Heximax 5 mg (Tablet)
Unit Price: ৳ 10.00 (3 x 10: ৳ 300.00)
Strip Price: ৳ 100.00
Medicine Details
| Category | Details |
|---|---|
| Generic | Trihexyphenidyl hydrochloride |
| Company | Goodman pharmaceuticals ltd |
| Also available as |
Indications
- Adjunct in the treatment of all forms of parkinsonism
- Adjuvant therapy for parkinsonism with levodopa
- Control of extrapyramidal disorders caused by CNS drugs
Description
- Direct inhibitory effect upon the parasympathetic nervous system
- Relaxing effect on smooth musculature
Pharmacology
- Non-selective muscarinic acetylcholine receptor antagonist
- Binds with higher affinity to the M1 subtype
- Higher affinity for central muscarinic receptors in the cerebral cortex
- Lower affinity for peripherally located receptors
- May modify nicotinic acetylcholine receptor neurotransmission
- May lead indirectly to enhanced dopamine release in the striatum
Dosage & Administration
- Individualized dosage
- Low initial dose, gradually increased, especially in patients over 60 years
- May be given before or after meals depending on patient's reaction
- Preferable to take before meals if tending to dry the mouth excessively
- Initial therapy for parkinsonism: 1 mg administered on the first day, then increased gradually
- Range of total daily dosage for idiopathic parkinsonism: 6 to 15 mg
- Concomitant use with Levodopa
- Total daily intake is best divided into 3-4 doses
Interaction
- Additive effects with cannabinoids, barbiturates, opiates, and alcohol
- Increased sedative effects with alcohol or other CNS depressants
- Potentiation of anticholinergic effects by MAOIs and tricyclic antidepressants
- Increased risk of tardive dyskinesia with concomitant administration of anticholinergics and neuroleptics
- Possible need for dosage reduction of either trihexyphenidyl or levodopa during concomitant therapy
Contraindications
- Hypersensitivity to trihexyphenidyl
- Narrow angle glaucoma
Side Effects
- Dryness of the mouth
- Blurred vision
- Dizziness
- Mild nausea
- Nervousness
- Suppurative parotitis
- Skin rashes
- Dilatation of the colon
- Paralytic ileus
- Psychiatric manifestations such as delusions, hallucinations, and paranoia
- Cognitive dysfunctions
- Constipation
- Drowsiness
- Urinary hesitancy or retention
- Tachycardia
- Dilation of the pupil
- Increased intraocular pressure
- Choreiform movements
- Weakness
- Vomiting
- Headache
- Exacerbation of parkinsonism with abrupt treatment withdrawal
- Neuroleptic malignant syndrome with abrupt treatment withdrawal
- Angle-closure glaucoma
- Paradoxical sinus bradycardia
- Dry skin
- Cycloplegia
- Hyperkinesia (in pediatric patients)
- Psychosis (in pediatric patients)
- Forgetfulness (in pediatric patients)
- Weight loss (in pediatric patients)
- Restlessness (in pediatric patients)
- Chorea (in pediatric patients)
- Sleep alterations (in pediatric patients)
Pregnancy & Lactation
- Use during pregnancy only when clearly needed and benefit outweighs risk
- Caution in administration to nursing women due to potential for suppression of lactation
Precautions & Warnings
- Gonioscope evaluation and monitoring of intraocular pressures for patients to be treated with trihexyphenidyl
- Potential for angle closure and increase in intraocular pressure
- Caution in hot weather, especially when given with other atropine-like drugs
- Potential for anhidrosis and hyperthermia, especially in the presence of pre-existing sweating disturbance
- Potential occurrence of Neuroleptic Malignant Syndrome with dose reduction or discontinuation of trihexyphenidyl
Overdose Effects
- Typical central symptoms of atropine intoxication
- Peripheral signs of parasympathetic blockade
- Neuropsychiatric signs such as delirium, seizures, confusion
- Treatment involves symptomatic and supportive therapy, gastric lavage, respiratory support
Therapeutic Class
- Antiparkinson drugs
Storage Conditions
- Store at temperature not exceeding 30°C
- Store in a dry place
- Protect from light