Kemadrin

How does it work?

Kemadrin tablets and injection contain the active ingredient procyclidine hydrochloride, which is a type of medicine called an anticholinergic. (NB. Procyclidine is also available without a brand name, ie as the generic medicine.) Anticholinergic medicines (sometimes also called antimuscarinics) work by preventing the activity of a neurotransmitter called acetylcholine.

Neurotransmitters are chemical compounds that are found in the brain and nerves. They act as chemical messengers between the nerve cells. There are many different neurotransmitters in the body and these have various different functions. Several diseases and conditions involve either overactivity or underactivity of certain neurotransmitters.

In Parkinson’s disease, there is a deficiency of a neurotransmitter called dopamine in the brain. Normally there is a balance between the activity of dopamine and the activity of acetylcholine in the brain. However, in Parkinson's disease, the deficiency of dopamine causes overactivity of acetylcholine. This causes some of the symptoms of the disease.

Procyclidine works by blocking the receptors that acetylcholine acts on. This reduces the activity of the acetylcholine, and helps restore the balance of acetylcholine and dopamine in the brain. In this way, procyclidine helps control some of the symptoms of Parkinson's disease. It is most effective at reducing the tremor and rigidity associated with the disease, but it has little effect on the slow movements (bradykinesia).

By contrast, some psychiatric illnesses, for example schizophrenia, are associated with overactivity of dopamine in the brain. Antipsychotic medicines that are used to treat these diseases work by decreasing the activity of dopamine in the brain. However, because they decrease dopamine they can produce side effects that resemble the symptoms of Parkinson's disease. These side effects are known as extrapyramidal side effects, and include abnormal face and body movements, restlessness and tremor. Procyclidine can be used to treat this type of side effect.

What is it used for?

Parkinson's disease

Reducing the "extrapyramidal" side effects of antipsychotic medicines, for example, tremor, restlessness, or involuntary face and body movements.

Warning!

This medicine may cause various side effects, such as blurred vision, dizziness or confusion, that may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

You should not suddenly stop taking this medicine, unless your doctor tells you otherwise, as this could cause your symptoms to come back.

This medicine can normally be used effectively and uneventfully in combination with antipsychotic medicines, to treat the extrapyramidal side effects of the antipsychotic. However, on rare occasions, it may worsen the abnormal body movements. Tell your doctor if you get any new or worsening involuntary movements of your tongue, face, arms or legs after you start taking this medicine.

The combination of procyclidine and an antipsychotic medicine may on rare occasions increase the risk of getting heat stroke in hot and humid conditions. This is because antipsychotic medicines can sometimes interfere with the body's ability to control body temperature, and both medicines may reduce sweating.

Use with caution in

Elderly people

Decreased kidney function

Decreased liver function

People at risk of glaucoma

People at risk of obstruction of the stomach or intestines, eg due to severe constipation

Men with difficulty passing urine

People taking antipsychotic medicines who are suffering from or are predisposed to tardive dyskinesias (rhythmical involuntary movements of the tongue, face, mouth and jaw, which may sometimes be accompanied by involuntary movements of the arms and legs).

Not to be used in

Closed angle glaucoma

Obstruction of the stomach or intestines

Untreated difficulty in passing urine (urinary retention)

This medicine is not recommended for children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. It's safety for use during breastfeeding has not been established. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Dry mouth

Blurred vision

Constipation

Difficulty in passing urine (urinary retention)

Nausea and vomiting

Inflammation of the gums (gingivitis)

Nervousness

Rash

Dizziness

Confusion

Impaired memory or concentration

Disorientation

Agitation

Anxiety

False perceptions of things that are not really there (hallucinations)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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