Benztropine 2mg Tablets
It is used to treat Parkinson's disease.It is used to treat side effects caused by some other drugs.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Antiparkinsonian Agent
Pharmacologic Class
Centrally Acting Anticholinergic; Muscarinic Antagonist
Pregnancy Category
C
FDA Approved
Aug 2025
DEA Schedule
Not Controlled
Overview
What is this medicine?
Benztropine is a medication used to treat symptoms of Parkinson's disease, such as tremors and stiffness, and to control muscle spasms and stiffness caused by certain medications (drug-induced extrapyramidal symptoms). It works by helping to balance certain natural substances in the brain.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
It's also important to stay hydrated by drinking plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature in a dry place, avoiding the bathroom. Keep all medications in a secure location, out of the reach of children and pets. When your medication is no longer needed or has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your doctor or pharmacist. If you're unsure about the best way to dispose of your medication, consult with your pharmacist, who may be aware of drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. Continue taking your medication as prescribed by your doctor or healthcare provider, even if you start to feel better.
It's also important to stay hydrated by drinking plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature in a dry place, avoiding the bathroom. Keep all medications in a secure location, out of the reach of children and pets. When your medication is no longer needed or has expired, dispose of it properly. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your doctor or pharmacist. If you're unsure about the best way to dispose of your medication, consult with your pharmacist, who may be aware of drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for the missed one.
Lifestyle & Tips
- Avoid alcohol and other CNS depressants, as they can increase drowsiness and dizziness.
- Be cautious in hot weather or during exercise, as this medication can decrease sweating and increase the risk of heatstroke.
- Stay hydrated to help manage dry mouth and constipation.
- Avoid driving or operating machinery until you know how this medication affects you, as it can cause dizziness or blurred vision.
- Do not stop taking this medication suddenly without consulting your doctor, as it can worsen your symptoms.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
1-2 mg orally once or twice daily
Dose Range:
0.5 - 6 mg
Condition-Specific Dosing:
Parkinsonism:
0.5-1 mg at bedtime, gradually increased to 1-2 mg 2-3 times daily, max 6 mg/day.
Drug-induced Extrapyramidal Disorders:
1-4 mg once or twice daily, or 1-2 mg 2-3 times daily. Start with 1-2 mg, adjust as needed.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (contraindicated in children under 3 years)
Child:
Not established (contraindicated in children under 3 years); for older children (3 years and older) with drug-induced extrapyramidal symptoms, 0.02-0.05 mg/kg/dose once or twice daily, max 6 mg/day, use with extreme caution.
Adolescent:
Similar to adult dosing for drug-induced extrapyramidal symptoms, use with caution.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution, monitor for increased anticholinergic effects.
Moderate:
Use with caution, monitor for increased anticholinergic effects; consider lower initial doses.
Severe:
Use with caution, monitor for increased anticholinergic effects; consider lower initial doses and slower titration.
Dialysis:
Not dialyzable; use with caution, monitor for adverse effects.
Hepatic Impairment:
Mild:
Use with caution, monitor for increased anticholinergic effects.
Moderate:
Use with caution, monitor for increased anticholinergic effects; consider lower initial doses.
Severe:
Use with caution, monitor for increased anticholinergic effects; consider lower initial doses and slower titration.
Pharmacology
Mechanism of Action
Benztropine is a centrally acting anticholinergic agent that also possesses antihistaminic properties. It acts by blocking cholinergic muscarinic receptors in the central nervous system, thereby helping to restore the balance between cholinergic and dopaminergic activity in the basal ganglia, which is disrupted in Parkinson's disease and drug-induced extrapyramidal symptoms. It also inhibits the reuptake of dopamine, prolonging its action.
Pharmacokinetics
Absorption:
Bioavailability:
Not well established for oral administration, but well absorbed.
Tmax:
2-8 hours (oral)
FoodEffect:
Food may delay absorption but does not significantly affect extent of absorption.
Distribution:
Vd:
Not precisely quantified, but widely distributed.
ProteinBinding:
Not precisely quantified.
CnssPenetration:
Yes
Elimination:
HalfLife:
6-10 hours (variable, can be longer in some individuals)
Clearance:
Not precisely quantified.
ExcretionRoute:
Renal (primarily as metabolites, small amount unchanged drug).
Unchanged:
Less than 10%
Pharmacodynamics
OnsetOfAction:
Within 1 hour (oral)
PeakEffect:
2-8 hours
DurationOfAction:
6-10 hours (up to 24 hours in some cases)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
New or worsening mental, mood, or behavior changes
Hallucinations (seeing or hearing things that are not there)
Feeling confused
Changes in eyesight, eye pain, or severe eye irritation
Trouble swallowing or speaking
Decreased appetite
Weight loss
Trouble passing urine
Pain when passing urine
Fast heartbeat
Larger pupils
Memory problems or loss
Severe constipation or stomach pain, which may be signs of a severe bowel problem
Weakness
Trouble moving around
Numbness of fingers
Sweating less, heat stroke, and deadly high body temperatures have occurred with this medication. Be cautious in hot weather and during physical activity. If you experience a fever or do not sweat during activities or in warm temperatures, contact your doctor immediately.
Other Possible Side Effects
Like all medications, this drug may cause side effects. Many people experience no side effects or only minor ones. If you are bothered by any of the following side effects or if they do not go away, contact your doctor or seek medical help:
Constipation
Upset stomach or vomiting
Dry mouth
Feeling nervous and excitable
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
New or worsening mental, mood, or behavior changes
Hallucinations (seeing or hearing things that are not there)
Feeling confused
Changes in eyesight, eye pain, or severe eye irritation
Trouble swallowing or speaking
Decreased appetite
Weight loss
Trouble passing urine
Pain when passing urine
Fast heartbeat
Larger pupils
Memory problems or loss
Severe constipation or stomach pain, which may be signs of a severe bowel problem
Weakness
Trouble moving around
Numbness of fingers
Sweating less, heat stroke, and deadly high body temperatures have occurred with this medication. Be cautious in hot weather and during physical activity. If you experience a fever or do not sweat during activities or in warm temperatures, contact your doctor immediately.
Other Possible Side Effects
Like all medications, this drug may cause side effects. Many people experience no side effects or only minor ones. If you are bothered by any of the following side effects or if they do not go away, contact your doctor or seek medical help:
Constipation
Upset stomach or vomiting
Dry mouth
Feeling nervous and excitable
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe confusion or hallucinations
- High fever, especially with hot, dry skin (signs of heatstroke)
- Difficulty urinating or inability to urinate
- Severe constipation or abdominal pain
- Rapid or irregular heartbeat
- Eye pain or vision changes (especially sudden blurred vision or halos around lights)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have been diagnosed with tardive dyskinesia, a severe muscle condition.
* If you have glaucoma.
For Children:
If your child is under 3 years of age, do not administer this medication. It is not approved for use in children younger than 3 years.
Additional Considerations:
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have been diagnosed with tardive dyskinesia, a severe muscle condition.
* If you have glaucoma.
For Children:
If your child is under 3 years of age, do not administer this medication. It is not approved for use in children younger than 3 years.
Additional Considerations:
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health conditions. Never start, stop, or change the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before engaging in activities that require alertness, such as driving, wait until you understand how this drug affects you.
When taken with certain other medications, this drug can increase the risk of severe and potentially life-threatening conditions, including paralytic ileus (a type of bowel blockage), fever, and heat stroke. To minimize this risk, carefully review all your medications with your doctor and pharmacist.
To manage dry mouth, a common side effect, practice good oral hygiene, and consider sucking on hard, sugar-free candy or chewing sugar-free gum. Regular dental check-ups are also recommended.
If you are a parent or caregiver of a child taking this medication, be aware that children may be more susceptible to certain side effects. Use this drug with caution in pediatric patients.
For individuals 65 years or older, this medication should be used with caution, as older adults may be more prone to experiencing side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
When taken with certain other medications, this drug can increase the risk of severe and potentially life-threatening conditions, including paralytic ileus (a type of bowel blockage), fever, and heat stroke. To minimize this risk, carefully review all your medications with your doctor and pharmacist.
To manage dry mouth, a common side effect, practice good oral hygiene, and consider sucking on hard, sugar-free candy or chewing sugar-free gum. Regular dental check-ups are also recommended.
If you are a parent or caregiver of a child taking this medication, be aware that children may be more susceptible to certain side effects. Use this drug with caution in pediatric patients.
For individuals 65 years or older, this medication should be used with caution, as older adults may be more prone to experiencing side effects.
If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe dry mouth
- Dilated pupils
- Blurred vision
- Flushed, hot, dry skin
- Fever
- Tachycardia
- Urinary retention
- Constipation
- Confusion
- Agitation
- Hallucinations
- Delirium
- Seizures
- Coma
- Respiratory depression
What to Do:
Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Treatment is supportive and may include physostigmine for severe anticholinergic toxicity.
Drug Interactions
Contraindicated Interactions
- Thioridazine (increased risk of severe anticholinergic effects, including paralytic ileus, hyperthermia, and CNS depression)
- Other anticholinergics (additive effects, increased risk of toxicity)
Major Interactions
- Phenothiazines (additive anticholinergic effects, increased risk of tardive dyskinesia)
- Tricyclic antidepressants (additive anticholinergic effects, increased risk of paralytic ileus, hyperthermia)
- MAO inhibitors (additive anticholinergic effects)
- Amantadine (additive anticholinergic effects)
- Digoxin (may increase digoxin levels due to decreased GI motility)
- Potassium chloride (wax-matrix formulations) (increased risk of GI lesions due to delayed transit)
Moderate Interactions
Minor Interactions
- Drugs that cause dry mouth (additive effect)
- Drugs that cause constipation (additive effect)
Monitoring
Baseline Monitoring
Baseline neurological assessment (e.g., tremor, rigidity, dystonia)
Rationale: To establish the severity of symptoms and monitor therapeutic response.
Timing: Prior to initiation of therapy.
Mental status assessment
Rationale: To assess for pre-existing cognitive impairment and monitor for anticholinergic-induced confusion or hallucinations.
Timing: Prior to initiation of therapy.
Ophthalmologic exam (intraocular pressure)
Rationale: To rule out narrow-angle glaucoma, a contraindication.
Timing: Prior to initiation of therapy, especially in at-risk patients.
Routine Monitoring
Efficacy (reduction in extrapyramidal symptoms)
Frequency: Regularly during dose titration and periodically thereafter.
Target: Symptom improvement with tolerable side effects.
Action Threshold: Lack of efficacy or worsening symptoms may require dose adjustment or alternative therapy.
Anticholinergic side effects (e.g., dry mouth, blurred vision, constipation, urinary retention, confusion, hallucinations)
Frequency: Regularly, especially during dose titration.
Target: Minimal to tolerable side effects.
Action Threshold: Severe or intolerable side effects require dose reduction or discontinuation.
Vital signs (heart rate, blood pressure, temperature)
Frequency: Periodically, especially in patients at risk for cardiovascular effects or hyperthermia.
Target: Within normal limits.
Action Threshold: Significant changes may indicate adverse effects.
Bowel and bladder function
Frequency: Regularly.
Target: Normal function.
Action Threshold: Severe constipation or urinary retention requires intervention.
Symptom Monitoring
- Dry mouth
- Blurred vision
- Constipation
- Urinary retention
- Dizziness
- Nausea
- Nervousness
- Confusion
- Hallucinations
- Memory impairment
- Tachycardia
- Hyperthermia (especially in hot weather or during exercise)
Special Patient Groups
Pregnancy
Category C. Use only if the potential benefit justifies the potential risk to the fetus. Limited human data suggest no increased risk of major birth defects, but animal studies show some adverse effects. Neonatal withdrawal symptoms (e.g., irritability, feeding difficulties) have been reported with chronic use of anticholinergics during pregnancy.
Trimester-Specific Risks:
First Trimester:
Limited data, but generally considered low risk for major malformations based on available human data.
Second Trimester:
Limited data, monitor for fetal growth.
Third Trimester:
Potential for neonatal anticholinergic effects or withdrawal symptoms if used close to delivery.
Lactation
L3 (Moderately Safe). Benztropine is excreted into breast milk in small amounts. Monitor the infant for anticholinergic effects (e.g., drowsiness, constipation, urinary retention, dry mouth, decreased feeding). Use with caution, especially in preterm or jaundiced infants.
Infant Risk:
Low to moderate. Potential for drowsiness, constipation, or decreased feeding. Monitor infant closely.
Pediatric Use
Contraindicated in children under 3 years of age due to increased risk of hyperthermia and other adverse effects. Use with extreme caution in older children for drug-induced extrapyramidal symptoms, with careful dose titration and monitoring for adverse effects.
Geriatric Use
Increased sensitivity to anticholinergic effects (e.g., confusion, hallucinations, urinary retention, constipation, dry mouth, blurred vision). Higher risk of falls. Start with lower doses and titrate slowly. Avoid in elderly patients with cognitive impairment or prostatic hypertrophy.
Clinical Information
Clinical Pearls
- Benztropine is particularly useful for drug-induced extrapyramidal symptoms (e.g., dystonia, akathisia, pseudoparkinsonism) caused by antipsychotics.
- It is less effective for tardive dyskinesia and may even worsen it.
- Titrate dose slowly to minimize anticholinergic side effects.
- Advise patients to avoid activities requiring mental alertness until effects are known.
- Educate patients on managing anticholinergic side effects (e.g., sugar-free candies for dry mouth, increased fiber/fluids for constipation).
- Caution patients about the risk of hyperthermia, especially during hot weather or strenuous activity, due to decreased sweating.
Alternative Therapies
- Trihexyphenidyl (another anticholinergic)
- Amantadine (for Parkinsonism and drug-induced EPS)
- Dopamine agonists (e.g., pramipexole, ropinirole for Parkinson's disease)
- Levodopa/Carbidopa (for Parkinson's disease)
- Beta-blockers (e.g., propranolol for akathisia)
- Benzodiazepines (e.g., lorazepam for acute dystonia)
Cost & Coverage
Average Cost:
$10 - $30 per 30 tablets (generic 2mg)
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.