Benztropine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Extrapyramidal Reaction

Acute dystonic reaction:
Initial: 1 to 2 mg administered IM or IV one time usually relieves the acute condition.

Maintenance: 1 to 2 mg orally administered once or twice a day as needed until the source of the dystonia (e.g., phenothiazine or other drug) has been removed. Once the offending agent has been discontinued, benztropine therapy should be continued for 24 to 72 hours, then ceased.

Usual Adult Dose for Parkinson's Disease

Initial: 0.5 to 2 mg administered orally, IM, or IV, once a day.

Idiopathic parkinsonism: start with a dose of 0.5 to 1 mg orally once daily at bedtime.

postencephalitic parkinsonism: most patients require larger doses. It may be appropriate to initiate therapy at 1 to 2 mg orally once daily at bedtime.

Maintenance: titration up from the initial dose should occur gradually by raising the dose in 0.5 mg increments every 5 to 6 days, up to 6 mg/day, until optimal relief is obtained.

Usual Pediatric Dose for Extrapyramidal Reaction

0 to 3 years: use of benztropine in this patient population should be restricted to life-threatening emergencies.

> 3 years: 0.02 to 0.05 mg/kg administered orally, IM, or IV 1 to 2 times a day.

Dose Adjustments

A single 4 mg IM dose of benztropine has been used in adults treated in the emergency room setting.

The dosage should be individualized based on severity of symptoms and patient characteristics. Elderly patients and those who are thin or underweight generally do no tolerate higher dosages and should be dosed and titrated cautiously. If possible, anticholinergic drugs, such as benztropine, should be avoided in the elderly.

Benztropine is indicated as adjunctive therapy in the management of Parkinson's disease and is not usually prescribed as monotherapy. If given concomitantly with levodopa/carbidopa agents, periodic adjustments in dosage may be required to obtain maximal therapeutic benefit.

Because the onset of drug action associated with both routes of parenteral administration is essentially the same, intravenous administration should be reserved for situations that preclude intramuscular injection.

Precautions

Because of atropine-like side effects benztropine should be used with caution in pediatric patients over 3 years of age.

Other Comments

Benztropine is ineffective in the treatment of tardive dyskinesia, and should therefore not be used for that indication.

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