Trihexy 2mg/5ml Syrup

✔️ Uses of Trihexy Syrup

Treatment of Parkinson's disease

✔️ How does Trihexy Syrup work?

Trihexy Syrup improves muscle control and reduces stiffness, thereby helps the muscles move naturally. 

✔️ Side Effects of Trihexy Syrup

• Nausea
• Vomiting
• Dizziness
• Constipation
• Weakness
• Headache
• Dry mouth
• Decreased urination
• Drowsiness
• Feeling nervous or restless

✔️ Quick Suggestions:

• Dry mouth may occur as a side effect. Frequent mouth rinses, good oral hygiene, increased water intake, and sugarless candy may help.
• It may cause dry eyes. Avoid wearing contact lenses and inform your doctor if it bothers you.
• It may cause dizziness and sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
• Monitoring of intraocular pressure is required while taking this medicine, as an increase in eye pressure may cause blurry vision.
• Take special care with your dental hygiene while using Trihexy Syrup (like brushing, and flossing), and have regular dental check-ups.
• Inform your doctor if you suffer from glaucoma or if you have trouble passing urine.

✔️ Indication of Trihexy Syrup

Trihexy has a direct inhibitory effect on the parasympathetic nervous system and also relaxes smooth muscles, both through direct action on muscle tissue and by inhibiting the parasympathetic system.

✔️ Pharmacology

Trihexyphenidyl is a non-selective muscarinic acetylcholine receptor antagonist, with a higher affinity for the M1 subtype. In vivo, studies show it binds more readily to central muscarinic receptors in the cerebral cortex than peripheral ones. Other studies suggest Trihexyphenidyl may influence nicotinic acetylcholine receptor signaling, indirectly enhancing dopamine release in the striatum. Though useful in treating Parkinson’s disease and movement disorders, its full mechanism of action remains unclear.

✔️ Dosage & Administration of Trihexy Syrup

Trihexyphenidyl should be taken with food, ideally during meals. If dry mouth occurs, take the medication before meals; if drooling or nausea occurs, take it after meals. It is important to take the medication at the same time each day.

Adult Dosage

• Drug-induced extrapyramidal symptoms: 5-15 mg per day, administered orally in divided doses every 6-8 hours.
• Parkinson's Disease: Start with 1 mg daily, increasing the dose gradually by 2 mg every 3-5 days until a daily dose of 6-10 mg is reached, divided into 3-4 doses.
  • Maintenance: 5-15 mg per day, divided into doses every 6-8 hours.
• Parkinsonism: 5-15 mg per day, divided into doses every 6-8 hours.
• Elderly patients: May require lower doses.

Pediatric Dosage

Safety and efficacy in children have not been established.

Overdose Effects

Doses up to 300 mg of Trihexyphenidyl have been taken without fatal consequences, but rare deaths have occurred when combined with CNS depressants or in patients with compromised respiratory conditions. Symptoms of overdose include signs of parasympathetic blockade and neuropsychiatric disturbances. Treatment involves symptomatic management, gastric lavage, and CNS depressant therapy.

✔️ Interaction

Cannabinoids, barbiturates, opiates, and alcohol may enhance the effects of Trihexy, creating the potential for abuse. Combining Trihexy with CNS depressants like alcohol may increase sedation. Anticholinergic effects can be intensified by monoamine oxidase inhibitors and tricyclic antidepressants. It is not recommended to use prophylactic anticholinergics to prevent drug-induced Parkinsonism during neuroleptic therapy, as this may increase the risk of tardive dyskinesia. The dosage of Trihexyphenidyl or levodopa may need adjustment during concurrent use, as involuntary movements may increase.

✔️ Contraindications

Trihexyphenidyl is contraindicated in patients with hypersensitivity to the drug and those with narrow-angle glaucoma. Blindness due to long-term use in narrow-angle glaucoma patients has been reported.

✔️ Pregnancy & Lactation

There is limited data on Trihexyphenidyl use during pregnancy. It should only be used if the potential benefit to the mother outweighs the risks. It is not known if the drug is excreted in human milk, but caution is advised when administering it to nursing mothers, as it may suppress lactation.

✔️ Precautions & Warnings

Patients starting on Trihexy should undergo a gonioscopy to assess the risk of narrow-angle glaucoma and be monitored for increased intraocular pressure. Caution is advised in hot weather or with conditions that affect sweating, as anhidrosis and fatal hyperthermia have been reported. Gradual withdrawal of the drug is essential to avoid neuroleptic malignant syndrome (NMS).

✔️ Storage:

Store in a dry place at temperatures below 30°C, away from light.