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Saraswati Vihar, Delhi

INDICATIONS: Benzhexol is used for the symptomatic control of all forms of Parkinsonism, including the postencephalitic arteriosclerotic, and idiopathic types. It favourably influences rigidity and akinesia in the majority of patients. Tremor is generally improved also, but in some instances of severe rigidity, the tremor may be accentuated when the rigidity is diminished. Benzhexol favourably effects mood and reduces salivation. DOSAGE AND DIRECTIONS FOR USE: Dosage should be individualised. The initial dose should be low and then increased gradually especially in elderly patients. It is usually given in 3 or 4 divided doses daily before or with food. The initial dose of 1 or 2 mg a day is gradually increased to 6 to 10 mg a day according to the condition of the patient; for advanced cases, 15 mg or more may be needed daily.Treatment should never be terminated suddenly and it is usual when changing from one drug to another, to withdraw the one in small amounts while gradually increasing the dose of the other. SIDE-EFFECTS AND SPECIAL PRECAUTIONS: 5 to 10% of patients cannot tolerate fully effective doses. Side-effects such as dry mouth and blurred vision are not uncommon. Dizziness, mild nausea or nervousness may be experienced by 30 to 50 per cent of patients on benzhexol.The reactions may be less pronounced as treatment continues. Suppurative parotitis skin rashes dilation of the colon, paralytic ileus, and delusions and hallucinations occur rarely. Patients with arteriosclerosis or with idiosyncrasy may show mental confusion, agitation nausea and vomiting. Potential side-effects associated with the use of any atropine-like drugs include constipation, drowsiness, urinary hesitancy or retention, tachycardia, dilation of the pupil, increased intra-ocular tension, weakness, and headache. Occasionally giddiness and staggering occurs. Large doses may cause cerebral stimulation.