Benztropine Disease Interactions
There are 12 disease interactions with benztropine.
- Infectious diarrhea
- Angle-closure glaucoma.
- Psychoses
- Anhydrosis
- BPH
- CNS disorders
- Dysuria
- GI obstruction
- Hypertension
- Tachycardia
- Tardive dyskinesia
- Fever
Antiperistaltic agents (applies to benztropine) infectious diarrhea
Major Potential Hazard, High plausibility. Applicable conditions: Infectious Diarrhea/Enterocolitis/Gastroenteritis
The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.
References
- Brown JW "Toxic megacolon associated with loperamide therapy." JAMA 241 (1979): 501-2
- Walley T, Milson D "Loperamide related toxic megacolon in Clostridium difficile colitis." Postgrad Med J 66 (1990): 582
- "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals (2001):
- Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
- "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
- "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
Benztropine (applies to benztropine) angle-closure glaucoma.
Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension
Benztropine should not be used in angle-closure glaucoma. Although benztropine does not appear to have any adverse effect on simple glaucoma, it probably should not be used in angle-closure glaucoma as anticholinergics cause mydriasis and they may exacerbate this condition.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Antimuscarinics (applies to benztropine) psychoses
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis
Toxic psychosis manifested as confusion, disorientation, agitation, excitation, memory impairment, delusions and hallucinations may develop at toxic and therapeutic dosages of antimuscarinic agents. Therapy with these agents should be administered cautiously in patients with mental disorders receiving antimuscarinic agents for control of drug-induced extrapyramidal effects, especially at the beginning of therapy or during dosage adjustment. Psychiatric deterioration and psychotic flare-ups have also been reported following withdrawal of therapy. Symptoms include delusions, hallucinations, aggression or violent behavior, and suicidal tendencies. In high dosages, antimuscarinic agents may sometimes produce euphorigenic effects. For this reason, it can be a drug of abuse.
References
- Jellinek T, Gardos G, Cole JO "Adverse effects of antiparkinson drug withdrawal." Am J Psychiatry 138 (1981): 1567-71
- Goggin DA, Solomon GF "Trihexyphenidyl abuse for euphorigenic effect." Am J Psychiatry 136 (1979): 459-60
- Macvicar K "Abuse of antiparkinsonian drugs by psychiatric patients." Am J Psychiatry 134 (1977): 809-11
- Craig DH, Rosen P "Abuse of antiparkinsonian drugs." Ann Emerg Med 10 (1981): 98-100
- Pullen GP, Best NR, Maguire J "Anticholinergic drug abuse: a common problem?" Br Med J (Clin Res Ed) 289 (1984): 612-3
- Rubinstein JS "Abuse of antiparkinsonism drugs. Feigning of extrapyramidal symptoms to obtain trihexyphenidyl." JAMA 239 (1978): 2365-6
- McInnis M, Petursson H "Trihexyphenidyl dependence." Acta Psychiatr Scand 69 (1984): 538-42
- Mohan D, Mohandas E, Dube S "Trihexyphenidyl abuse." Br J Addict 76 (1981): 195-7
- Kaminer Y, Munitz H, Wijsenbeek H "Trihexyphenidyl (Artane) abuse: euphoriant and anxiolytic." Br J Psychiatry 140 (1982): 473-4
- Warnes H "Toxic psychosis due to antiparkinsonian drugs." Can Psychiatr Assoc J 12 (1967): 323-6
- Hidalgo HA, Mowers RM "Anticholinergic drug abuse." DICP 24 (1990): 40-1
- Wilcox JA "Psychoactive properties of benztropine and trihexyphenidyl." J Psychoactive Drugs 15 (1983): 319-21
- Laski E, Taleporos E "Anticholinergic psychosis in a bilingual: a case study." Am J Psychiatry 134 (1977): 1038-40
- Brower KJ "Smoking of prescription anticholinergic drugs." Am J Psychiatry 144 (1987): 383
- Baker LA, Cheng LY, Amara IB "The withdrawal of benztropine mesylate in chronic schizophrenic patients." Br J Psychiatry 143 (1983): 584-90
- Moreau A, Jones BD, Banno V "Chronic central anticholinergic toxicity in manic depressive illness mimicking dementia." Can J Psychiatry 31 (1986): 339-41
- Yassa R "Antiparkinsonian medication withdrawal in the treatment of tardive dyskinesia: a report of three cases." Can J Psychiatry 30 (1985): 440-2
- Ananth JV, Jain RC "Benztropine psychosis." Can Psychiatr Assoc J 18 (1973): 409-14
- Woody GE, O'Brien CP "Anticholinergic toxic psychosis in drug abusers treated with benztropine." Compr Psychiatry 15 (1974): 439-42
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
- Kulik AV, Wilbur R "Delirium and stereotypy from anticholinergic antiparkinson drugs." Prog Neuropsychopharmacol Biol Psychiatry 6 (1982): 75-82
- "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories (2001):
Benztropine (applies to benztropine) anhydrosis
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Alcoholism, CNS Disorder
Since benztropine contains structural features of atropine, it may produce anhidrosis. Benztropine should be administered with caution during hot weather, especially when given concomitantly with other atropine-like drugs to the chronically ill, the alcoholic, those who have central nervous system disease, and those who do manual labor in a hot environment. Anhidrosis may occur more readily when some disturbance of sweating already exists. If there is evidence of anhidrosis, the possibility of hyperthermia should be considered. Severe anhidrosis and fatal hyperthermia have occurred with the use of benztropine. Caution is recommended when prescribing benztropine to patients with inability to sweat normally.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) BPH
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Benign Prostatic Hyperplasia
Therapy with benztropine should be administered cautiously in patients with prostatic hypertrophy. Close monitoring is recommended when benztropine is prescribed to these patients.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) CNS disorders
Moderate Potential Hazard, Moderate plausibility.
The use of benztropine may cause mental confusion and excitement may occur with large doses, or in susceptible patients. In addition, visual hallucinations have been reported. Furthermore, in the treatment of extrapyramidal disorders due to neuroleptic drugs (e.g., phenothiazines), in patients with mental disorders, occasionally there may be intensification of mental symptoms. In such cases, antiparkinsonian drugs can precipitate a toxic psychosis. Patients with mental disorders should be kept under careful observation, especially at the beginning of treatment or if dosage is increased.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) dysuria
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Urinary Retention
Dysuria may occur with the use of benztropine, but it rarely becomes a problem. Also, urinary retention has been reported. Caution is advised even when using benztropine in patients with urinary blockage, particularly in elderly patients.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) GI obstruction
Moderate Potential Hazard, High plausibility. Applicable conditions: Gastrointestinal Obstruction, Esophageal Obstruction
Benztropine should be used with caution in patients with obstructive diseases such as achalasia, esophageal stricture or stenosis, pyloroduodenal stenosis, stenosing peptic ulcer, pyloric obstruction, and paralytic ileus. Anticholinergics may further suppress intestinal motility with resultant precipitation or aggravation of toxic megacolon. Caution is recommended when prescribing benztropine to these patients.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) hypertension
Moderate Potential Hazard, Moderate plausibility.
Cardiovascular effects of anticholinergic agents may exacerbate hypertension. Therapy with benztropine should be administered cautiously in patients with hypertension.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) tachycardia
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Arrhythmias, Congestive Heart Failure
Therapy with benztropine should be administered cautiously in patients with tachycardia, or congestive heart failure. Close monitoring is recommended when this agent is prescribed to these patients.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine (applies to benztropine) tardive dyskinesia
Moderate Potential Hazard, High plausibility.
Benztropine may precipitate symptoms of tardive dyskinesia (TD), a syndrome consisting of rhythmic involuntary movements variously involving the tongue, face, mouth, lips, jaw, and/or trunk and extremities, following chronic use of at least several months but often years. Elderly patients, particularly women, are most susceptible. Antiparkinsonism agents do not alleviate the symptoms of tardive dyskinesia, and in some instances may aggravate them. Benztropine is not recommended for use in patients with tardive dyskinesia.
References
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Atropine-like agents (applies to benztropine) fever
Minor Potential Hazard, Moderate plausibility.
Atropine-like agents may increase the risk of hyperthermia in patients with fever by producing anhidrosis. Therapy with atropine-like agents should be administered cautiously in febrile patients.
References
- Stadnyk AN, Glezos JD "Drug-induced heat stroke." Can Med Assoc J 128 (1983): 957-9
- Sarnquist F, Larson CP Jr "Drug-induced heat stroke." Anesthesiology 39 (1973): 348-50
- Lee BS "Possibility of hyperpyrexia with antipsychotic and anticholinergic drugs." J Clin Psychiatry 47 (1986): 571
- Forester D "Fatal drug-induced heat stroke." JACEP 7 (1978): 243-4
- "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
- "Product Information. Cogentin (benztropine)." Merck & Company Inc (2001):
Benztropine drug interactions
There are 340 drug interactions with benztropine.
Benztropine alcohol/food interactions
There are 2 alcohol/food interactions with benztropine.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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