Rocy

Indications

Procyclidine Hydrochloride is used to:

• treat movement side effects caused by antipsychotic medicines, such as stiffness, shaking, restlessness and sudden muscle spasms (acute dystonia);
• help the stiffness, tremor and slowness of Parkinson's disease, usually alongside other medicines.

How It Works

Procyclidine is an anticholinergic medicine. In conditions like Parkinson's disease, or when antipsychotics block dopamine, the brain chemical acetylcholine becomes too active compared with dopamine. Procyclidine blocks acetylcholine, which restores the balance and reduces stiffness, shaking and muscle spasms.

Dosage and Administration

Adults, tablets: usually started at 2.5 mg three times a day, after meals. The doctor may increase the dose slowly, by 2.5 mg a day every few days, until symptoms are controlled. The final dose is as prescribed; older people usually need lower doses.

Sudden severe muscle spasms: an injection may be given into a muscle or vein by a doctor or nurse.

Do not stop suddenly, as symptoms can return strongly; the doctor will reduce the dose gradually. Children: not usually used.

Interactions

• Other medicines with anticholinergic effects (such as Amitriptyline and other tricyclic antidepressants, some antihistamines, Chlorpromazine and Clozapine) increase dry mouth, constipation, urine retention and confusion.
• Alcohol and sedatives increase drowsiness.
• Procyclidine can slow stomach emptying and change how some medicines are absorbed.
• It may reduce the effect of medicines such as Metoclopramide and Domperidone.

Contraindications

• Narrow-angle (angle-closure) glaucoma
• Difficulty passing urine, such as from an enlarged prostate
• Blockage of the stomach or bowel
• Myasthenia gravis
• Allergy to Procyclidine
• Tardive dyskinesia (late-onset involuntary movements), which it may worsen

Side Effects

Common: dry mouth, blurred vision, constipation, difficulty passing urine, dizziness and drowsiness. Less often: nervousness, confusion, memory problems, fast heartbeat and rash. Older people are more likely to have confusion.

Get medical help at once for severe eye pain with red eye and blurred vision (possible acute glaucoma), being unable to pass urine, severe confusion or hallucinations, a very high temperature with hot dry skin, or signs of an allergic reaction.

Pregnancy and Lactation

There is limited information on use in pregnancy; use only if your doctor decides it is needed. It is not known whether Procyclidine passes into breast milk, and anticholinergics may reduce milk supply; ask your doctor before breastfeeding.

Precautions and Warnings

• It can cause drowsiness and blurred vision; do not drive or use machines until you know how it affects you.
• It reduces sweating, so avoid overheating in hot weather or during exercise, and drink enough fluids.
• Take extra care in older people and with heart, liver or kidney disease, prostate enlargement or a history of glaucoma.
• It can be misused for its mood effects; take only as prescribed.

Overdose

Overdose can cause agitation, confusion, hallucinations, dilated pupils, fast heartbeat, high temperature, dry hot skin, inability to pass urine and fits. Go to hospital at once.

Therapeutic Class

Anticholinergic (antimuscarinic) antiparkinsonian medicine.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.