Antimuscarinic
Procyclidine hydrochloride
Brand names: Kemadrin
Adult dose
Dose: PO: 2.5mg TDS, increase by 2.5–5mg/day; usual 5–10mg TDS. Acute dystonia: 5–10mg IM/IV
Route: PO/IM/IV
Frequency: TDS
Clinical pearls
- Acute drug-induced dystonia (IM/IV — rapid response), drug-induced parkinsonism
- Avoid in tardive dyskinesia (worsens)
Contraindications
- Closed-angle glaucoma
- GI obstruction
- Urinary retention
- Myasthenia gravis
- Tardive dyskinesia
Side effects
- Anticholinergic effects
- Sedation/agitation
- Tachycardia
- Urinary retention
- Dry mouth
Interactions
- Other antimuscarinics
- CNS depressants
- Levodopa
Reference: BNF; NICE CG178; https://bnf.nice.org.uk/drugs/procyclidine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS