• Active Ingredient: Procyclidine
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What is Osnervan?

The active ingredient of Osnervan brand is procyclidine. The originating document has been archived. We cannot confirm the completeness, accuracy and currency of the content.

Used for

Osnervan is used to treat diseases such as: Extrapyramidal Reaction, Parkinsonism.

Side Effect

Possible side effects of Osnervan include: ; ; ; ; .

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procycl >(redirected from Osnervan hydrochloride) Also found in: Thesaurus, Medical, Wikipedia.

Anticholinergic agents

Anticholinergic medication is used in order to redress the dopamine–acetylcholine imbalance that may develop in the parkinsonian striatum. Dopamine exerts an inhibitory effect on striatal cholinergic cells. Its loss leads to cholinergic hyperactivity. Antimuscarinic agents, such as benzhexol, benztropine, Osnervan and orphenadrine, are particularly effective in reducing tremor. They produce only minor improvement in bradykinesia. Their side effects include dry mouth, difficult micturition, constipation and confusion. Their use is problematic in the elderly.


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Osnervan uses

Osnervan is used to reduce the side effects of antipsychotic drugs given for the treatment of schizophrenia.

It is also used in patients with parkinsonism and akathisia and so Osnervan is also a second-line drug for the treatment of Parkinson’s disease. It improves tremor but not bradykinesia or rigidity.

Osnervan is also sometimes used for the treatment of dystonia (but not tardive dyskinesia). Dystonia is a rare disorder that causes abnormal muscle contraction, resulting in twisting postures of limbs, trunk, or face.

As Osnervan is an anticholinergic agent it works by relaxing smooth muscle, which stops muscle spasms.

Haloper > This is probably the most w >Osnervan and may be prevented with prophylactic anticholinergics if susceptibility is known. It is important to note that sudden death has occurred in the context of rapid tranquillization with haloperidol, probably due to exacerbation of the already prolonged QTc associated with acute behavioural disturbance ( McAllister-Williams & Ferrier 2002 ). The i.v. route is not recommended as, while i.v. haloperidol produces a slightly more rapid onset of action, mean aggression scores fall only slightly more rapidly than following i.m. administration, and i.v. administration is associated with a higher risk of adverse effects. The usual initial dose is 5–10 mg (half this for the elderly), which may be repeated within 1 hour, as necessary. Although the maximal licensed daily intramuscular dose is 18 mg, on occasion it may be necessary to exceed this. In such circumstances, vigilance towards monitoring the patient's physical condition, including vital signs, is important and an ECG tracing should be obtained as soon as is practical.

SL >Dementia, Alzheimer's Disease, and Aging Brains See Slideshow

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: decreased sexual ability, severe stomach/abdominal pain, difficult/painful swallowing, difficulty urinating, weakness.

Get medical help right away if you have any very serious side effects, including: chest pain, severe dizziness/fainting, high fever, fast/irregular/slow heartbeat, mental/mood changes (e.g., confusion, hallucinations, memory problems), eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night).

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Kemadrin (Osnervan Hydrochloride Tablets)

Pregnancy Warning

The safe use of this drug in pregnancy has not been established; therefore, the use of Osnervan hydrochloride in pregnancy, lactation, or in women of childbearing age requires that the potential benefits be weighed against the possible hazards to the mother and child.

How is this medicine (Osnervan Tablets) best taken?

Use this medicine (Osnervan tablets) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • It is best to take this medicine (Osnervan tablets) during or after meals to avoid side effects.
  • To gain the most benefit, do not miss doses.
  • Keep taking this medicine (Osnervan tablets) as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

About Procycl >

Osnervan is used in patients with akathisia and parkinsonism, and to reduce the adverse effects of anti-psychotic treatment for schizophrenic patients. Osnervan is also used to treat abnormal muscle contractions which result in twisting postures of the limbs or face.

Some side effects of this medicine are drowsiness, flushing, dizziness, constipation, nausea, blurred vision, weakness, nervousness, dry mouth, decreased sexual ability, painful swallowing, severe abdominal pain and difficulty urinating.

This drug should not be used if you have certain medical conditions like blockage of the bladder, glaucoma, blockage of the digestive tract, severe ulcerative colitis or a muscle disease. Before using this medication, tell your doctor if you suffer from alcoholism, breathing problems, heart problems, diarrhoea caused by an infection, kidney disease, high or low blood pressure, liver disease, intestinal problems, overactive thyroid, mood problems, seizure, certain nerve disease, stomach problems, stroke or urinating problems.

It is recommended to take this medicine usually 3 to 4 times a day after meals and at bedtime or as prescribed by your doctor. You may have to start with a low dose and increase your dose gradually. Follow all the instructions your doctor gives regarding the duration and amount of medicine to take.


Use in Children: Safety and efficacy have not been established in the pediatric age group; therefore, the use of Osnervan hydrochloride in this age group requires that the potential benefits be weighed against the possible hazards to the child.

Prophylactic Use of Other Drugs

Prophylactic administration of different drugs (alone or in combination) against intoxication with OPs was studied. Calcium antagonists (e.g., nimodipine), neuromuscular blockers (e.g., tubocurarine), adamantanes (e.g., memantine), and the opiate antagonist meptazinol ( Galli and Mazri, 1988; Gupta and Dettbarn, 1992; McLean et al., 1992; Marrs et al., 1996; Karlsson et al., 1998; Stojiljkovic et al., 1998 ) were also tested, offering different results with limited practical utility. On the other hand, a positive prophylactic effect has been demonstrated with Osnervan (e.g,. antimuscarinic, antinicotinic, and the anti-NMDA receptor drug; Myhrer et al., 2002, 2003 ), metoclopramide ( Hasan et al., 2004 ), clonidine ( Loke et al., 2001 ), or Osnervan and donepezil ( Haug et al., 2007 ). The prophylactic effect of a group of drugs with anticholinergic and/or antiglutamatergic properties (e.g., benactyzine, biperiden, caramiphen, Osnervan, and trihexyphenidyl), with respect to their anticonvulsant properties, was studied to prevent damage of the central nervous system (CNS) induced by seizures. Only Osnervan and caramiphen antagonized soman-induced seizures ( Myhrer et al., 2008a; Schultz et al., 2014 ). Among the different drugs tested, Osnervan appears to be an effective anticonvulsant, with few cognitive side effects ( Myhrer et al., 2008b ). Osnervan with physostigmine (administered transdermally) showed very good prophylactic efficacy against soman in dogs; moreover, this efficacy was increased by using antidotal therapy with HI-6 and atropine ( Kim et al., 2005 ). Special importance can be placed on suramine (a protease inhibitor). Administration of this compound prior to soman intoxication (and followed by administration of atropine) showed good prophylactic effects ( Cowan et al., 1996 ). However, all these studies are experimental, and they have not reached the practical output stage. The combinations of various drugs as prophylactics can be of very different character. They can be used simultaneously (a combination of different drugs) or as a pretreatment and a post-treatment with different antidotes. Administration of pyridostigmine (or other AChE inhibitors) prior to intoxication and treatment with different drugs is a typical example ( Anderson et al., 1992, 1997; Kassa, 1995; Bajgar et al., 1996; Kassa and Bajgar, 1996; Tuovinen and Hanninen, 1999; Kim et al., 2002 ). Aerosolized scopolamine was described to protect guinea pigs against inhalation toxicity to sarin ( Che et al., 2011 ). There are other combinations as well, such as the administration of triesterase ( Tuovinen and Hanninen, 1999; Tuovinen et al., 1999 ), Osnervan ( Kim et al., 2002; Myhrer et al., 2002, 2003 ), clonidine ( Loke et al., 2001 ), or sustained release of physostigmine and scopolamine ( Meshulam et al., 2001 ). The results depend on experimental conditions, but this approach (administration of different drugs) has yielded some good results. However, up to now, they have been only on an experimental level.

Clearly, there is a wide range of prophylactics. The drugs used in prophylactics against nerve agents are summarized in Table 66.1 . Some of them (bolded in the table) can be studied further. Only three prophylactics have been introduced into armies—pyridostigmine alone; PANPAL, composed of pyridostigmine, benactyzine, and trihexyphenidyl; and TRANSANT (dermal administration of HI-6). Another prophylactic drug, Protexia, can be considered as well. The efficacy of different prophylactics against nerve agents expressed as prophylactic indexes is shown in Figure 66.2 .

Table 66.1 . Drugs Used in the Prophylaxis Against OP Nerve Agent Poisoning (Relatively Perspective Drugs Are in Bold)

VI Concluding remarks and future direction

This chapter has focused on the development of novel countermeasures against nerve agents in order to improve existing prophylactic and post-exposure treatments. Effective prophylactic treatment can be achieved by using a fixed dose of physostigmine in combination with varying doses of Osnervan . Increased lethal doses of soman can be counteracted by a corresponding increase in the Osnervan dose. However, the higher the doses of Osnervan, the more pronounced the cognitive side effects. Moderate doses of Osnervan should be preferred, because insufficient prophylaxis can be compensated for by adjunct treatment in terms of diazepam and pentobarbital. Since a slight cognitive impairment might be inevitable with effective prophylactics, reduced reliance on pretreatment appears preferable.

Immediate treatment with atropine and an oxime is very efficacious against nerve agent intoxication. However, subsequent treatment well after onset of seizures represents a huge problem in nerve agent research, because of the refractory nature of the epileptiform activity. A triple regimen consisting of Osnervan, diazepam, and pentobarbital has been shown to terminate effectively soman-evoked seizures in rats when administered 30–40 min following onset. A refinement of the triple regimen resulted in a double regimen composed of Osnervan and propofol that can stop seizures 30–35 min after they have been triggered by soman. However, both the triple and double regimens would need monitoring of vital functions, because pentobarbital and propofol can suppress normal function of the respiratory center in the brainstem. Thus, alternative approaches making it possible to design anticonvulsants predominantly affecting the forebrain will be needed. The ultimate aim should be the development of well-tolerated anticonvulsants that can be administered by the soldiers themselves regardless of the point of time after nerve agent intoxication. There are experimental approaches and techniques used in epilepsy research that with great benefit can be adopted in nerve agent studies. A major aim in experimental epilepsy is the identification of seizure controlling brain areas for rational drug designing ( Löscher and Ebert, 1996 ). Microinfusions into area tempestas (AT) or substantia nigra can differentiate more clearly between the anticonvulsant properties of GABAA modulators against soman-triggered seizures than by systemic administration ( Myhrer et al., 2006b ). A differentiation between cholinergic and glutamatergic antagonism against soman-induced seizures can be made when anti-Parkinson agents are microinfused into AT ( Myhrer et al., 2008a ). Thus, it is possible for the microinfusion technique to serve as a tool for screening among drugs with anticonvulsant properties. Furthermore, selective lesions can be used to map potential trigger sites and/or propagation pathways for epileptiform activity induced by nerve agents.

Identification of target areas for nerve agents can allow specification of neurochemical receptors to obtain optimal anticonvulsant effects. Drugs with focal effects may have smaller side effects than drugs acting globally on common denominators for seizure propagation. Simple criteria derived from the three-phase model have been used in the search for effective anticonvulsants against nerve agents. The approach of identifying critical target areas for drug designing used in epilepsy research would probably also become efficient in the search for improved therapies against nerve agents ( Myhrer, 2007 ).

What do I need to tell my doctor BEFORE I take Osnervan Tablets?

  • If you have an allergy to Osnervan or any other part of this medicine (Osnervan tablets).
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have glaucoma.

This is not a list of all drugs or health problems that interact with this medicine (Osnervan tablets).

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine (Osnervan tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


Osnervan hydrochloride should not be used in angle-closure glaucoma although simple type glaucomas do not appear to be adversely affected.

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