Adult: As biperiden HCl: 2 mg 1-3 times daily. Elderly: Lower initial dose and increase gradually to the lowest effective dose.
Oral Parkinsonism
Adult: As biperiden HCl: Initially, 2 mg 3-4 times daily, may increase according to response. Max: 16 mg/day. Elderly: Lower initial dose and increase gradually to the lowest effective dose.
Adult: As biperiden lactate: Up to 10-20 mg daily by IM or slow IV inj. Elderly: Lower initial dose and increase gradually to the lowest effective dose.
Administration
Should be taken with food.
Contraindications
Untreated narrow-angle glaucoma, mechanical stenoses in the GI tract, paralytic ileus, megacolon, prostatic adenoma and diseases that can lead to perilous tachycardia.
Special Precautions
Patient w/ thyrotoxicosis, cardiac failure, tachycardia, and those at risk of convulsions. Avoid abrupt withdrawal. Elderly. Pregnancy and lactation.
This drug may cause drowsiness, dizziness or blurred vision, if affected, do not drive or operate machinery.
Overdosage
Symptoms: Mydriasis, dryness of mucous membranes, flushing, increased heart rate, reduced bowel motility, reduced ureter and bladder tone, increased temp, excitation, confusion, clouding of consciousness and/or hallucinations; cardiac and resp depression in severe overdosage. Management: Supportive treatment. Gastric lavage or emesis may be considered. May give acetylcholinesterase inhibitor as an antidote. Artificial ventilation, reduction of fever and application of a bladder emptying catheter may be necessary. May administer a cardiac stimulant (e.g. dobutamine) if cardiac depression occurs.
Drug Interactions
Increased CNS and peripheral side effects w/ anticholinergic psychotropic drugs, antihistamines, other antiparkinsonian drugs and antispasmodics. May potentiate dyskinesia w/ levodopa. Increased anticholinergic effects w/ quinidine. May reduce the effect of metoclopramide and other compounds w/ similar activity on the GI tract. May antagonise the therapeutic effects of anticholinesterases.
Food Interaction
Alcohol may enhance the CNS effects of biperiden.
Action
Description: Biperiden is an anticholinergic agent w/ marked effect on the CNS which is important for its therapeutic application and has weak peripheral vegetative effects. The mechanism of action is considered to relate to competitive antagonism of acetylcholine at cholinergic receptors in the corpus striatum, which then restores the balance. Pharmacokinetics: Absorption: Readily absorbed from the GI tract. Bioavailability: Approx 30%. Metabolism: Undergoes extensive first-pass metabolism. Excretion: Elimination half-life: Approx 20 hr.
Chemical Structure
Biperiden Source: National Center for Biotechnology Information. PubChem Database. Biperiden, CID=2381, https://pubchem.ncbi.nlm.nih.gov/compound/Biperiden (accessed on Mar. 9, 2020)
Biperiden, CID=2381. National Center for Biotechnology Information. PubChem Database. https://pubchem.ncbi.nlm.nih.gov/compound/Biperiden. Accessed 18/11/2014.Buckingham R (ed). Biperiden. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/11/2014.McEvoy GK, Snow EK, Miller J et al (eds). Biperiden. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 23/11/2014.
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