Orphenadrine Hydrochloride

Registered South African indications: 

• Parkinsonism
• Pre-Parkinsonism
• Neuroleptic syndrome
• Senile and pre-senile depression

Contraindications 

• Hypersensitivity to the active ingredient or any of its excipients
• Glaucoma
  - Closed-angle glaucoma and patients with a narrow-angle between the iris and the cornea
• Porphyria
• Prostatic enlargement
• Paralytic ileus
• Pyloric stenosis
• Should be used with caution in conditions characterised by tachycardia, such as thyrotoxicosis, cardiac insufficiency or failure, and in cardiac surgery

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Cardiovascular disease
• Micturition difficulty
• History of drug abuse
• Thyrotoxicosis
• Cardiac surgery
• Abrupt withdrawal
• Galactose intolerance
• Lapp-lactase deficiency  
• Glucose-galactose malabsorption

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

Parkinsonism

• Oral (tab): 50-100mg, 6-8hrly; Max: 400mg/24hrs

Neuroleptic malignant syndrome

• Oral (tab): 150mg, 8hrly

Pre-Parkinsonism
Senile and pre-senile depression

• Oral(tab): 50mg,12hrly

See additional prescribing point

Not established for use in children

Pregnancy

• Caution
• There is inadequate evidence of safety in human pregnancy, and, although it has been widely used for many years without apparent ill consequence, if considered necessary orphenadrine should be used with caution during pregnancy. Animal studies have not revealed any hazard

Breastfeeding

• Caution
• It is probably excreted in milk during lactation. Although the quantity is unlikely to be significant at normal therapeutic doses, if considered necessary orphenadrine should be used with caution during breastfeeding

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended

Porphyria Information

• Porphyrinogenic (P)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Euphoria
• Insomnia
• Dizziness
• Nervousness

Cardiovascular Disorders

• Tachycardia

Gastrointestinal Disorders

• Dry mouth
• Gastrointestinal disturbances

Genitourinary Disorders

• Micturition disturbances

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity

Sensory Disorders

• Disturbance of visual accommodation

• Amantidine
• Antidepressants
• Antihistamines
• Disopyramide
• Phenothiazines  
• Ketoconazole
• Metoclopramide

None routine 

Often overused by clinicians to potentially minimise parkinsonism that occasionally develops on neuroleptic agents. It is occasionally noted to have a mild effect of euphoria. Patients are documented to become addicted to it.

Orphenadrine hydrochloride is a centrally-acting anticholinergic. Its site of action is the ventro-caudal region of the diencephalon. This action results in its ability to alleviate the symptoms of Parkinsonism and similar conditions. It also has mild euphoriant actions.

Tablet 50mg

• Disipal (iNova) originator
• Phenerine (Pharmacare)