Cyclid 5

Indications

Cyclid is indicated as an adjunctive therapy for all forms of parkinsonian syndrome. It is primarily used to alleviate symptoms of idiopathic parkinsonism (paralysis agitans), post-encephalitic parkinsonism, and arteriosclerotic parkinsonism. Additionally, Cyclid helps manage troublesome extrapyramidal symptoms, including pseudoparkinsonism, acute dystonic reactions, and akathisia, often caused by neuroleptic medications like phenothiazine derivatives.

Always consult a registered healthcare professional before use.

Pharmacology

Procyclidine hydrochloride is an antimuscarinic agent specifically designed to treat parkinsonism with relatively low toxicity. As a synthetic tertiary amine, it alleviates parkinsonian symptoms by addressing the cholinergic excess that arises from dopamine deficiency. Procyclidine is rapidly absorbed from the gastrointestinal tract and quickly clears from tissues. After intravenous administration, its effects begin within 5 to 20 minutes and last up to 4 hours.

Dosage & Administration

Tablets: Administer orally, preferably after meals.

• Parkinsonism: Start with 2.5 mg three times daily, increasing to 5 mg three times daily, and occasionally 5 mg at bedtime. Adjust dosage based on tolerance, up to a maximum of 20 to 30 mg per day divided into 3 to 4 doses.
• Drug-Induced Extrapyramidal Symptoms: Begin with 2.5 mg three times daily, increasing by 2.5 mg per day as needed and tolerated.

IM or IV Injection: Administer 5-10 mg, with repeat doses as needed after 20 minutes, not exceeding a total of 20 mg daily.

Always consult a registered healthcare professional before use.

Interactions

Procyclidine’s anticholinergic effects may be amplified when used with other anticholinergic agents, such as amantadine. Additionally, coadministration with procyclidine may decrease the absorption of ketoconazole.

Contraindications

Caution is advised when administering Cyclid to children and elderly patients. It should also be used with care in individuals with diarrhea, cardiovascular diseases, glaucoma, urinary retention, and liver or kidney impairment. The safety of procyclidine during pregnancy is not established, and there is no data regarding its excretion in breast milk.

Side Effects

At standard dosages, dryness of the mouth is the most common side effect. Other potential side effects include mydriasis, blurred vision, and gastrointestinal disturbances (nausea, vomiting, epigastric discomfort, constipation). Allergic reactions, muscular weakness, dizziness, confusion, and hallucinations may occur, especially at higher doses. These adverse effects can often be mitigated by adjusting the dosage and administering the medication after meals.

Pregnancy & Lactation

The use of Cyclid during pregnancy and lactation should only be considered if the potential benefits outweigh any risks to the mother and child.

Precautions & Warnings

Special precautions should be taken in patients with hepatic or renal impairment, children, the elderly, and during pregnancy and lactation. Individuals with mental health disorders may experience a worsening of psychotic symptoms when using Cyclid for managing extrapyramidal side effects. Abrupt discontinuation of Cyclid should be avoided, as it may lead to rebound symptoms of parkinsonism.

Use in Special Populations

Pediatric Use: The safety and efficacy of Cyclid have not been established in children, necessitating careful consideration of the potential benefits and risks before use.

Therapeutic Class

Antiparkinsonian drugs

Storage Conditions

Store below 25°C, protected from light and moisture. Keep out of reach of children.