Brand Names: Cogentin

Generic Name: benztropine (Pronunciation: BENZ troe peen)

• What is benztropine (Cogentin)?
• What are the possible side effects of benztropine (Cogentin)?
• What is the most important information I should know about benztropine (Cogentin)?
• What should I discuss with my healthcare provider before taking benztropine (Cogentin)?
• How should I take benztropine (Cogentin)?
• What happens if I miss a dose (Cogentin)?
• What happens if I overdose (Cogentin)?
• What should I avoid while taking benztropine (Cogentin)?
• What other drugs will affect benztropine (Cogentin)?
• Where can I get more information?

What is benztropine (Cogentin)?

Benztropine reduces the effects of certain chemicals in the body that may become unbalanced as a result of disease (such as Parkinson's), drug therapy, or other causes.

Benztropine is used to treat the symptoms of Parkinson's disease, such as muscle spasms, stiffness, sweating, drooling, and poor muscle control. Benztropine is also used to treat and prevent these symptoms when they are caused by drugs such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), and others.

Benztropine may also be used for other purposes not listed in this medication guide.

Benztropine 0.5 mg-IVA

round, white, imprinted with par 164

Benztropine 0.5 mg-UPS

round, white, imprinted with 832 BM 05

Benztropine 1 mg-IVA

oval, white, imprinted with par 165

Benztropine 1 mg-ROS

elliptical, white, imprinted with 832 BM1

Benztropine 2 mg-PAR

round, white, imprinted with par 166

Benztropine 2 mg-UPS

round, white, imprinted with 832 BM2

What are the possible side effects of benztropine (Cogentin)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using benztropine and call your doctor at once if you have a serious side effect such as:

• high fever;
• headache, dizziness, weakness, and hot dry skin with no sweating;
• feeling like you might pass out;
• severe stomach pain;
• chest pain, fast or uneven heart rate;
• painful or difficult swallowing;
• impotence, trouble having an orgasm;
• urination problems;
• changes in your vision; or
• confusion, unusual thoughts or behavior, hallucinations.

Less serious side effects may include:

• drowsiness;
• feeling nervous;
• nausea, vomiting, constipation;
• dry mouth, nose, or throat;
• decreased sweating;
• blurred vision, increased sensitivity to light; or
• warmth, redness, or tingly feeling under your skin.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about benztropine (Cogentin)?

You should not take this medication if you are allergic to benztropine, or if you are also taking a medication called pramlintide (Symlin).

Before you take benztropine, tell your doctor about all of your medical conditions, especially if you have glaucoma, kidney or liver disease, heart disease, high blood pressure, a history of heart attack or stroke, a breathing disorder, a nerve or muscle disorder, seizures, urination problems, overactive thyroid, mental illness, or a stomach or intestinal disorder.

Avoid taking a diarrhea medication or antacid within 2 hours before or after you take benztropine. Also avoid taking ketoconazole (Nizoral) within 2 hours after you take benztropine.

Benztropine can cause side effects that may impair your vision, thinking, or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Benztropine can decrease perspiration and you may be more prone to heat stroke.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. Tell your doctor if the medication does not seem to be working as well in treating your symptoms. Do not change your doses or medication schedule without advice from your doctor.

Do not stop taking this medication without first talking to your doctor. Stopping suddenly may make your condition worse. You may need to use less and less before you stop the medication completely.

What should I discuss with my healthcare provider before taking benztropine (Cogentin)?

You should not take this medication if you are allergic to benztropine, or if you are also taking a medication called pramlintide (Symlin).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take benztropine, tell your doctor if you have:

• glaucoma;
• kidney or liver disease;
• heart disease, a heart rhythm disorder, or a history of heart attack or stroke;
• high or low blood pressure;
• asthma, emphysema, or other breathing disorder;
• a nerve disorder;
• a muscle disorder such as myasthenia gravis;
• seizures;
• enlarged prostate;
• overactive thyroid;
• mental illness or dementia;
• infectious diarrhea;
• ulcerative colitis;
• stomach ulcer, reflux disease, hiatal hernia; or
• a history of bowel obstruction or other intestinal disorder.

FDA pregnancy category C. It is not known whether benztropine is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether benztropine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

Children may be more likely to have an increased heart rate while taking benztropine.

How should I take benztropine (Cogentin)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Benztropine is sometimes given up to 4 times daily, at meals and at bedtime. If you take benztropine only once per day, it may be best to take the medication at bedtime. Follow your doctor's instructions.

Benztropine can be taken with food to lessen stomach upset.

Your mouth may feel dry while taking benztropine. To prevent or relieve dry mouth, suck on a piece of sugar-free hard candy, chew sugar-free gum, drink water, chew on ice chips, or use a saliva substitute.

Dry mouth may lead to gum disease or cavities. Brush and floss your teeth regularly and see a dentist for routine check-ups while you are taking benztropine.

It may take up to 3 days of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve or if they get worse.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. Tell your doctor if the medication does not seem to be working as well in treating your symptoms. Do not change your doses or medication schedule without advice from your doctor.

Do not stop taking this medication without first talking to your doctor. Stopping suddenly may make your condition worse. You may need to use less and less before you stop the medication completely.

Store benztropine at room temperature, away from moisture, heat, and light

What happens if I miss a dose (Cogentin)?

Benztropine is sometimes taken only when needed, so you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Cogentin)?

Seek emergency medical attention of you think you have used too much of this medicine.

Overdose can cause confusion, hallucinations, loss of balance or coordination, fever, urinating more or less than usual, vision problems, dilated pupils, fast or slow heartbeat, weak or shallow breathing, seizures, and fainting.

What should I avoid while taking benztropine (Cogentin)?

Avoid taking a diarrhea medication (such as Kaopectate, Donnagel, or Rheaban) or an antacid (such as Amphojel, Maalox, Mylanta, Rolaids, Rulox, or Tums) within 2 hours before or after you take benztropine. These medications can make it harder for your body to absorb benztropine, which can make it less effective.

Also avoid taking ketoconazole (Nizoral) within 2 hours after you take benztropine. Benztropine can make it harder for your body to absorb ketoconazole.

Benztropine can cause side effects that may impair your vision, thinking, or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. It can increase some of the side effects of benztropine.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Benztropine can decrease perspiration and you may be more prone to heat stroke.

What other drugs will affect benztropine (Cogentin)?

Before using benztropine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by benztropine.

Tell your doctor about all other medications you use, especially:

• amantadine (Symmetrel);
• donepezil (Aricept);
• galantamine (Razadyne);
• glycopyrrolate (Robinul);
• mepenzolate (Cantil);
• potassium supplements (K-Lyte, K-Dur, Klor-Con, and others);
• atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), dimenhydrinate (Dramamine), meclizine (Antivert), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
• an antidepressant such as amitriptyline (Elavil, Etrafon), doxepin (Sinequan), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), and others;
• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
• a heart rhythm medication such as quinidine (Quinaglute, Quinidex, Quin-Release), procainamide (Procan, Procanbid, Pronestyl), disopyramide (Norpace), propafenone, (Rythmol), and others;
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine);
• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
• medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), risperidone (Risperdal), trazodone (Desyrel), and others;
• narcotic pain medication such as fentanyl (Actiq, Duragesic), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Avinza, Kadian, MS Contin, Oramorph), oxycodone (OxyContin, Percocet), and others; or
• steroid medicine (prednisone and others).

This list is not complete and there may be other drugs that can interact with benztropine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about benztropine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed

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Last Updated: April 12, 2009