Benztropine

Medically reviewed by Rosanna Sutherby, PharmD on May 4, 2023
Written by Alex Brewer, PharmD, MBA

Specifically, the Food and Drug Administration (FDA) has approved benztropine to treat:

• symptoms of parkinsonism, including Parkinson’s disease, when used with other medications in adults
• extrapyramidal side effects in adults and some children

This article describes benztropine’s uses and dosage, ways to save on cost, and more. Below you’ll find some coupon options for benztropine.

Benztropine may cause mild or serious side effects (also known as adverse effects). More common mild side effects of benztropine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age and overall health and any other medications you take.

To learn more about benztropine’s side effects, ask your doctor or pharmacist. You can also read the prescribing information* for benztropine.

* To view benztropine’s prescribing information, see the “Article resources” section below.

Mild side effects

More common mild side effects reported with some forms of benztropine are listed below.

This article doesn’t include all possible mild side effects of the drug. To learn more about benztropine’s side effects based on the form, see the prescribing information* for benztropine.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of benztropine injection and oral tablet include:

• nausea and vomiting
• dry mouth
• constipation
• blurry vision
• mild allergic reaction†

* To view benztropine’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for benztropine” section below.

Serious side effects

Serious side effects of benztropine are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about benztropine’s side effects based on the  form, see the prescribing information* for benztropine.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, benztropine’s serious side effects include:

• fast heart rate
• heat stroke (a life threatening condition in which your body can no longer regulate its temperature)
• mental health side effects, including confusion, disorientation, memory loss, hallucinations, and new or worsening depression
• bladder problems, including urinary retention (inability to empty your bladder) and discomfort or pain while urinating
• paralytic ileus (paralysis of intestinal muscles that leads to a buildup or blockage in your gut)
• severe allergic reaction†

* To view benztropine’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for benztropine” section below.

The Food and Drug Administration (FDA) approves prescription drugs such as benztropine for certain conditions. Approved uses for benztropine are described below.

Use for parkinsonism

Doctors may prescribe benztropine for treating symptoms of parkinsonism, including Parkinson’s disease. It’s used for this purpose in adults and is usually prescribed as a long-term treatment.

Parkinsonism refers to a group of neurological conditions that make it difficult to move. (Neurological conditions affect your brain and spinal cord.) Parkinsonism is caused by an imbalance of acetylcholine and dopamine levels in your brain. (Acetylcholine and dopamine are chemical messengers that help regulate your body’s movements.)

Symptoms of parkinsonism include:

• slow movements
• tremors (shaking)
• rigid muscles
• trouble walking
• posture problems

Parkinson’s disease is the most common type of parkinsonism. It’s caused by the loss of brain cells that produce dopamine.

Benztropine is prescribed together with other medications for parkinsonism and Parkinson’s disease. Examples include:

• levodopa/carbidopa (Sinemet)
• pramipexole (Mirapex)
• selegiline (Zelapar)

Use for extrapyramidal side effects (EPS)

Doctors may prescribe benztropine for treating extrapyramidal side effects (EPS). It’s used for this purpose in adults and children ages 3 and older. It’s prescribed as a long-term or short-term treatment, depending on how well the drug works to treat your symptoms.

Extrapyramidal symptoms are certain side effects that certain antipsychotic medications and other drugs may cause. Examples of these symptoms include:

• involuntary or uncontrollable movements
• dystonia (involuntary muscle contractions or unusual postures, including eye spasms and twisting head)
• tremors (shaking)
• restlessness and a constant need to move

Examples of medications that may cause EPS include:

• thioridazine
• haloperidol (Haldol)
• risperidone (Risperdal)
• clozapine (Clozaril)

EPS can go away with treatment, or it may be long term, even with treatment. Medications such as benztropine may make EPS symptoms less severe and more manageable.

Doctors will likely not prescribe benztropine for tardive dyskinesia (TD). (TD is a rare but serious type of EPS.) This is because benztropine is not effective at treating TD. And in some cases, it may worsen the condition.

Below you’ll find answers to a few commonly asked questions about benztropine.

Can benztropine be used for tardive dyskinesia, anxiety, or sweating?

No, benztropine is not used for tardive dyskinesia (TD). TD is a rare but serious type of extrapyramidal side effect (EPS).* It causes sudden involuntary movements such as twitching, eye blinking, and grimacing. In fact, benztropine may worsen TD in people who have this condition.

Benztropine also isn’t approved for treating anxiety or sweating. However, doctors may still prescribe benztropine off-label for either use. With off-label use, a drug is prescribed in a way that’s not approved by the Food and Drug Administration (FDA).

Talk with your doctor if you’d like to learn more about treatments for TD or off-label uses for benztropine.

* Benztropine is used to treat EPS. To learn more, see the “Uses of benztropine” section above.

How does benztropine work? And how long does it take to start working?

Benztropine is a type of anticholinergic drug. This means it works by blocking the actions of a type of chemical messenger called acetylcholine. This helps treat symptoms of parkinsonism, which is caused by an imbalance of acetylcholine and dopamine levels in your brain. (Dopamine is another type of chemical messenger found in your brain.)

Benztropine begins working when you take your first dose. But how quickly the drug treats your symptoms depends on the form used:

• Benztropine injection usually begins working to relieve symptoms within a few minutes.
• Benztropine oral tablet is known to have cumulative effects. This means it works more effectively as you continue taking the medication. It may take several days before you notice the drug’s effects on your symptoms.

Due to the difference in how quickly forms of benztropine work, your doctor may prescribe both forms to treat your symptoms. For example, they may prescribe a one-time benztropine injection to provide quick symptom relief. And they may also prescribe benztropine oral tablet for you to take at home every day for long-term treatment of symptoms.

Talk with your doctor or pharmacist if you have questions about how benztropine works. They can also discuss when you should expect your symptoms to ease.

Do side effects of benztropine last for a long time?

Maybe. Like most drugs, mild side effects caused by benztropine often go away within a few hours or days. Rarely, mild side effects may last a couple of weeks.

Serious side effects of benztropine are rare. But there are a few that may not go away unless treatment with benztropine is stopped. These include:

• mental health side effects, such as confusion, disorientation, memory loss, hallucinations, and new or worsening depression
• bladder problems, including urinary retention (inability to empty your bladder) and discomfort or pain while urinating

If you have side effects that bother you or don’t go away while taking benztropine, talk with your doctor or pharmacist. They can review your symptoms and discuss possible treatments. Do not stop taking benztropine without your doctor’s recommendation.

Is withdrawal possible with benztropine?

No, it doesn’t appear so. Withdrawal was not reported in studies* of benztropine.

Withdrawal refers to symptoms that can occur when you stop taking a drug your body is dependent on. But this effect isn’t expected with benztropine. That said, if you stop treatment with benztropine, symptoms of your condition may return. Do not stop taking benztropine unless your doctor recommends it’s safe for you to do so.

Talk with your doctor if you have questions about withdrawal or what to expect when stopping benztropine treatment.

* For details about benztropine’s studies, see its prescribing information in the “Article resources” section below.

Can I take chlorpromazine with benztropine?

Yes, if your doctor says it’s safe for you to do so. Chlorpromazine is a drug used to treat certain mental health conditions, such as schizophrenia and bipolar disorder.

If your doctor prescribes you chlorpromazine with benztropine, they’ll discuss what to expect during your treatment. For example, they may discuss what side effects these drugs may cause and monitor you more frequently.

If you have questions about taking chlorpromazine with benztropine, talk with your doctor. 

Are there any alternatives to benztropine?

Yes, there are alternatives to benztropine. Some examples include:

• trihexylphenidyl
• amantadine (Gocovri, Osmolex ER)
• pramipexole (Mirapex)
• ropinirole

Whether an alternative medication is safe and effective for you will depend on a few factors. These include your medical history and other medications you may take.

Talk with your doctor or pharmacist to learn more about alternatives to benztropine.

The dosage of benztropine your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take or receive.

Receiving and taking benztropine

Benztropine injection is given as an injection into the muscle. If needed, it may also be given as an intravenous (IV) injection (an injection given into your vein over time). Your doctor will explain how benztropine will be given to you and where you’ll receive it. They’ll also explain how much you’ll receive and how often.

Benztropine oral tablet is swallowed with or without food. Your doctor will talk with you about how to take benztropine oral tablet. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Overdose of benztropine

If you swallow your doses of benztropine, you should not take more than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much benztropine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Below, you’ll find information about benztropine’s possible interactions and warnings.

Interactions of benztropine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take or receive benztropine, ask your doctor to check for possible interactions. They can check for interactions these items may cause with benztropine. Be sure to tell them about any of the following you take or use:

• prescription drugs
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for benztropine” section below.

Warnings for benztropine

Some people should not take benztropine, and others should take it cautiously.

Benztropine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether benztropine is a safe option for you.

Ask your doctor about specific warnings for benztropine, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Benztropine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to benztropine or any of its ingredients, your doctor will likely not prescribe benztropine. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to benztropine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and benztropine

Information about benztropine and pregnancy and breastfeeding is described below.

Benztropine and pregnancy

It’s not known whether benztropine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Benztropine and breastfeeding

It’s not known whether benztropine should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

You may be able to save money on your prescription for benztropine by using our Perks discount coupons. These can be found at the end of this article.

If you have questions about how to pay for benztropine, talk with your doctor or pharmacist.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes benztropine’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about benztropine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Does my health history increase my risk of side effects from benztropine treatment?
• Will I need lab tests to monitor for side effects while I’m taking benztropine?
• If I have side effects from benztropine, but it’s working for my condition, can you prescribe a lower dose for me?

• Benztropine mesylate- benztropine mesylate injection. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/ecaeaadf-0847-4605-a205-a674f75f8bb2/spl-doc
• Benztropine mesylate- benztropine mesylate tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c548b645-0a3c-436e-9a62-0f5fd295efca/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.