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Trihexyphenidyl HCl

Trihexyphenidyl HCl is an anticholinergic medication used to treat symptoms of Parkinson’s disease and drug-induced extrapyramidal symptoms (EPS), such as tremors, stiffness, and involuntary movements. It works by blocking acetylcholine, a chemical in the brain that is involved in the regulation of muscle movements. By restoring the balance between dopamine and acetylcholine, trihexyphenidyl helps reduce muscle stiffness and improve movement control.



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Frequently Asked Questions

How long does it take for trihexyphenidyl to work?
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Trihexyphenidyl may begin to reduce symptoms like tremors and stiffness within a few days of starting treatment, though full effects may take up to 1 to 2 weeks.

Can I take trihexyphenidyl with other Parkinson's medications?
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Yes, trihexyphenidyl is often used in combination with other Parkinson's medications, such as levodopa. Your doctor will adjust the doses to find the best combination for managing your symptoms.

Can I stop taking trihexyphenidyl suddenly?
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No, do not stop trihexyphenidyl suddenly. Abruptly stopping the medication can cause withdrawal symptoms or worsen Parkinson’s disease symptoms. Talk to your doctor before making any changes to your medication regimen.

Can trihexyphenidyl cause memory problems?
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Yes, trihexyphenidyl may cause cognitive impairment, especially in older adults. This includes symptoms like confusion, difficulty concentrating, and memory problems.

Does trihexyphenidyl interact with alcohol?
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Yes, alcohol can increase the drowsiness and dizziness caused by trihexyphenidyl. It’s best to limit or avoid alcohol while taking this medication.

Comprehensive Drug Guide

How Does Trihexyphenidyl HCl Work?

Trihexyphenidyl works by blocking the action of acetylcholine, a neurotransmitter that influences muscle movement. In Parkinson’s disease, there is an imbalance between dopamine and acetylcholine, leading to symptoms like tremors and stiffness. By inhibiting acetylcholine, trihexyphenidyl reduces the overactivity of muscles, helping to ease tremors, muscle stiffness, and other motor symptoms.



Common Dosages

  • 2 mg tablets
  • 5 mg tablets
  • Oral solution (2 mg per 5 mL)

Typical Dosing

  • For Parkinson's disease, the initial dose is typically 1 mg daily, which may be gradually increased by 2 mg increments at intervals of 3 to 5 days. The usual maintenance dose is 6 to 10 mg daily, divided into 2-3 doses.
  • For drug-induced extrapyramidal symptoms, the typical dose is 5 to 15 mg daily, divided into 2-3 doses.
  • Dosage adjustments are based on individual response and tolerability.


Typical Dosing

FDA Approved Indications

  • The treatment of Parkinson's disease symptoms, such as tremors, muscle rigidity, and bradykinesia (slowness of movement).
  • The management of extrapyramidal symptoms (EPS) caused by antipsychotic medications, such as tardive dyskinesia, muscle spasms, and tremors.


Who Shouldn't Take Trihexyphenidyl HCl?

  • Narrow-angle glaucoma
  • Tachycardia or other cardiovascular conditions sensitive to anticholinergic effects
  • Bowel obstruction or urinary retention
  • Known hypersensitivity to trihexyphenidyl or any components of the formulation


Advice From The Pharmacist

  • Take trihexyphenidyl exactly as prescribed, with or without food. If you experience stomach upset, it can be taken with food to reduce discomfort.
  • This medication may cause dry mouth. Drink plenty of fluids or use sugarless candy to alleviate dry mouth symptoms.
  • Avoid activities that require clear vision or alertness, such as driving or operating heavy machinery, until you know how trihexyphenidyl affects you.
  • Alcohol can increase drowsiness or dizziness caused by trihexyphenidyl. It is advised to limit alcohol consumption while on this medication.
  • Do not stop taking trihexyphenidyl suddenly without consulting your doctor, as stopping abruptly can worsen Parkinson's symptoms or EPS.


Side Effects of Trihexyphenidyl HCl

Common Side Effects

  • Dry mouth
  • Blurred vision
  • Drowsiness or dizziness
  • Constipation
  • Nausea


Uncommon/Severe Side Effects

  • Urinary retention
  • Confusion or hallucinations
  • Increased intraocular pressure (which can worsen glaucoma)
  • Difficulty swallowing or speaking
  • Tachycardia or heart palpitations


Risks and Warnings of Trihexyphenidyl HCl

  • Cognitive Impairment: Trihexyphenidyl can cause confusion, especially in older adults. Monitor for signs of mental status changes, especially if used long-term.
  • Heat Sensitivity: This medication may reduce the body’s ability to sweat, increasing the risk of heatstroke in hot environments. Drink fluids and stay cool, especially in hot weather or when exercising.
  • Glaucoma: Trihexyphenidyl is contraindicated in patients with narrow-angle glaucoma, as it can increase intraocular pressure. Routine eye exams may be required for patients at risk.
  • Additive Anticholinergic Effects: Combining trihexyphenidyl with other medications that have anticholinergic properties (e.g., antihistamines, antidepressants) can increase the risk of side effects such as dry mouth, blurred vision, and urinary retention.


Interactions with Trihexyphenidyl HCl

Common Drug Interactions

  • Other anticholinergic drugs: Medications such as antihistamines (e.g., diphenhydramine) and tricyclic antidepressants (e.g., amitriptyline) may increase the risk of anticholinergic side effects.
  • Levodopa: When taken with levodopa, trihexyphenidyl may enhance the therapeutic effects of the medication for Parkinson's disease. Dosage adjustments of either drug may be necessary.
  • Alcohol: May enhance the sedative and cognitive-impairing effects of trihexyphenidyl. Avoid or limit alcohol use while taking this medication.


Alternatives to Trihexyphenidyl HCl

  • Benztropine (Cogentin): Another anticholinergic used to treat Parkinson’s symptoms and extrapyramidal side effects from antipsychotic medications.
  • Amantadine (Symmetrel): An antiviral medication also used for Parkinson's disease symptoms.
  • Levodopa/Carbidopa (Sinemet): A primary treatment for Parkinson’s disease that helps restore dopamine levels in the brain.