Biperiden Oral: Dosing and Precautions

Therapeutic action

Anticholinergic antiparkinson drug.

Indications

First-line treatment of extrapyramidal reactions induced by antipsychotics.

Forms and strengths

• 2 mg tablet.

Dose

• Adult: 2 mg once daily, then increase if necessary up to 2 mg 2 to 3 times daily, maximum 12 mg daily.
• Administer at the lowest effective dose in elderly patients and do not exceed 10 mg daily.

Duration

As long as the antipsychotic treatment lasts.

Contra-indications, adverse effects, precautions

• Do not administer to patients with closed-angle glaucoma, prostate disorders, gastrointestinal obstruction, or atony.
• Administer with caution and carefully monitor use in elderly patients because of the risk of confusion and hallucinations.
• May cause dry mouth, constipation, blurred vision, tachycardia, disorders of micturition, confusion, hallucinations, and memory impairment.
• Avoid or monitor combination with other drugs known to have anticholinergic effects, including atropine, amitriptyline, chlorpromazine, and promethazine.
• Pregnancy: re-evaluate whether the antipsychotic treatment is still necessary. If treatment is continued, administer biperiden at the lowest effective dose and observe the child if the mother was under treatment in the 3rd trimester.
• Breast-feeding: if treatment is necessary, administer at the lowest effective dose and observe the child for anticholinergic effects such as tachycardia, constipation, and thickening of bronchial secretions.