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Biperiden is an antiparkinsonian agent of the anticholinergic type. The original brand name - still existing - is Akineton®, manufactured by BASF/Knoll Pharma. Generics are available worldwide.
Additional recommended knowledge
The oral bioavailability is only 33 +/- 5% due to extensive first-pass metabolization. In young, healthy volunteers peak plasma concentrations following an oral single dose of 4mg in immediate release form are reached after 1.5 hours. The elimination half-life has been determined as 18.4 hours, and may be prolonged in geriatric patients. After IV dosing of 4mg the elimination half-life is approximately 24 hours.
Biperiden has an atropine-like blocking effect on all peripheral structures which are parasympathetic-innervated (e.g. cardiovascular and visceral organs). It also has a prominent central blocking effect on M1 receptors.
Biperiden is used for the adjunctive treatment of all forms of Parkinson's disease (postencephalitic, idiopathic, and arteriosclerotic). It seems to exert better effects in the postencephalitic and idiopathic than in the arteriosclerotic type. Biperiden is also commonly used to improve parkinsonian signs and symptoms related to antipsychotic drug therapy. It relieves muscle rigidity, reduces abnormal sweating and salivation, improves abnormal gait, and to lesser extend, tremor.
Contraindications and cautions
Special patient groups
Pregnancy and lactation
Children and adolescents aged 1 year and older may be treated. The clinical experience is mainly on the shortterm treatment of acute drug induced dystonic reactions. Doses should be reduced according to the weight of the patients.
Dose-dependent side effects are frequent. Particularly geriatric patients may react with confusional states or develop delirium.
Strictly individual. Oral, and in some countries, IV and IM use is possible. The usual oral daily doses are between 2 and 16mg. If possible, patients should be started with a low initial dose which is increased slowly.
Biperiden mimics an atropine intoxication with mydriasis, dryness of mucous membranes, red face, atonic states of bowels and bladder, and hyperthermia in high doses. Central consequences are agitation, confusion, and hallucinations. An untreated overdose may be fatal, particular in children. Premortal signs are respiratory depression and cardiac arrest. A specific antagonist is physostigmine which combines a peripheral and a central action. Carbachol can be used to treat atonic bowels and bladder. The vital functions should be monitored and stabilized. It may be necessary to treat hyperthermia with cooling blankets.
Biperiden was synthesized by the German chemist W. Klavehn from Knoll AG, Germany. In March 1953 a patent was applied for in Germany and subsequently in many other countries.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Biperiden". A list of authors is available in Wikipedia.