Tricalm 2 | 10'S

✔️ Side Effects

• Dry mouth, blurred vision, dizziness, nausea, nervousness
• Constipation, urinary retention, drowsiness
• Tachycardia, pupil dilation, confusion, memory impairment
• Hallucinations, paranoia, psychosis
• Suppurative parotitis, paralytic ileus, skin rashes
• Exacerbation of glaucoma (can lead to blindness)
• Neuroleptic Malignant Syndrome (on abrupt withdrawal)

✔️ Dosage & Administration

Individualized dosing – start low and increase gradually, especially in elderly patients.

Idiopathic Parkinsonism: Usually 6–10 mg/day (may go up to 12–15 mg in some cases).

Drug-induced Parkinsonism: 5–15 mg/day (starting from 1 mg; adjust as needed).

With Levodopa: Typically 3–6 mg/day in divided doses; both drugs may need dose reduction.

Best tolerated when divided into 3 doses with meals (higher doses may be split into 4).

Avoid abrupt withdrawal – may trigger worsening Parkinsonism or Neuroleptic Malignant Syndrome (NMS).

Not established for use in children.

✔️ Contraindications

Hypersensitivity to trihexyphenidyl.

Narrow-angle glaucoma (risk of blindness).

✔️ Drug Interactions

Additive CNS depression: Alcohol, barbiturates, opioids, cannabinoids.

Enhanced anticholinergic effect: Tricyclic antidepressants, MAO inhibitors.

Concomitant use with neuroleptics ↑ risk of tardive dyskinesia.

With levodopa → may require dose adjustment due to increased involuntary movements.

✔️ Pregnancy & Lactation

Limited safety data in pregnancy; use only if benefit outweighs risk.

May suppress lactation; caution if used in breastfeeding mothers.

✔️ Precautions & Warnings

• Monitor intraocular pressure before and during therapy (risk of angle-closure glaucoma).
• Use cautiously in hot climates or patients with impaired sweating → risk of severe hyperthermia.
• Caution in the elderly, alcoholics, and patients with CNS disease.
• May cause anhidrosis (absence of sweating) → reduce dose if symptoms occur.
• Avoid abrupt discontinuation to prevent NMS.

✔️ Storage:

Store below 30°C, in a dry place, protected from light.

Keep out of reach of children.