Artane (Trihexyphenidyl) – Complete Product Information

Artane (trihexyphenidyl hydrochloride) is a synthetic anticholinergic agent that plays a crucial role in managing Parkinson’s disease and medication-induced movement disorders. As a parasympathetic nervous system inhibitor, trihexyphenidyl helps restore the delicate balance between dopamine and acetylcholine in the brain, which becomes disrupted in these conditions.

The medication works by blocking acetylcholine receptors in the brain, particularly in areas that control movement and muscle coordination. In Parkinson’s disease, the loss of dopamine-producing cells creates an imbalance where acetylcholine activity becomes relatively excessive. By inhibiting acetylcholine, trihexyphenidyl helps compensate for this imbalance, reducing tremors, rigidity, and other motor symptoms.

Artane is available in two formulations: tablets (2 mg and 5 mg) and elixir (2 mg/5 mL), allowing for flexible dosing and administration options. The medication can be taken before or after meals, depending on individual patient tolerance and specific symptoms. The elixir form is particularly useful for patients who have difficulty swallowing tablets or require precise dose adjustments.

Clinical Applications and Therapeutic Benefits: Artane is indicated for all forms of parkinsonism, including idiopathic (primary) Parkinson’s disease, postencephalitic parkinsonism, and arteriosclerotic parkinsonism. The medication is often used as adjunctive therapy alongside levodopa, helping to enhance overall symptom control and potentially reducing some of levodopa’s side effects.

For patients requiring neurological symptom management, Artane offers particular benefits in controlling specific types of movement problems. The medication is especially effective for tremor control and can help reduce drooling (sialorrhea) that commonly affects Parkinson’s patients. Many patients experience improved quality of life through better motor control and reduced disability.

Drug-Induced Movement Disorder Management: One of Artane’s important applications is treating extrapyramidal side effects caused by psychiatric medications. Antipsychotic drugs like phenothiazines, butyrophenones, and thioxanthenes can cause involuntary movements, muscle stiffness, and other motor problems that Artane can effectively counteract.

These medication-induced movement disorders can be distressing and may lead to treatment non-compliance if not properly managed. Artane provides rapid relief for acute dystonic reactions and helps prevent chronic movement problems when used prophylactically, though prophylactic use is generally not recommended due to potential risks.

Dosing and Administration Considerations: Treatment with Artane requires careful individualization and gradual dose titration. Initial doses are typically low (1 mg daily) and increased slowly over several days to weeks until optimal symptom control is achieved. This approach minimizes side effects while allowing patients to develop tolerance to anticholinergic effects.

The medication can be administered 3-4 times daily with meals or at bedtime for higher doses. Timing of administration can be adjusted based on individual symptoms – patients with excessive salivation may prefer taking it after meals, while those experiencing nausea may benefit from pre-meal dosing. Careful monitoring is essential throughout treatment.

Special Populations and Safety Considerations: Elderly patients require particular caution when using Artane due to increased sensitivity to anticholinergic effects. The medication can cause cognitive impairment, confusion, and memory problems, especially in older adults. Starting with lower doses and slower titration is essential in this population.

Patients with certain medical conditions including narrow-angle glaucoma, prostate enlargement, gastrointestinal obstruction, or severe heart, liver, or kidney disease need careful evaluation before treatment initiation. Regular monitoring for side effects and therapeutic response is crucial for safe and effective treatment outcomes.

For patients managing complex movement disorders, coordination with neurologists and movement disorder specialists is essential. Those exploring accessible Parkinson’s treatment options should work with qualified healthcare providers to ensure proper diagnosis, appropriate medication selection, and ongoing monitoring for both therapeutic effectiveness and potential complications, as anticholinergic medications require specialized expertise and should never be managed without appropriate neurological supervision and regular assessment for motor and cognitive effects.

Brand	Rodenal Generic
Form	2mg 30 Tablets

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Artane can cause various side effects ranging from common anticholinergic effects to serious complications requiring immediate medical attention. Most side effects are dose-related and can often be managed through careful dose adjustment and timing modifications.

Very Common Side Effects (30-50% of patients):

Dry mouth: Decreased saliva production leading to oral discomfort
Blurred vision: Difficulty focusing, especially for near vision
Dizziness: Lightheadedness, unsteadiness
Mild nausea: Stomach discomfort, especially when starting treatment
Nervousness: Anxiety, restlessness, agitation

Common Anticholinergic Effects:

Constipation: Reduced bowel motility and hard stools
Drowsiness: Sedation, fatigue, especially with higher doses
Urinary hesitancy: Difficulty initiating urination
Urinary retention: Inability to completely empty bladder
Tachycardia: Increased heart rate
Pupil dilation: Enlarged pupils, increased light sensitivity
Increased intraocular pressure: Eye pressure elevation
Weakness: General muscle weakness and fatigue
Vomiting: Nausea progressing to vomiting
Headache: Tension headaches, especially during dose adjustments

Serious Cognitive and Neurological Effects:

Cognitive dysfunction: Difficulty thinking clearly, processing information
Confusion: Disorientation, difficulty understanding
Memory impairment: Both short-term and long-term memory problems
Mental confusion: Altered mental status, especially in elderly
Agitation: Restlessness, aggressive behavior
Disturbed behavior: Personality changes, inappropriate actions
Psychiatric disturbances: Mood changes, behavioral problems

Severe Psychiatric Manifestations:

Delusions: False beliefs, paranoid thoughts
Hallucinations: Seeing, hearing, or feeling things that aren't there
Paranoia: Suspicious, fearful thoughts
Delirium: Severe confusion with altered consciousness
Disorientation: Loss of awareness of time, place, person
Anxiety: Excessive worry, panic attacks
Incoherence: Inability to speak or think clearly
Hyperactivity: Excessive movement, restlessness
Combativeness: Aggressive, fighting behavior

Life-Threatening Complications:

Angle-closure glaucoma: Sudden severe eye pressure increase causing blindness
Paralytic ileus: Complete bowel obstruction
Hyperthermia: Dangerous body temperature elevation
Heat stroke: Life-threatening overheating, especially in hot weather
Anhidrosis: Inability to sweat, leading to heat retention
Cardiac arrhythmias: Dangerous heart rhythm disturbances
Respiratory depression: Severely reduced breathing
Seizures: Convulsions, especially in overdose

Neuroleptic Malignant Syndrome (NMS):

Hyperpyrexia: Extremely high fever (over 104°F)
Muscle rigidity: Severe muscle stiffness throughout body
Altered mental status: Confusion, delirium, coma
Autonomic instability: Irregular pulse, blood pressure changes
Diaphoresis: Excessive sweating
Cardiac dysrhythmias: Irregular heartbeat patterns
Risk factors: Dose reduction or abrupt discontinuation

Eye-Related Complications:

Acute angle-closure glaucoma: Sudden severe eye pain, vision loss
Increased intraocular pressure: Gradual pressure buildup
Cycloplegia: Paralysis of eye focusing muscles
Photophobia: Extreme sensitivity to light
Blurred vision: Inability to focus clearly
Blindness: Permanent vision loss from untreated glaucoma

Gastrointestinal Complications:

Severe constipation: Prolonged inability to have bowel movements
Colonic dilation: Dangerous bowel distension
Paralytic ileus: Complete intestinal blockage
Suppurative parotitis: Infected salivary glands from dry mouth
Foul-smelling breath: Oral hygiene problems from reduced saliva
Decreased bowel sounds: Reduced intestinal motility

Cardiovascular Effects:

Tachycardia: Rapid heart rate, often over 100 bpm
Cardiac arrhythmias: Irregular heart rhythms
Paradoxical sinus bradycardia: Unusually slow heart rate
Blood pressure changes: Both high and low blood pressure
Palpitations: Awareness of heartbeat irregularities
Cardiac arrest: Complete heart stoppage in severe cases

Thermoregulatory Problems:

Anhidrosis: Complete inability to sweat
Hyperthermia: Dangerous body temperature elevation
Heat intolerance: Inability to cope with warm temperatures
Heat stroke: Life-threatening overheating
Elevated temperature: Fever from heat retention
Dry, warm skin: Hot, flushed appearance

Genitourinary Effects:

Urinary retention: Inability to empty bladder completely
Urinary hesitancy: Difficulty starting urination
Bladder distension: Painful bladder enlargement
Urinary tract infections: From incomplete bladder emptying
Catheterization requirement: Need for bladder drainage

Pediatric-Specific Side Effects:

Hyperkinesia: Excessive movement, hyperactivity
Psychosis: Loss of contact with reality
Forgetfulness: Memory problems beyond normal
Weight loss: Significant decrease in body weight
Restlessness: Inability to remain still or calm
Chorea: Involuntary jerky movements
Sleep alterations: Insomnia or disturbed sleep patterns

Skin and Dermatological Effects:

Skin rashes: Various types of skin irritation
Dry skin: Reduced skin moisture and elasticity
Facial flushing: Red, warm facial appearance
Decreased secretions: Reduced oil and sweat production

Drug Abuse and Dependence Effects:

Euphoria: Artificial feelings of well-being
Stimulant effects: Increased energy and alertness
Psychological dependence: Craving for the drug's effects
Tolerance development: Need for increasing doses
Withdrawal symptoms: Problems when stopping abruptly

Overdose Symptoms (Anticholinergic Toxicity):

Central nervous system: Delirium, stupor, coma, seizures
Peripheral signs: Dilated pupils, warm dry skin, fever
Cardiovascular: Rapid heart rate, arrhythmias, arrest
Respiratory: Depression, arrest
Motor symptoms: Ataxia, paralysis, lip smacking
Progression: Can lead to death without treatment

Signs Requiring Immediate Emergency Care:

Sudden severe eye pain: Possible angle-closure glaucoma
High fever with muscle rigidity: Possible NMS
Severe breathing problems: Respiratory depression
Irregular heartbeat: Cardiac arrhythmias
Loss of consciousness: Severe CNS depression
Seizures: Convulsions of any type
Inability to urinate: Complete urinary retention
Severe abdominal pain: Possible bowel obstruction

Critical Safety Warning: Artane requires careful monitoring, especially in elderly patients who are at higher risk for cognitive side effects. Patients should be evaluated for narrow-angle glaucoma before starting treatment, and any vision changes require immediate medical evaluation. The medication should be discontinued gradually to avoid withdrawal symptoms and potential neuroleptic malignant syndrome.

Artane (trihexyphenidyl hydrochloride) has specific FDA-approved indications for treating movement disorders, based on decades of clinical experience demonstrating effectiveness in managing symptoms of Parkinson's disease and drug-induced extrapyramidal effects when used appropriately under medical supervision:

Primary Indications:

Parkinsonism (All Forms):

Idiopathic Parkinson's disease: Primary progressive neurodegenerative condition
Postencephalitic parkinsonism: Movement disorder following brain inflammation
Arteriosclerotic parkinsonism: Vascular-related parkinsonian symptoms
Secondary parkinsonism: Drug-induced or other acquired forms
Adjunctive therapy: Often used alongside levodopa for enhanced symptom control

Extrapyramidal Disorders (Drug-Induced):

Phenothiazine-induced: Movement problems from antipsychotic medications
Butyrophenone-induced: Side effects from medications like haloperidol
Thioxanthene-induced: Extrapyramidal effects from this drug class
Dibenzoxazepine-induced: Movement disorders from related medications
Other CNS drugs: Various psychotropic medications causing motor side effects

Specific Symptom Targets:

Motor Symptoms in Parkinson's Disease:

Tremor control: Particularly effective for resting tremor
Rigidity reduction: Muscle stiffness and resistance to movement
Bradykinesia improvement: Slowness of movement and reduced spontaneous motion
Postural instability: Balance and coordination problems
Freezing episodes: Sudden inability to initiate movement

Non-Motor Symptoms:

Sialorrhea control: Excessive drooling and saliva production
Dystonia relief: Sustained muscle contractions
Oculogyric crisis: Involuntary upward eye movement
Speech improvement: Reduced hypophonia (soft voice)
Swallowing function: Improved coordination for eating

Dosing Guidelines and Administration:

Idiopathic Parkinson's Disease:

Initial dose: 1 mg tablet or elixir on first day
Dose escalation: Increase by 2 mg every 3-5 days
Target dose range: 6-10 mg daily for most patients
Maximum dose: Up to 12-15 mg daily for postencephalitic patients
Frequency: Divided into 3-4 doses throughout the day

Drug-Induced Movement Disorders:

Initial approach: Start with 1 mg daily
Dose range: Typically 5-15 mg daily
Rapid titration: May increase doses every few hours if needed
Minimum effective dose: As little as 1 mg daily in some cases
Temporary approach: May reduce antipsychotic temporarily while establishing control

Combination Therapy with Levodopa:

Typical dose: 3-6 mg daily in divided doses
Dose adjustment: Both medications may need reduction
Careful titration: Monitor for increased involuntary movements
Symptom balance: Optimize control while minimizing side effects
Individual response: Highly variable between patients

Administration Considerations:

Timing and Food Relations:

Meal timing: Can be taken before or after meals based on tolerance
Excessive salivation: May prefer after-meal dosing
Nausea concerns: Before-meal timing may help
Dry mouth: Before-meal dosing if mouth becomes too dry
Consistency: Maintain regular timing for optimal control

Formulation Selection:

Tablets: 2 mg and 5 mg strengths for standard dosing
Elixir: 2 mg/5 mL for precise dosing or swallowing difficulties
Divided dosing: 3 doses at mealtimes for total daily intake
High doses: 4 doses daily (3 with meals, 1 at bedtime)
Gradual changes: Slow adjustments to minimize side effects

How long does it take for Artane to start working?

Artane typically begins working within a few hours to a few days of starting treatment. For drug-induced movement disorders, improvement may be seen within hours, while Parkinson's symptoms may take several days to weeks for optimal benefit. The medication is started at low doses and gradually increased, so full therapeutic effects may not be apparent until the appropriate dose is reached, which can take 2-3 weeks.

Can I take Artane with food?

Yes, Artane can be taken with or without food. If you experience stomach upset, taking it with food may help. Patients with excessive drooling often prefer taking it after meals, while those prone to nausea may do better taking it before meals. The timing can be adjusted based on your individual response and symptoms.

Why is Artane not recommended for elderly patients?

According to the Beers Criteria, Artane is considered potentially inappropriate for older adults because anticholinergic medications can cause serious cognitive side effects in elderly patients, including confusion, memory problems, and increased fall risk. Elderly patients are more sensitive to these effects and may experience delirium or worsening dementia. If used in older adults, it requires very careful monitoring and usually lower doses.

Can Artane be stopped suddenly?

No, Artane should not be stopped abruptly, especially if youve been taking it for an extended period. Sudden discontinuation can cause severe worsening of Parkinson's symptoms and may trigger neuroleptic malignant syndrome, a potentially life-threatening condition. Your doctor will gradually reduce the dose over time to safely discontinue the medication while monitoring for any worsening symptoms.

What should I do if I experience vision problems?

Any vision changes while taking Artane require immediate medical attention, especially sudden eye pain, severe headache, or seeing halos around lights. These could indicate angle-closure glaucoma, which can cause permanent blindness if not treated quickly. Patients should have eye exams before starting Artane and regular monitoring during treatment, particularly if they have any risk factors for glaucoma.

Can Artane cause addiction or abuse?

While Artane is not classified as a controlled substance, it does have potential for abuse due to its stimulant and mood-elevating properties. Some people may misuse it for its euphoric effects, and psychological dependence can develop. Healthcare providers should monitor for signs of misuse, especially in patients with a history of substance abuse. The medication should only be used as prescribed for legitimate medical conditions.

Is it safe to drive while taking Artane?

Artane can impair your ability to drive safely due to side effects like drowsiness, blurred vision, dizziness, and confusion. You should avoid driving or operating machinery until you know how the medication affects you. Even after adjusting to the medication, be cautious about driving, especially during dose changes or if you experience any vision problems or dizziness.

How does Artane interact with other medications?

Artane can interact with several types of medications. Alcohol and CNS depressants increase sedation effects. MAO inhibitors and tricyclic antidepressants can intensify anticholinergic side effects. When used with levodopa, doses of both medications may need adjustment. Always inform your healthcare providers about all medications, supplements, and over-the-counter drugs youre taking to avoid dangerous interactions.

What precautions should I take in hot weather?

Artane can impair your bodys ability to regulate temperature by reducing sweating, putting you at risk for heat stroke. During hot weather, stay in air-conditioned environments when possible, drink plenty of fluids, avoid strenuous outdoor activities, and watch for signs of overheating like dizziness, nausea, or confusion. Contact your doctor immediately if you develop fever or heat-related symptoms.

Can pregnant or breastfeeding women take Artane?

Artane is classified as pregnancy category C, meaning its safety during pregnancy hasnt been established. It should only be used if the potential benefits outweigh the risks. The medication may suppress lactation and could potentially harm nursing infants. Pregnant or breastfeeding women should discuss the risks and benefits with their healthcare provider before using Artane.

How should Artane be stored?

Store Artane tablets and elixir at room temperature (68-77°F) in a tightly closed container, away from moisture and heat. Keep the elixir from freezing. Store all medications out of reach of children and pets. Dont use expired medication, and dispose of unused medication safely through a take-back program or as directed by your pharmacist.

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember unless its almost time for your next dose. Dont take two doses at once to make up for a missed dose. If you frequently forget doses, consider using a pill organizer or setting reminders. Consistent dosing is important for maintaining symptom control, so discuss strategies with your healthcare provider if you have trouble remembering doses.

Can children take Artane?

The safety and effectiveness of Artane in children havent been established. Children may experience different side effects than adults, including hyperactivity, psychosis, weight loss, and sleep problems. If Artane is considered for a child, it requires very careful monitoring by a specialist familiar with pediatric movement disorders, and the potential benefits must clearly outweigh the risks.

What monitoring is needed while taking Artane?

Regular monitoring includes checking for side effects, especially cognitive changes, eye problems, and urinary retention. You should have periodic eye exams to check for glaucoma, especially if you have risk factors. Your doctor will monitor your response to treatment and may need to adjust doses. Report any unusual symptoms immediately, and maintain regular follow-up appointments to ensure safe and effective treatment with movement disorder medications.

Artane