Key facts
- Type: Anticholinergic Medicine · Anti-EPS Agent / Antiparkinsonism
- ATC Code: N04AA04
- Kenya EML 2023: Listed
- Level of Use: Level 4-6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Prescription Only Medicine
Used alongside antipsychotic medicines to manage movement side effects.
What it treats
Which conditions is Procyclidine used for?
Drug-induced movement side effects (EPS) · Drug-induced Parkinsonism
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?
Antipsychotic medicines reduce dopamine activity, causing the movement control pathways to become imbalanced, with acetylcholine becoming relatively overactive. Procyclidine blocks acetylcholine receptors, correcting this imbalance and relieving the movement problems that result.
Formulations in Kenya
How is it available?
Tablet 5 mg Taken by mouth Available at Level 4 to 6
Injection 5 mg/mL Given by healthcare professional Available at hospital level
Availability across Africa
Where is it available in Africa and what is it called?
Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
| 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
Go to a doctor or emergency room straight away if you notice any of the following.
- 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
Tell your doctor about all your medical conditions, allergies, and other medicines before starting Procyclidine.
- 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
Pregnancy
Use only if clearly necessary. Speak to your doctor.
Breastfeeding
Not recommended. Anticholinergic effects in the infant are possible.
Other medicines
Medicines and substances that can interact with it
Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
- 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?
Can generally be tapered gradually when antipsychotic doses are reduced or movement side effects have resolved.
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.