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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 — no UK product information found

We found no UK product information (SmPC) for this medicine or presentation on the eMC or MHRA Products (checked October 2026). It may be unlicensed in the UK, imported, a medical device, or no longer marketed. ClinCalc Pro shows only doses it can trace to official product information, so none is shown — follow your specialist service or local guideline.

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