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Biperiden

Brand names: AKINETON

Interactions

Active ingredient Biperiden interacts in the following cases:

Alcohol

An increase in the effects of alcohol under biperiden may occur (avoid alcohol).

Psycho-pharmaceuticals, antihistamines, anti-Parkinson drugs, spasmolytics

Combination with other anti-cholinergic drugs, e.g. psycho-pharmaceuticals, antihistamines, antiParkinson drugs and spasmolytics, can lead to an increase in central and peripheral side-effects.

Neuroleptics

Tardive dyskinesia induced by neuroleptics may be enhanced by biperiden. Occasionally, Parkinson symptoms in existing delayed dyskinesia may be so serious, that anti-cholinergic treatment becomes necessary.

Lactation

Anti-cholinergic drugs can inhibit lactation. Due to the chemical structure of the active substance, it can be assumed that biperiden passes into breast milk. For this reason, weaning is recommended.

Pregnancy

Biperiden should be administered during pregnancy only after a careful risk-benefit analysis, as no experience is available with its use in pregnancy.

Levodopa, carbidopa

Levodopa and the concomitant administration of biperiden can enhance dyskinesia. Generalised Ī½choreiform disturbances of movement have been observed with the concomitant use of biperiden and Levodopa/Carbidopa preparations in patients with Parkinson’s disease.

Metoclopramide

The effect of metoclopramide and compounds with similar effects on the gastro-intestinal tract is antagonised by anti-cholinergic drugs such as biperiden.

Pethidine

Anti-cholinergics can increase the central-nervous side-effects of pethidine.

Quinidine

Taking quinidine concomitantly with biperiden can lead to an enhancement of anti-cholinergic cardio-vascular effects (in particular to AV-conduction).

Glucose-galactose malabsorption, lactase deficiency

Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucosegalactose malabsorption should not take this medicine.

Urinary retention

In the case of urinary retention, patients should empty the bladder before taking the respective dose of biperiden.

Effects on ability to drive and use machines

Due to central nervous and peripheral side-effects, such as e.g. tiredness, dizziness and drowsiness, even when used correctly this drug can also change the ability to react to such an extent that – independent of the limitation due to the underlying disease to be treated – the ability to actively participate in road traffic or operate electrically or motor-driven tools and machines is further impaired. This is particularly true with the concomitant use of other centrally active drugs, anticholingeric drugs and especially in connection with alcohol.

Tachycardia

In patients who suffer from diseases which can lead to tachycardia, biperiden should be used with caution.

Prostate hypertrophy

Biperiden can lead sporadically to difficulties in micturition, in particular in patients with prostate hypertrophy, more seldom to urinary retention.

Increased tendency to convulsions

Anti-cholinergic drugs, such as biperiden, with a central mode of action can lead to an increased tendency to cerebral seizures. In patients with an increased tendency to convulsions, biperiden is to be dosed carefully.

Myasthenia gravis

Biperiden may only be used with particular caution in patients with Myasthenia gravis.

Pregnancy

Biperiden should be administered during pregnancy only after a careful risk-benefit analysis, as no experience is available with its use in pregnancy.

Nursing Mothers

Anti-cholinergic drugs can inhibit lactation. Due to the chemical structure of the active substance, it can be assumed that biperiden passes into breast milk. For this reason, weaning is recommended.

Carcinogenesis, Mutagenesis and Fertility

Fertility

No data are available on the effects of biperiden on fertility.

Effects on Ability to Drive and Use Machines

Due to central nervous and peripheral side-effects, such as e.g. tiredness, dizziness and drowsiness, even when used correctly this drug can also change the ability to react to such an extent that – independent of the limitation due to the underlying disease to be treated – the ability to actively participate in road traffic or operate electrically or motor-driven tools and machines is further impaired. This is particularly true with the concomitant use of other centrally active drugs, anticholingeric drugs and especially in connection with alcohol.