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Uses and Administration Adverse Effects, Treatment, And Mesilote 895 Antidepressants. A report1 of 5 patients who developed Biperiden is used in the symptomatic treatment of Profile delirium while taking an antipsychotic, an SSRI, and ben­ parkinsonism (p. 889.1 ), including the alleviation of the zatropine suggested that there might be an interaction extrapyramidal syndrome induced by drugs such as Bornaprine hydrochloride is a quaternary ammonium between SSRis and benzatropine. phenothiazines, but, like other antimuscarinics, is of no antimuscarinic with actions and uses similar to those of I. Roth A, et al. Delirium associated with the combination of a neuroleptic, value against tardive dyskinesias. trihexyphenidyl (p. 917.3). It is used in the 'ymptomatic an SSRI. and benztropine. J Clin Psychiatry 1994; 55: 492-5. Biperiden is given orally as the hydrochloride and by treatment of parkinsonism (p. 889.1), including the injection as the lactate; doses are expressed in terms of the alleviation of the extrapyramidal syndrome induced by Antipsychalics. Fatal heat stroke after exposure to an relevant salt. drugs such as phenothiazines, but, like other antirnusca­ ambient temperature of over 29 degrees has been US licensed product information gives the initial oral rinics, is of no value against tardive dyskinesias; it is claimed reportedt2 in patients receiving benzatropine with dose for Parkinson's disease as 2 mg of the hydrochloride to be mainly effective against tremor. Bomaprine hydro­ antipsychotics. Paralytic ileus, sometimes fatal, has also 3 or 4 times daily which can then be increased according to chloride is given orally in initial doses of 2 mg daily been seen in patients taking benzatropine with antipsy­ response to a maximum of l6mg daily. In some countries a gradually increased to 6 to 12 mg daily according to chotics.3 much lower initial oral dose of I mg twice daily is response. It is also used in the treatment of hyperhidrosis Can Med Assoc J recommended. In the USA the recommended oral dose for (p. 1685.1) in a dose of 4 to Smg daily. l. Stadnyk AN. Glezos JD. Drug-induced heat stroke. 1983; 128: 957-9. drug-induced extrapyramidal symptoms is 2 mg of the 2. Tyndel F, Labonte R. Drug-facilitated heat stroke. Can Med Assoc J 1983; P epa a ons hydrochloride 1 to 3 times daily. In other countries a wider r .r ti 129: 680. ..... .. .......... ! dose range of I to 4mg I to 4 times daily is used. Modified­ 3. Wade LC, Ellenor GL Combination mesoridazine- and benztropine ProprietaryPreparations (details are given in Volume B) mesylate-induced paralytic ileus: two case reports. Drug Intel! Clin Pharm release tablets with different dose schedules are available in Austria: Sormodren; Ger.: Sor­ 1980; 14: 17�22. some countries. Single-ingredient Preparations. modren; Gr. : Sormodren; Ital. : Sormodren; Turk.: Sormodren. In severe cases, or when biperiden cannot be given orally, the lactate can be given by intramuscular or slow r i i P.r.�P.<l. (]_l ?.n.� intravenous injection; total daily doses of up to I 0 to 20 mg (details are given in Volume B) ProprietaryPreparations daily have been used. Bromocriptine Mesilate IBANM, riNNM! Single�ingredient Preparations. Austral. : Benztrop; Cogentin; Brqmocriprina, mesifato Bromocriptine, rjJesilat Austria: Cogentint; Cz.: Apo-Benztropinet; Hong Kong: � Adverse Effects, Treatment, and Precautions Bromocriptine Mesyiate (USAN);de; Bromocrlptine Metha,ne"de:ul­ Cogentin; NZ: Benztrop; Cogentin; Singapore: Cogentin; Thai.: pho ate; . llromocriptini , Mesitas;. BromocrlpMmesilat; Cogentin; UK: Cogentin; USA: Cogentin. As for Atropine Sulfate, p. 1312. I. ocryptine M�sy!are; 2-Bro �o-tiri;)pcryptin� Me$ytate; Parenteral use may be followed by slight transient • m r; sio-2· Pharmacopoeial Preparations hypotension. S.romoe,rQaC!yptin� Monomethanesult;n foflate; Bromokriptii­ BP 2014: Benzatropine Injection; Benzatropine Tablets; riimesilaattf; Bromokriptln Mesilat: · Bibmokriptinmesi\a_t; USP 36: Benztropine Mesylate Injection; Benztropine Mesylate Abuse. Abuse of biperiden has been reported in psychia­ Bromo�ripti n·mesylll.t; lliompl,riptin-mezilat; Bromokriptino Tablets. .. tric patients.1'2 mesilatas; CBc (brtJmo�:rip�ine); Mesilato de bromocripti­ et a!. BMJ l. Pullen GP, Anticholinergic drug abuse: a common problem? na; 5pat00KpwmMHiJ154 Me3wnar. 1984; 289: 612�13. 12' �(1 h hy 2. Ozucelik DN, et al. Gluteal abscess following intramuscular injection of 5)-2,Bromo- ·hydroxy, 2' ,m t let � ' ·(2,methyl· !BAN. riNNJ 61: Biperiden dissolved biperiden tablets. Int J Clin Pract 2007; 1417�18. (5'prop yl);ergotaman-3� ,6�,! 8-trione. mee tbanesufpi1onay [) S te: Biperideeni; Biperidene; Biperideno; Biperidenum; 5�nepft- ;::,2H.wBrN50s,CH,0,$!"750.7 . Porphyria. The Drug Database for Acute Porphyria, com­ '(bromocriprlnt;); (bromocriptine • piled by the Norwegian Porphyria Centre (NAPOS) and 4E'H.1 ·(8icyclo[2.2, l ]hept-5-en-2-yl)-1-phenyl-3cpiperidinopro­ CAS-256 14·03- 3 22260.-51-1 the Porphyria Centre Sweden, classifies biperiden as possi­ ml:sJitlte), pan·1-of. bly porphyrinogenic; it should be used only when no safer ATC-G02CB0 1; N04BC0 1, alternative is available and precautions should be consid­ ATCVet - QG0.2CBO I; QIV0413CO I. C"H29N0±=3H.5�:- 57 4-65:8. ered in vulnerable patients.1 UNti - FFP983J30D. CAS l. The Drug Database for Acute Porphyria. Available at: http://�. Pharmacopoeias. In Bur. (see p. vii), Jpn, and US. ATC -N04M02,QN04M02. drugs-porphyria.org {accessed 30/09/11) Ph, Eur. 8: (Bromocriptine Mesilate). A white or slightly ATCVet - coloured fine crystalline powder. Practically insoluble in UN/I - OFRP6G56LD. Pharmacopoeias. In Int. and US. Interactions water; soluble in alcohol; sparingly soluble in dichlor­ omethane; freely soluble in methyl alcohoL A I% solution USP 36: (Biperiden). A white, practically odourless, As for antimuscarinics in general (see Atropine Sulfate, in a mixture of 2 parts methyl alcohol to 8 of water has a pH crystalline powder. Practically insoluble in water; sparingly p. 1312.3). of 3.1 to 3.8. Store in airtight containers at a temperature soluble in alcohol; freely soluble in chloroform. Protect from not exceeding -15 degrees. Protect from light. light. Pharmacokinetics USP 36: (Bromocriptine Mesylate). A white or slightly Biperiden is readily absorbed from the gastrointestinal tract, coloured fine crystalline powder; odourless or having a Biperiden Hydrochloride (BANM. r/NNM) but bioavailability is only about 30% suggesting that it weak characteristic odour. Store in airtight containers at a undergoes extensive first -pass metabolism. Biperiden has an Biperideenihydrokloriql; Biperlden idroklorOr; Biperidene, temperature not exceeding 8 degrees. Protect from light. H elimination half-life of about 20 hours. Chlorhydrate Biperiden·hidroklorld; Biperidenhydro­ References. chlorid; Siperidede;nchydr ochlorid; Biperidenhydroklorid; Biper­ 1. Hollmann M, et a!. Biperiden effects and plasma levels in volunteers. Eur Uses and Administration tcleni Hydrochioridum; Biperideno hidrochloridas; Biperide­ J Clin Pharmacal 1984; 27: 619�21. Bromocriptine, an ergot derivative (p. 2137.1), is a no, . hidr.oclorura de; Hidrodoruro de bl perideno: 2. Grimaldi R, et a!. Pharmacokinetic and pharmacodynamic stuclies dopamine D �agonist. It inhibits the secretion of prolactin 2 51'tnep�,qe8a following the intravenous and oral administration of the antiparkinso­ nian drug biperiden to normal subjects. Bur J Clin Pharmacal 1986; 29: (p. 2145.1) from the anterior pituitary and is used in the r�APO X110P;:tA. 735�7. treatment of prolactinoma and endocrinological disorders C1,H1<iNO,HCI=347.9 associated with hyperprolactinaemia (p. 896.2), including CAS � 1235,82-1. amenorrhoea, galactorrhoea, hypogonadism, and infertility in both men and women. Bromocriptine is also used to ArC - NIJ4M02. (details are given in Volume B) ProprietaryPreparations suppress puerperal lactation for medical reasons (p. 896.2); ATC Ver"- - QN04M 02. UNit K35N76CUHF. Single-ingredient Preparations. Arg. : Akineton; Berofin; Darci­ it is not recommended for the routine suppression of Pharmacopoeias. In Bur. (see p. vii), Int., Jpn, and US. pirenot; Denzolam; Sinekin; Austral.: Akineton; Austria: physiological lactation or for the treatment of postpartum Ph. Eur. 8: (Biperiden Hydrochloride). A white or almost Akineton; Belg. : Akineton; Braz. : Akineton; Cinetol; Parkinsol; breast pain and engorgement that may be adequately white, crystalline powder. Slightly soluble in water and in Propark; Chile: Akinetont; Cz. : Akineton; Denm.: Akineton; relieved with simple analgesics and breast support. Growth alcohol; very slightly soluble in dichloromethane. A 0.2% Fin.: Akineton; Ipsatol; Fr.: Akineton; Ger.: Akineton; Gr.: hormone secretion may be suppressed by bromocriptine in solution in water has a pH of 5.0 to 6.5. Store in airtight Akineton; Hung. : Akineton; Irl. : Akineton; Israel: Dekinet; some patients with acromegaly (p. 896.1). Because of its Ital.: Akineton; Mex. : Akineton; Bikipent; Kinex; Neth.: containers. Protect from light. dopaminergic activity bromocriptine is also used in the Akineton; Norw.: Akineton; Philipp.: Aketon; Akidin; management of Parkinson's disease (p. 896.3). It is used in USP 36: (Biperiden Hydrochloride). A white, practically Akineton; Pol.: Akineton; Port.: Akineton; Rus.: Akineton odourless, crystalline powder. Slightly soluble in water, in (AKHHeTOH); Mendilex (MeH.n;HneKc); S.Afr. : Akineton; Spain: some countries as an adjunct to diet and exercise to improve alcohol. in chloroform, and in ether; sparingly
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