Kemadrin: Effective Control of Parkinsonian Tremor and Rigidity
| Product dosage: 5mg | |||
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Synonyms | |||
Kemadrin (procyclidine hydrochloride) is a well-established anticholinergic agent specifically formulated for the management of symptoms associated with Parkinson’s disease and drug-induced extrapyramidal symptoms. As a centrally acting muscarinic antagonist, it works by restoring the balance between acetylcholine and dopamine in the basal ganglia, a key area of the brain affected by these conditions. This medication is valued for its targeted action in reducing muscle stiffness, tremor, and spasms, thereby improving motor control and overall quality of life for patients. Its clinical profile is supported by decades of use, making it a reliable choice for neurologists and geriatric specialists in the therapeutic management of parkinsonian syndromes.
Features
- Active ingredient: Procyclidine hydrochloride
- Available in 5 mg tablet formulation
- Selective central anticholinergic activity
- Rapid absorption following oral administration
- Metabolized hepatically with renal excretion of metabolites
- Demonstrated efficacy in both idiopathic and drug-induced parkinsonism
Benefits
- Significantly reduces the severity of resting tremor, aiding in daily activities requiring fine motor skills.
- Alleviates muscle rigidity, leading to improved mobility and a decreased risk of falls.
- Minimizes the occurrence of acute dystonic reactions and other extrapyramidal symptoms caused by antipsychotic medications.
- Enhances overall functional capacity, allowing for greater independence in patients with Parkinson’s disease.
- Provides a predictable pharmacokinetic profile, facilitating dose titration and long-term management.
- Serves as an adjunct therapy, potentially reducing the required dosage of levodopa and mitigating its associated side effects.
Common use
Kemadrin is primarily indicated for the treatment of all forms of parkinsonism, including post-encephalitic, arteriosclerotic, and idiopathic Parkinson’s disease. It is also highly effective in controlling extrapyramidal symptoms that may arise as adverse effects of neuroleptic drugs, such as phenothiazines and butyrophenones. In clinical practice, it is often used either as monotherapy in mild cases or as part of a combination regimen with levodopa in more advanced stages of Parkinson’s disease to optimize symptomatic control.
Dosage and direction
The dosage of Kemadrin must be individualized based on the patient’s response and tolerance. For adults, the initial dose is typically 2.5 mg administered three times daily after meals. This may be gradually increased by 2.5 mg increments every 2–3 days until optimal therapeutic effect is achieved, usually within a range of 15–30 mg daily divided into 3–4 doses. The maximum recommended daily dose is 60 mg. For drug-induced extrapyramidal symptoms, a lower starting dose of 2.5 mg three times daily is advised, with adjustment as necessary. Tablets should be swallowed whole with a full glass of water; crushing or chewing is not recommended.
Precautions
Patients should be advised that Kemadrin may cause dizziness, drowsiness, or blurred vision; therefore, activities requiring mental alertness, such as driving or operating machinery, should be avoided until the individual’s response is known. Use with caution in patients with cardiovascular disease, hypertension, prostate hypertrophy, or gastrointestinal obstruction. Elderly patients are more susceptible to anticholinergic side effects and may require lower doses. Regular monitoring of intraocular pressure is recommended in patients with a history of glaucoma. Abrupt discontinuation should be avoided to prevent rebound cholinergic effects.
Contraindications
Kemadrin is contraindicated in patients with known hypersensitivity to procyclidine hydrochloride or any component of the formulation. It must not be used in individuals with narrow-angle glaucoma, myasthenia gravis, obstructive disease of the gastrointestinal tract (such as paralytic ileus), or significant urinary retention. Concomitant use with other anticholinergic agents is not advised due to the increased risk of adverse effects.
Possible side effect
Common side effects include dry mouth, blurred vision, constipation, nausea, and dizziness. These are often dose-dependent and may diminish with continued therapy. Less frequently, patients may experience urinary retention, tachycardia, confusion, hallucinations, or exacerbation of glaucoma. In elderly patients, there is an increased risk of cognitive impairment or delirium. Any persistent or severe side effects should be reported to a healthcare provider promptly.
Drug interaction
Kemadrin may interact with other drugs possessing anticholinergic properties (e.g., tricyclic antidepressants, antihistamines, antipsychotics), potentially leading to additive effects and increased side effects. It can reduce the gastrointestinal absorption of levodopa; administering these medications at least 1–2 hours apart is recommended. Concurrent use with amantadine may enhance anticholinergic adverse effects. Kemadrin may also diminish the effects of metoclopramide and other prokinetic agents.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed one is not advised, as it may increase the risk of side effects.
Overdose
Symptoms of overdose may include severe central nervous system disturbances (e.g., agitation, confusion, seizures), tachycardia, hypertension, hyperthermia, and respiratory depression. Management is primarily supportive and symptomatic, including gastric lavage if ingestion was recent, administration of activated charcoal, and use of physiostigmine salicylate as an antidote in severe cases under strict medical supervision. Immediate medical attention is required.
Storage
Store Kemadrin tablets at room temperature (15–30°C), in a tightly closed container, and protect from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or altering any medication regimen. Individual patient needs and responses may vary.
Reviews
“After starting Kemadrin, my father’s tremor reduced noticeably within two weeks. His ability to feed himself has improved, and he experiences fewer stiffness-related discomforts.” – Caregiver of a 72-year-old patient with Parkinson’s disease.
“As a neurologist, I find Kemadrin to be a reliable option for managing drug-induced parkinsonism, especially in patients on long-term antipsychotics. Dose titration is straightforward, and tolerability is generally good.” – Dr. A. Smith, MD.