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Anticholinergic (antimuscarinic, antiparkinsonian)

Benzatropine mesilate

Brand names: Cogentin

An antimuscarinic (anticholinergic) agent used principally to treat drug-induced parkinsonism and acute dystonic reactions caused by antipsychotics.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It blocks central muscarinic acetylcholine receptors, helping to redress the dopamine-acetylcholine imbalance in the basal ganglia produced by dopamine-blocking drugs.

Prescribing in practice

  • Its antimuscarinic effects make it hazardous in angle-closure glaucoma, urinary retention, prostatic enlargement and gastrointestinal obstruction, and it can cause confusion especially in older people.
  • It is not indicated for tardive dyskinesia, which it may worsen, and should not be used routinely to prevent extrapyramidal effects.
  • Anticholinergic burden is additive with other antimuscarinic drugs, and abrupt withdrawal should be avoided.

Monitoring

No routine laboratory monitoring is required; monitor for anticholinergic adverse effects such as confusion, constipation, dry mouth and urinary retention, particularly in the elderly.

Counselling the patient

  • It can cause dry mouth, blurred vision, and constipation; report difficulty passing urine.
  • Avoid alcohol and tell the team if you become confused or drowsy.
  • Do not stop it suddenly without advice.

Evidence & guidelines

Use reflects established clinical practice for managing drug-induced movement disorders as set out in current prescribing references.

Reference: SmPC Cogentin; Maudsley Prescribing Guidelines 14th ed.; NICE CG178 Psychosis & Schizophrenia; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways