پروستات، آريتمي و تشنج با احتياط مصرف شود.

سایر اطلاعات

طبقه‌بندي فارماكولوژيك: آنتيكولينرژيك


طبقه‌بندي درماني: ضد پاركينسون


طبقه‌بندي مصرف در بارداري: رده C


ملاحظات اختصاصي


علاوه بر ملاحظات مربوط به تمامي داروهاي ضد كولينرژيك، موارد زير نيز توصيه مي‌شوند:


1- در صورت مصرف تزريقي دارو، بيمار بايد در حالت خوابيده بخ پشت نگه داشته شود. مصرف تزريقي بي‌پريدن ممكن است موجب افت فشار خون وضعيتي گذرا و اشكال در حفظ تعادل شود.


2- مصرف تزريقي بي‌پريدن بايد به آهستگي صورت گيرد.


3- بي‌پريدن ممكن است موجب سرگيجه شود، در اين صورت، بيمار هنگام راه رفتن احتياج به كمك خواهد داشت.


4- در بيماران مبتلا به پاركينسونيسم شديد، در صورت مصرف دارو براي تسكين اسپاسم، ممكن است لرزش افزايش يابد.


5- دارو ممكن است باعث توهم و يا گيجي (عموما در دوزهاي بالا) و سايكوز توكسيك در بيماراني كه اختلال رواني دارند شود. بعلت ضعف CNS، كارهايي كه به هوشياري كامل احتياج دارند انجام نشود.


6- در بيماران با مشكلات قلبي عروقي مانند تاكيكاردي، آريتمي، افزايش و يا كاهش فشارخون، گلوكوم زاويه باز، هيپرتيروئيدي، زخم معده، هيپرپلازي پروستات و يا احتباس ادرار و سابقه تشنج با احتياط مصرف شود.


نكات قابل توصيه به بيمار


با مصرف طولاني مدت اين دارو، ممكن است مقاومت در مقابل اثرات درماني و عوارض جانبي اين دارو حاصل شود.


مصرف در سالمندان


مصرف بي‌پريدن در بيماران سالخورده بايد با احتياط صورت گيرد. كاهش مقدار مصرف توصيه مي‌شود.


مصرف در كودكان: مصرف اين دارو در كودكان توصيه نمي‌شود.


مصرف در شيردهي: بي‌پريدن ممكن است در شير مادر ترشح شود و موجب بروز مسموميت در نوزاد شود. اين دارو ممكن است توليد شير را نيز كاهش دهد. مادراني كه به نوزاد خود شير مي‌دهند، بايد از مصرف اين دارو خودداري كنند.


Biperiden (Akineton)

AKINETON
(biperiden hydrochloride) Tablet

DRUG DESCRIPTION

Each AKINETON tablet for oral administration contains 2 mg biperiden hydrochloride. Other ingredients may include corn syrup, lactose, magnesium stearate, potato starch and talc. AKINETON (biperiden) is an anticholinergic agent. Biperiden is a5-Norbornen-2-yl-a-phenyl-1-piperidinepropanol. It is a white, crystalline, odorless powder, slightly soluble in water and alcohol. It is stable in air at normal temperatures. Biperiden may be represented by the following structural formula:

AKINETON (biperiden hydrochloride)  structural formula illustration

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

  • As an adjunct in the therapy of all forms of parkinsonism (idiopathic, postencephalitic, arteriosclerotic)
  • Control of extrapyramidal disorders secondary to neuroleptic drug therapy (e.g., phenothiazines)

DOSAGE AND ADMINISTRATION

Drug-induced Extrapyramidal Symptoms

Oral: One tablet one to three times daily.

Parkinson's Disease: Oral: The usual beginning dose is one tablet three or four times daily. The dosage should be individualized with the dose titrated upward to a maximum of 8 tablets (16 mg) per 24 hours.

HOW SUPPLIED

AKINETON (biperiden hydrochloride) Tablets, 2 mg each, white, embossed on one face with a triangle, bisected on the reverse and imprinted with the number "11."

Bottles of 100 - NDC # 49884-693-01

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Dispense in tight, light-resistant container as defined in USP.

Manufactured for: Par Pharmaceutical, Inc., Spring Valley , New York 10977. Manufactured by: Abbott Laboratories, North Chicago, IL 60064, U.S.A.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

Atropine-like side effects such as dry mouth; blurred vision; drowsiness; euphoria or disorientation; urinary retention; postural hypotension; constipation; agitation; disturbed behavior may been seen. A case of generalized choreic movements has been reported in a Parkinson's disease patient when biperiden was added to carbidopa/levodopa. A reduction in rapid eye movement (REM) sleep, characterized by increased REM latency and decreased percentage of REM sleep, has been reported. There usually are no significant changes in blood pressure or heart rate in patients who have been given the parenteral form of AKINETON (biperiden) . Mild transient postural hypotension and bradycardia may occur. These side effects can be minimized or avoided by slow intravenous administration. No local tissue reactions have been reported following intramuscular injection. If gastric irritation occurs following oral administration, it can be avoided by administering the drug during or after meals.

The central anticholinergic syndrome can occur as an adverse reaction to properly prescribed anticholinergic medication. See OVERDOSAGE section for signs and symptoms of the central anticholinergic syndrome, and for treatment.

Read the Akineton (biperiden) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

The central anticholinergic syndrome can occur when anticholinergic agents such as AKINETON (biperiden) are administered concomitantly with drugs that have secondary anticholinergic actions, e.g., certain narcotic analgesics such as meperidine, the phenothiazines and other antipsychotics, tricyclic antidepressants, certain antiarrhythmics such as the quinidine salts, and antihistamines. See OVERDOSAGE section for signs and symptoms of the central anticholinergic syndrome, and for treatment.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

Isolated instances of mental confusion, euphoria, agitation and disturbed behavior have been reported in susceptible patients. Also, the central anticholinergic syndrome can occur as an adverse reaction to properly prescribed anticholinergic medication, although it is more frequently due to overdosage. It may also result from concomitant administration of an anticholinergic agent and a drug that has secondary anticholinergic actions (see PRECAUTIONS - DRUG INTERACTIONS and OVERDOSAGE sections). 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 (biperiden) therapy.

PRECAUTIONS

Pregnancy

Pregnancy Category C

Animal reproduction studies have not been conducted with AKINETON (biperiden) . It is also not known whether AKINETON (biperiden) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. AKINETON (biperiden) should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when AKINETON (biperiden) is administered to a nursing woman.

Pediatric Use

Safety and effectiveness in children have not been established.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

Signs and Symptoms

Overdosage with AKINETON (biperiden) produces typical central symptoms of atropine intoxication (the central anticholinergic syndrome). Correct diagnosis depends upon recognition of the peripheral signs of parasympathetic blockade including 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, and urinary retention. Neuropsychiatric signs such as delirium, disorientation, anxiety, hallucinations, illusions, confusion, incoherence, agitation, hyperactivity, ataxia, loss of memory, paranoia, combativeness, and seizures may be present. The condition can progress to stupor, coma, paralysis, and cardiac and respiratory arrest and death.

Treatment

Treatment of acute overdose revolves around symptomatic and supportive therapy. If AKINETON (biperiden) was administered orally, gastric lavage or other measures to limit absorption should be instituted. A small dose of diazepam or a short acting barbiturate may be administered if CNS excitation is observed. Phenothiazines are contraindicated because the toxicity may be intensified due to their antimuscarinic action, causing coma. Respiratory support, artificial respiration or vasopressor agents may be necessary. Hyperpyrexia must be reversed, fluid volume replaced and acid-base balance maintained. Urinary catheterization may be necessary.

Routine use of physostigmine for overdose is controversial. Delirium, hallucinations, coma, and supraventricular tachycardia (not ventricular tachycardias or conduction defects) seem to respond. If indicated, 1 mg (half this amount for the children or elderly) may be given intramuscularly or by slow intravenous infusion. If there is no response within 20 minutes, and additional 1 mg dose may be given; this may be repeated until a total of 4 mg has been administered, a reversal of the toxic effects occur or excessive cholinergic signs are seen. Frequent monitoring of clinical signs should be done. Since physostigmine is rapidly destroyed, additional injections may be required every one or two hours to maintain control. The relapse intervals tend to lengthen as the toxic anticholinergic agent is metabolized, so the patient should be carefully observed for 8 to 12 hours following the last relapse.

Toxicity in Animals

The LD50 of biperiden in the white mouse is 545 mg/kg orally, 195 mg/kg subcutaneously, and 56 mg/kg intravenously. The acute oral toxicity (LD50) in rats is 750 mg/kg. The intraperitoneal toxicity (LD50) of biperiden lactate in rats was 270 mg/kg and the intravenous toxicity (LD50) in dogs was 222 mg/kg. In dogs under general anesthesia, respiratory arrest occurred at 33 mg/kg (intravenous) and circulatory standstill at 45 mg/kg (intravenous). The oral LD50in dogs is 340 mg/kg. Chronic toxicity studies in both rat and dog have been reported.

CONTRAINDICATIONS

1) Hypersensitivity to biperiden 2) Narrow angle glaucoma 3) Bowel obstruction 4) Megacolon

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

AKINETON (biperiden) is a weak peripheral anticholinergic agent. It has, therefore, some antisecretory, antispasmodic and mydriatic effects. In addition, AKINETON (biperiden) possesses nicotinolytic activity. Parkinsonism is thought to result from an imbalance between the excitatory (cholinergic) and inhibitory (dopaminergic) systems in the corpus striatum. The mechanism of action of centrally active anticholinergic drugs such as AKINETON (biperiden) is considered to relate to competitive antagonism of acetylcholine at cholinergic receptors in the corpus striatum, which then restores the balance.

The parenteral form of AKINETON (biperiden) is an effective and reliable agent for the treatment of acute episodes of extrapyramidal disturbances sometimes seen during treatment with neuroleptic agents. Akathisia, akinesia, dyskinetic tremors, rigor, oculogyric crisis, spasmodic torticollis, and profuse sweating are markedly reduced or eliminated. With parenteral AKINETON (biperiden) , these drug-induced disturbances are rapidly brought under control. Subsequently, this can usually be maintained with oral doses which may be given with tranquilizer therapy in psychotic and other conditions requiring an uninterrupted therapeutic program.

Pharmacokinetics and Metabolism

Only limited pharmacokinetic studies of biperiden in humans are available. The serum concentration at 1 to 1.5 hours following a single, 4 mg oral dose was 4-5 ng/mL. Plasma levels (0.1-0.2 ng/mL) could be determined up to 48 hours after dosing. Six hours after an oral dose of 250 mg/kg in rats, 87% of the drug had been absorbed. The metabolism of AKINETON (biperiden) is also incompletely understood, but does involve hydroxylation. In normal volunteers a single 10 mg intravenous dose of biperiden seemed to cause a transient rise in plasma cortisol and prolactin. No change in GH, LH, FSH, or TSH levels were seen. Biperiden lactate (10 mg/mL) was not irritating to the tissue of rabbits when injected intramuscularly (1.0 mL) into the sacrospinalis muscles and intradermally (0.25 mL) and subcutaneously (0.5 mL) into the shaved abdominal skin.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 4/13/2009
This monograph has been modified to include the generic and brand name in many instances.

Akineton Patient Information Including Side Effects

Brand Names: Akineton HCl

Generic Name: biperiden (Pronunciation: bye PEAR i den)

What is biperiden (Akineton)?

Biperiden reduces the effects of certain naturally occurring chemicals in your body that may become unbalanced as a result of disease (such as Parkinson's disease), drug therapy, or other causes.

Biperiden is used to treat the stiffness, tremors, spasms, and poor muscle control of Parkinson's disease. It is also used to treat and prevent these same muscular conditions when they are caused by drugs such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), and others.

Biperiden may also be used for purposes other than those listed in this medication guide.

Akineton 2 mg

round, white, imprinted with 11, embossed triangle

What are the possible side effects of biperiden (Akineton)?

If you experience any of the following serious side effects, stop taking biperiden and seek emergency medical attention:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • unusual fever;
  • fast or irregular heartbeat;
  • anxiety, hallucinations, confusion, agitation, hyperactivity, or loss of consciousness;
  • seizures;
  • a rash; or
  • eye pain.

Other, less serious side effects may be more likely to occur. Continue to take biperiden and talk to your doctor if you experience

  • a dry mouth;
  • large pupils or blurred vision;
  • drowsiness;
  • difficulty urinating or constipation;
  • nervousness or anxiety;
  • upset stomach; or
  • decreased sweating.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Read the Akineton (biperiden) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about biperiden (Akineton)?

Use caution when driving, operating machinery, or performing other hazardous activities. Biperiden may cause dizziness or blurred vision. If you experience dizziness or blurred vision, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking biperiden.

Avoid becoming overheated. Biperiden may cause decreased sweating. This could lead to heat stroke in hot weather or with vigorous exercise.

Side Effects Centers

Akineton Patient Information including How Should I Take

Who should not take biperiden (Akineton)?

You cannot take biperiden if you

  • have ever had an allergic reaction to it,
  • have narrow-angle glaucoma,
  • have an obstruction in your bowel or a complication of bowel disease known as megacolon; or
  • have myasthenia gravis.

Before taking this medication, tell your doctor if you have

  • an enlarged prostate or difficulty urinating,
  • epilepsy or another seizure disorder,
  • heart disease or an irregular heartbeat,
  • depression or any other psychiatric illness, or
  • kidney or liver disease.

You may need a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Biperiden is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Do not take biperiden without first talking to your doctor if you are pregnant.

It is also not known whether biperiden passes into breast milk. Do not take biperiden without first talking to your doctor if you are breast-feeding a baby.

How should I take biperiden (Akineton)?

Take biperiden exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse or doctor to explain them to you.

Take each dose with a full glass of water.

Take biperiden after a meal if it upsets your stomach.

Biperiden may be taken once or several times a day. The maximum amount of biperiden that should be taken in any one day is eight tablets (16 mg). Follow your doctor's instructions.

Store biperiden at room temperature away from moisture and heat.

Side Effects Centers

Akineton Patient Information including If I Miss a Dose

What happens if I miss a dose (Akineton)?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose (Akineton)?

Seek emergency medical attention.

Symptoms of a biperiden overdose include large pupils; warm, dry skin; flushed face; fever; dry mouth; fast or irregular heartbeat; anxiety; hallucinations; confusion; agitation; hyperactivity; loss of consciousness; and seizures.

What should I avoid while taking biperiden (Akineton)?

Use caution when driving, operating machinery, or performing other hazardous activities. Biperiden may cause dizziness or blurred vision. If you experience dizziness or blurred vision, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking biperiden.

Avoid becoming overheated. Biperiden may cause decreased sweating. This could lead to heat stroke in hot weather or with vigorous exercise. Try to keep as cool as possible and watch for signs of heat stroke such as decreased sweating, nausea, and dizziness.

What other drugs will affect biperiden (Akineton)?

Before taking this medication, tell your doctor if you are taking:

  • a tricyclic antidepressant (TCA) (used to treat depression, pain, or obsessive-compulsive disorder) such as amitriptyline (Elavil, Endep), doxepin (Sinequan), or clomipramine (Anafranil);
  • other commonly used tricyclic antidepressants, including amoxapine (Asendin), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil);
  • a phenothiazine (used to treat mania, schizophrenia, other psychiatric conditions, and nausea and vomiting) such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), mesoridazine (Serentil), thioridazine (Mellaril), promazine (Sparine), trifluoperazine (Stelazine), and others;
  • an antihistamine such as diphenhydramine (Benadryl, others), chlorpheniramine (Chlor-Trimeton, others), triprolidine (Actifed, others), brompheniramine (Dimetapp, others), clemastine (Tavist) and others (antihistamines are often found in prescription and over-the-counter cold, allergy, and sleep medicines);
  • quinidine (Quinora, Quinaglute, Quinidex, Cardioquin);
  • amantadine (Symmetrel);
  • digoxin (Lanoxin, Lanoxicaps); or
  • haloperidol (Haldol).

Drugs other than those listed here may also interact with biperiden. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has more information about biperiden written for health professionals that you may read.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2010 Cerner Multum, Inc. Version: 2.05. Revision date: 4/12/2009.

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Side Effects Centers

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