Used alongside antipsychotic medicines to manage movement side effects.
What it treats
Which conditions is Procyclidine used for?
Overview
What is Procyclidine?
Procyclidine is an anticholinergic medicine used to treat and prevent extrapyramidal side effects caused by first-generation antipsychotic medicines.
It is listed in Kenya's Essential Medicines List 2023 at Level 4-6 and is used in settings where biperiden is not available. Both medicines work through the same mechanism and serve the same clinical purpose.
The movement problems it addresses include drug-induced parkinsonism, acute dystonia, and akathisia.
How it works
What does it do in the brain?
Formulations in Kenya
How is it available?
Availability across Africa
Where is it available in Africa and what is it called?
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Uganda | Kemadrin, Procyclidine (generic) | Available at Butabika Hospital and larger hospitals; used where biperiden is not stocked. |
| South Africa | Kemadrin, Procyclidine (generic) | Available in public sector; used as an alternative anti-EPS agent. |
| Nigeria | Kemadrin | Available at teaching hospitals; often used alongside trifluoperazine and haloperidol. |
| Ghana | Procyclidine (generic) | Available at select hospitals; used when biperiden is unavailable. |
| Tanzania | Procyclidine (generic) | Available at Muhimbili National Hospital pharmacy. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Dry mouth
- Blurred vision
- Constipation
- Difficulty passing urine
- Mild memory and concentration difficulties
- Dizziness
- Mild euphoria at higher doses
- Confusion and delirium in elderly patients
- Severe constipation progressing to bowel obstruction if not managed
- Does not treat tardive dyskinesia, may worsen it. Report new involuntary movements to your doctor.
Who should not take it
Important warnings before starting
- Closed-angle glaucoma
- Benign prostatic hyperplasia causing urinary difficulty
- Severe constipation or bowel obstruction
Special care needed
Situations that need extra attention
- Bowel function must be maintained, report persistent constipation
- Elderly patients are significantly more vulnerable to confusion and anticholinergic effects
- Tell your doctor if you notice any new involuntary repetitive movements
- Regular review of whether procyclidine is still needed
Use only if clearly necessary. Speak to your doctor.
Not recommended. Anticholinergic effects in the infant are possible.
Other medicines
Medicines and substances that can interact with it
- Other anticholinergic medicines: Combined anticholinergic burden increases risk of confusion, constipation, and urinary retention.
- Alcohol: Increases dizziness and sedation.
Tests and follow-up
What your doctor will monitor
- Bowel function at every appointment
- Cognitive state, particularly in elderly patients
- Review of need at every antipsychotic follow-up
Stopping this medicine
What happens if you stop taking it?
In Kenya
What you should know about this medicine in Kenya
Procyclidine serves the same role as biperiden in Kenya, managing antipsychotic-induced movement side effects, and is used where biperiden is not the available option at a given facility.
Both medicines are listed in the KEML 2023 and healthcare workers should be familiar with both, as formulary availability varies by facility and county.
As with biperiden, regular review of the ongoing need for procyclidine should be built into routine psychiatric follow-up care.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.