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Cogentin: Learn the Side Effects and Reactions

Cogentin: Learn the Side Effects and Reactions

For those afflicted with Parkinson’s disease (PD), drug-induced abnormal muscle tone that causes spasm and abnormal posture (dystonia), and for those who need to have control over their bodily secretions, such as chronic drooling, healthcare providers can prescribe the medication known as Cogentin. This class of medication is called a synthetic muscarinic-receptor antagonist and is structurally similar to atropine and diphenhydramine (Benadryl), but has a longer duration of action and produces less central nervous system stimulation than certain other drugs in its class.

A receptor antagonist, in this instance, is a chemical that binds to receptor cells and prevents acetylcholine from binding to the receptor cell and producing its mechanism of action. The result is that the neurotransmitter acetylcholine is prevented from producing the symptoms of rigidity, shakiness, and imbalance, and it blocks the production of bodily fluids such as saliva.


What Is Cogentin? 

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Cogentin is a brand name of the drug known as Benztropine Mesylate. This drug belongs in two classes, known as anti-Parkinson's drugs and anti-cholinergic drugs. Parkinsonism is a term to describe a constellation of signs and symptoms found in Parkinson's disease (PD), such as slowness (bradykinesia), stiffness (rigidity), tremor (shakiness), and imbalance (instability of posture). Anti-cholinergic drugs block a neurotransmitter that helps to control functions such as salivation, digestion, urination, and the secretion of mucus; it also decreases involuntary muscle movement.

  • Uses

PD includes an ongoing loss of motor control, bradykinesia, rigidity, tremors, and instability. Parkinsonism is a general term that refers to a group of neurological disorders that cause movement problems similar to those seen in PD. Antipsychotic medications are notorious for producing side effects known as extrapyramidal symptoms. These are serious drug-induced movement disorders that can persist long after the medication is withdrawn.

Developmentally disabled people often have sialorrhea or chronic drooling. Operative patients often require their bodily secretions to be managed during surgery. Cogentin, in its anticholinergic capacity, serves both of these patient populations by its drying effect and by relaxing certain muscles.


Interactions, Reactions, and Side Effects 

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When describing the properties of Cogentin, three terms need to be defined; interaction, reaction, and side effect.



Side Effect


Drug Interactions

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Cogentin has well over 200 established drug and drug-combination interactions, classified as minor, moderate, or major. A minor interaction may occur when, for example, Levodopa and Cogentin are mixed together and the resulting enhanced dopamine effect may actually be beneficial to the patient.

Moderate interactions can occur when antacids such as magnesium hydroxide and Cogentin are mixed together, resulting in the inhibition of the oral absorption of Cogentin.

A major interaction occurs when oral potassium supplements are given with Cogentin; the decrease in gastric-intestinal motility causes an increase in gastric irritation from the potassium.


Adverse Reactions

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Reactions, also known as adverse reactions, are classified as mild, moderate, and severe. They may occur rapidly after the initial dose and can be quite extreme. They may occur early, sometime after the initial dose, or the reactions may be delayed. The incidence of occurrence is unknown for many of the adverse reactions due to Cogentin.




Since an adverse drug reaction is an unwanted and undesirable effect of the medication that occurs during the normally prescribed use of that medication, the patient should not hesitate to contact their healthcare provider should one of these symptoms occur. There are other medications that can be substituted for Cogentin.


Side Effects

  • Drowsiness
  • Dizziness
  • Headache
  • Loss of appetite
  • Nausea
  • Stomach upset
  • Vision changes
  • Sleeplessness
  • Trembling of the hands
  • Numbness in fingers
  • Depression
  • Memory problems
  • Nervousness
  • Excitability
  • Dry mouth
  • Double vision
  • Increased sensitivity to light
  • Muscle spasms
  • Dry eyes

Many of these side effects diminish or go away over time, but they should still be reported to the healthcare provider. If the benefit outweighs the discomfort, then the patient and the healthcare provider can decide together to adjust the dosage, timing, or route of administration, or the medication may be discontinued.



Cogentin is a very useful medication in the treatment of movement disorders and for the management of bodily fluids. It is also prescribed for the treatment of drug-induced disorders of movement. But this is a very serious medication that needs to be treated with respect. This is not the medication to forget or to take whenever one feels ready to take a pill.

If a dose has been missed, and it’s nearly time for the next dose, then the forgotten dose needs to be skipped. An unintentional overdose of Cogentin can cause:

  • Severe headache
  • Severe dizziness
  • Anxiety
  • Confusion
  • Trouble swallowing
  • Overheated skin
  • Dilated pupils
  • Weak pulse
  • Irregular heartbeat
  • Fainting
  • Seizure
  • Cardiac arrest

If the physician did not prescribe Cogentin to be taken as needed when certain symptoms appear, then it needs to be taken as prescribed at the same time every day. It is inconvenient to take such a medication that has so many potential interactions, but there are over 200 drugs and drug-combination interactions that can range from an unexpected benefit to a misadventure that could be lethal.

Patients and even healthcare providers are not expected to remember over 200 drug interaction combinations; that makes it even more important for the patient and the healthcare provider to work together. Patients have to give thought to what they are taking before they swallow a new medication, even over-the-counter preparations.

Since adverse drug reactions are unwanted and undesirable effects of the medication that occur during the normally prescribed use of that medication, hopefully, they will occur early enough in the therapeutic regimen so that the outcome is not so severe as to harm to the patient. The fact that Cogentin has multiple significant adverse reactions is reason enough to call your healthcare provider immediately, rather than deciding for yourself if the symptoms can be self-managed. Cogentin is also not the medication to be left around for children or drug seekers to ingest; this drug, like any medication, can be lethal.

The side effects are the most frequently cited reason for patient complaints. Dry mouth, dry eyes, and constipation are unpleasant. No matter how mild the side effects may be, they still need to be reported to the healthcare provider. If the patient and their provider decide together that the benefits of Cogentin outweigh the discomfort of the side effects, then this medication may be continued after an adjustment to the dosage, timing, or route of administration.

The bottom line is that nobody asks for the disorder that causes them to need Cogentin, but just like diabetes and hypertension, symptoms can be successfully managed. Whether it’s PD, Parkinsonism, drug-induced extrapyramidal symptoms or chronic drooling, a positive solution to the problem begins when the patient believes it is worthwhile to correctly manage their healthcare. By taking Cogentin exactly as prescribed and paying attention to a change in condition or a worsening condition, the interactions, reactions, and side effects of Cogentin may be minimized if not avoided altogether.

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