Benztropine Mesylate

Brand Name - Cogentin

  • Type of Drug: Anticholinergic.
  • Prescribed for: Treatment of all forms of Parkinson’s disease. Also used to prevent or manage uncontrolled muscle spasms caused by the phenothiazines and other drugs.

General Information

Benztropine Mesylate has an action on the body similar to that of Atropine Sulfate, but its side effects are less frequent and less severe. This drug, an anticholinergic, counteracts the effects of acetylcholine, one of the body’s major nerve impulse transmitters. It has the ability to reduce muscle spasms by about 20 percent, and also reduces other symptoms of Parkinson’s disease, like drooling. This property makes the drug useful in treating Parkinson’s disease and other diseases associated with spasms of skeletal muscles.

Cautions and Warnings

Benztropine Mesylate should be used with caution if you have narrow-angle glaucoma, stomach ulcers, heart disease, obstructions in the gastrointestinal tract, prostatitis, or myasthenia gravis.
When taken in hot weather, especially by seniors, chronically ill people, alcoholics, those with nervous-system disease, or those who work in hot environments, Benztropine Mesylate will reduce your ability to perspire, interfering with your body’s heat-control mechanisms, thus making you more likely to develop heat exhaustion or heat stroke. In severe instances, this can be fatal.

Possible Side Effects

  • Most common: difficulty or hesitancy in urination, painful urination, constipation, blurred vision, and increased sensitivity to bright light.
  • Less common: rash, disorientation, confusion, memory loss, hallucinations, psychosis, agitation, nervousness, delusions, delirium, paranoid feelings, listlessness, depression, drowsiness, euphoria (feeling “high”), excitement, light-headedness, dizziness, headache, weakness, giddiness, heaviness or tingling in the hands or feet, rapid heartbeat, palpitations, mild reduction in heart rate, low blood pressure, dizziness when rising quickly from a sitting or lying position, dry mouth (possibly extreme), swollen glands, nausea, vomiting, upset stomach, interference with normal bowel function, duodenal ulcer, double vision, dilated pupils, glaucoma, muscle weakness or cramping, high temperature, flushing, decreased sweating, heat stroke, and, in men, difficulty in achieving and keeping an erection.

Drug Interactions

  • Side effects may increase if Benztropine Mesylate is taken with antihistamines, phenothiazines, antidepressants, or other anticholinergic drugs. This drug should be used with caution by people taking barbiturates. Avoid alcoholic beverages.
  • Benztropine may reduce the absorption and effect of some drugs, including Levodopa, Haloperidol, and phenothiazines, leading to reduced drug effects.
  • Amantadine plus Benztropine may result in excessive drug side effects.

Food Interactions

This medicine (except Procyclidine) is best taken on an empty stomach, but it may be taken with food if it upsets your stomach.

Usual Dose

Benztropine: 0.5 to 6 mg per day.
Biperiden: 2 to 8 mg a day.
Ethopropazine: 50 to 600 mg daily.
Procyclidine: 2.5 to 5 mg 3 times a day after meals.
Trihexiphenidyl: 1 or 2 mg to start, increased gradually to 6 to 10 mg daily. Sequels are a more convenient way to take a high daily dosage.


Signs of drug overdose include the following: clumsiness or unsteadiness; severe drowsiness; severely dry mouth, nose, or throat; hallucinations; mood changes; difficulty breathing; rapid heartbeat; and unusually warm and dry skin. Overdose victims should be taken to a hospital emergency room at once. ALWAYS bring the medicine bottle.

Special Information

Dry mouth, nose, and throat can be easily relieved with candy or gum. These side effects can lead to tooth and gum disease. Maintain good oral hygiene to prevent cavities and gum disease while taking Benztropine.

A stool softener, like Docusate, will usually relieve constipation. Sunglasses will reduce the irritation brought on by bright lights.

Benztropine can interfere with driving or other tasks that require concentration and reliable vision. Be cautious while taking this medicine, and avoid alcohol and nervous-system depressants.

Call your doctor if you develop confusion, rash, eye pain, or a pounding heartbeat.

This medicine will make you less tolerant of hot weather because it makes you sweat less. Avoid exposure to hot weather because of the chance of developing heat stroke.

If you forget to take a dose of your medicine and you take it several times a day, take it as soon as you remember. If it is within 2 hours of your next regular dose, go back to the regular schedule and skip the missed dose. Do not take a double dose. If you take your medicine twice a day and forget a dose, take it as soon as you remember If it is within 4 hours of your next dose, take your medicine and then take the next two doses 8 hours apart. Then, continue with your regular schedule.

Special Populations

Drugs of this type have not been proven to be a cause of birth defects or of other problems in pregnant women. However, women who are, or may become, pregnant while taking this medication should discuss the possibility of birth defects and/or changing medication with their doctor.
This medication may reduce the amount of breast milk produced by a nursing mother. Infants are also particularly sensitive to Benztropine; nursing mothers who must take it should bottle-feed their babies.

Seniors taking this medication on a regular basis may be more sensitive to drug side effects, including a predisposition to developing glaucoma, confusion, disorientation, agitation, and hallucinations.