[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antiparkinson anticholinergics](https://durgical.com/en/pharmacology/classes/antiparkinson-anticholinergics/) › Benzatropine

[Pharmacology](https://durgical.com/en/pharmacology/) · [Antiparkinson anticholinergics](https://durgical.com/en/pharmacology/classes/antiparkinson-anticholinergics/)

# Benzatropine

A central anticholinergic used for drug-induced dystonia and parkinsonism and for Parkinson tremor. Older adults tolerate it poorly.

Updated 2026-11-01

- Class: [Antiparkinson anticholinergics](https://durgical.com/en/pharmacology/classes/antiparkinson-anticholinergics/)
- Receptor: Muscarinic acetylcholine receptors (M1 shown)
- ATC code: N04AC01

Also called: Benztropine, Benztropina

◎**Muscarinic acetylcholine receptors (M1 shown)**Benzatropine

ⓘ The figure shows tiotropium, another muscarinic antagonist, in the human M1 receptor; benzatropine blocks the same acetylcholine binding site.

**Target in 3D:** Muscarinic acetylcholine receptors (M1 shown). PDB structure 5CXV (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5CXV) · Drag to rotate · pinch to zoom

## Mechanism of action

Benzatropine blocks muscarinic acetylcholine receptors in the striatum, where cholinergic interneurons become overactive when dopamine is low. It also has antihistamine activity, but only the anticholinergic effect matters for parkinsonism.

- Low dopamine leaves striatal acetylcholine unopposed
- Benzatropine blocks muscarinic receptors in the brain
- The dopamine-acetylcholine balance is partly restored
- Tremor, rigidity and acute dystonia ease

## Pharmacokinetics

**Absorption**
Given by mouth; injectable forms are used for acute dystonia

**Distribution**
Lipid-soluble tertiary amine that enters the brain

## Indications

- Adjunct in all forms of parkinsonism [Parkinson disease →](https://durgical.com/en/conditions/parkinson-disease/)
- Drug-induced extrapyramidal disorders (acute dystonia, parkinsonism), not tardive dyskinesia [Antipsychotic-induced movement disorders (dystonia, akathisia, parkinsonism, tardive dyskinesia) →](https://durgical.com/en/conditions/antipsychotic-induced-movement-disorders/)

## Adverse effects

### Common

- Dry mouth, blurred vision, constipation
- Difficulty urinating
- Reduced sweating (anhidrosis)
- Sedation, confusion and excitement, more in older people

### Serious (rare, important)

- Heat stroke and hyperthermia, sometimes fatal, especially with antipsychotics or tricyclics in hot weather
- Paralytic ileus
- Urinary retention
- Delirium and psychotic symptoms

## Contraindications

- Children under three years of age
- Angle-closure glaucoma (avoided)
- Tardive dyskinesia (not recommended; may worsen it)
- Hypersensitivity to benzatropine

## Key interactions

**Phenothiazines, haloperidol, tricyclic antidepressants**
Additive anticholinergic effects: paralytic ileus, hyperthermia, heat stroke

**Other anticholinergics (antihistamines, bladder antimuscarinics)**
Higher anticholinergic burden: confusion, retention, constipation

**Alcohol and other sedatives**
More drowsiness

## What is monitored

- Mental state and cognition, especially in older adults
- Bowel movements, urination and temperature in hot weather
- Vision changes or eye pain (glaucoma)

## Administration and safety

- Oral tablets; an injectable form is used in hospital for acute dystonic reactions
- Withdrawn gradually to avoid rebound parkinsonism

## Nursing care

- Screen older adults for confusion, constipation and urinary retention
- Teach to avoid overheating and to drink fluids in hot weather or heavy work
- Warn about drowsiness before driving
- Report eye pain, fever or abdominal distension promptly

## Pregnancy and breastfeeding

Safe use in pregnancy has not been established.

## Memory aid

Anticholinergic signs: «dry as a bone, red as a beet, hot as a hare, blind as a bat, mad as a hatter» – and in older adults, «full as a flask» (urinary retention).

## Test yourself

Think of the answer, then tap the question to see it.

## Why is benzatropine usually avoided in people over 65?

It is less safe than alternatives: confusion, delirium, urinary retention, constipation and falls.

## Which antipsychotic movement disorder does benzatropine treat, and which does it not?

It treats acute dystonia and drug-induced parkinsonism; it does not treat tardive dyskinesia.

## Which dangerous effect can occur in hot weather with benzatropine plus an antipsychotic?

Heat stroke and hyperthermia, because sweating is reduced.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/benzatropine/)

## Related drugs

- [Trihexyphenidyl](https://durgical.com/en/pharmacology/trihexyphenidyl/)
- [Biperiden](https://durgical.com/en/pharmacology/biperiden/)
- [Levodopa + carbidopa](https://durgical.com/en/pharmacology/levodopa-carbidopa/)

## Related conditions

- [Parkinson disease](https://durgical.com/en/conditions/parkinson-disease/)
- [Antipsychotic-induced movement disorders (dystonia, akathisia, parkinsonism, tardive dyskinesia)](https://durgical.com/en/conditions/antipsychotic-induced-movement-disorders/)

[← Back to the class: Antiparkinson anticholinergics](https://durgical.com/en/pharmacology/classes/antiparkinson-anticholinergics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - BENZTROPINE MESYLATE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c19664aa-a797-4192-b5f3-e906a7cac048) (DailyMed (U.S. National Library of Medicine), 2026); [Benztropine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a682155.html) (MedlinePlus (U.S. National Library of Medicine), 2018); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 28 (McGraw Hill, 2025).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/benzatropine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/benzatropine/