neobookRx
DrugsLevel 4 LocalisationS4INJ · TABEML

Biperiden

AnticholinergicAntiparkinson agent

Indications

Registered South African indications: 

  • Acute dystonic reaction
  • Parkinsonism

Cautions

Contraindications

  • Hypersensitivity to the active ingredient or any of its excipients
  • Closed angle glaucoma
  • Mechanical stenoses in the gastrointestinal tract
  • Megacolon

Cautions

  • Pregnancy
  • Breastfeeding
  • Severe renal impairment
  • Severe hepatic impairment
  • Elderly
  • Cerebroarteriosclerosis
  • Prostatic adenoma
  • Conditions associated with significant tachycardia
  • In patients who show an increased tendency to seizures
  • May impair ability to drive and operate machinery

Adult dosage

Forms avail. in SA and covered in this monograph: tab, inj

Acute dystonic reaction

  • IM: 2-10mg

Parkinsonism

  • Oral (tab): Initial: 1mg, 12hrly; Maintenance: 1-4mg, 6-8hrly
  • IM/IV: 10-20mg/day, in divided doses

Use in Parkinsons is limited by significant anticholinergic side effects

Paediatric dosage

Paed. forms avail. in SA and covered in this monograph: inj, tab

Acute dystonic reaction 
- Secondary to haloperidol

  • IM/IV: 0.05-0.1mg/kg
    Refer to sedation of acutely disturbed child or adolescent awaiting psychiatric evaluation: EML, 2013

- Secondary to neuroleptic poisoning

Younger than 1 year

  • IV: 1mg
    Refer to neuroleptic poisoning: EML, 2013

Between 1-6 years

  • IV: 2mg
    Refer to neuroleptic poisoning: EML, 2013

Between 6-10 years

  • IV: 3mg
    Refer to neuroleptic poisoning: EML, 2013

IV to be given slowly

Special populations

Pregnancy

  • Caution
  • No animal studies have been conducted. Consider use of biperiden during pregnancy only after assessment of the benefits of treatment to the mother over potential risks to the foetus

Breastfeeding

  • Caution
  • It is not known whether biperiden is excreted in breast milk. Caution should be exercised when biperiden is administered to breastfeeding women

Renal Impairment

Hepatic Impairment

Elderly

Porphyria Information

Drugs in Sport

  • Permitted - No warnings

Adverse reactions

Central Nervous System Disorders

  • Dizziness
  • Fatigue
  • Vertigo
  • Restlessness
  • Confusion
  • Psychosis

Cardiovascular Disorders

  • Tachycardia
  • Hypotension

Gastrointestinal Disorders

  • Dry mouth
  • Gastric upset

Sensory Disorders

  • Accommodation disorders

Interactions

  • Alcohol
  • Other anti-parkinsonism agents
  • Quinidine antidepressants
  • Tricyclic antidepressants

Monitoring

None routine

Prescribing points

Injection - EML 1 (Primary)

Tablets - EML 2 (Hospital)

Mechanism of action

Biperiden is a competitive antagonist of acetylcholine at cholinergic receptors in the corpus striatum.

Dosage forms

  • Injection
  • Tablet

Formulation

Tablet 2mg

  • Akineton (Pharmaco) originator
  • Lennon Biperiden (Pharmacare)

Injection (per ml) 5mg

  • Akineton (Pharmaco) originator

References

1. SAMF_12th Edition_Page 465 2. https://drive.google.com/drive/folders/1ou2f57f7QThpSul3467U_ik2t70Ace-K (01/09/1990_Pharmaco_Akineton_tab, inj) 3. https://www.uptodate.com/contents/biperiden-international-drug-information-concise?source=search_result&search=biperiden&selectedTitle=1~7 4. https://www.drugs.com/pregnancy/biperiden.html 5. NAPOS The Drug Database for Acute Porphyria: N04AA02 Biperiden; Accessed online 13 Sep 2018 [http://www.drugs-porphyria.org/languages/UnitedKingdom/s3.php?l=gbr&atc_code=N04AA02] 6. South African Institute for Drug-Free Sport: Akineton Tablets, Injection; Accessed online 13 Sep 2018 [http://www.drugfreesport.org.za/online-medication-check/] 7. Clinical Pharmacologist - Dr. M Irhuma. 7.1 Brocks DR. Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective. J Pharm Pharm Sci. 1999;2(2):39-46. 7.2 Bellman MH. Treatment of phenothiazine drug intoxication with benztropine. Arch Dis Child.1974;49(8):664-665 8. AfriTox: Biperiden; Accessed online: 12 August 2021 [https://www.afritox.co.za/single-toxins/1160/] **No SPC available **U2D - no info special pops

Brands & products

5 products · stale NAPPI snapshot · refreshed 5/29/2026 · 158 days old

tabletGeneric· 4 products

from R1.53/unit
ProductStrengthPackSchedSEPUnitDisp feeNAPPI
Lennon Biperiden Hcl2 mg500S4R762.96R1.53R196.71713209001
Akineton2 mg500S4R2915.81R5.83R374.25701491027
Akineton2 mg100S4R695.05R6.95R186.71701491028
Akineton2 mg50S4R385.40R7.71R131.23701491019

injectionGeneric· 1 product

from R104.59/unit
ProductStrengthPackSchedSEPUnitDisp feeNAPPI
Akineton ampoule 1ml5 mg/ml1S4R522.96R104.59R161.40701505001
Trade names (2)
  • Akineton
  • Lennon Biperiden

Medical aid coverage

data not yet integrated
Discovery Health
not yet integrated
  • Comprehensive Series—
  • Executive Plan—
  • KeyCare Series—
  • Priority Series—
  • Saver Series—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

Bonitas Medical Fund
not yet integrated
  • BonClassic—
  • BonComprehensive—
  • BonEssential—
  • BonFit Select—
  • BonSave—
  • BonStart—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

GEMS — Government Employees Medical Scheme
not yet integrated
  • Beryl—
  • Emerald—
  • Onyx—
  • Ruby—
  • Sapphire—
  • Tanzanite One—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

POLMED — Police Medical Aid Scheme
not yet integrated
  • Aquarium Option—
  • Efficiency Option—
  • Marine Option—

Formulary scraper pending — coverage tier, co-pay and authorisation requirements will appear here once data is ingested.

Interacts with 1 known drugs

Check against other drugs →

Cited in 10 documents

NeoHealth® ID 14521 · updated 5/16/2024