Procyclidine

Pronunciation: proh-SYE-kli-deen.

Generic name
procyclidine hydrochloride
Brand names
Kemadrin (United Kingdom, Australia, New Zealand), Pendo-Procyclidine (Canada)
Drug class
Anticholinergic (antimuscarinic) antiparkinsonian agent
Form
Tablet or oral solution
Route
Oral
Legal status
Prescription-only medicine

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Kemadrin (6) · Full directory

What procyclidine hydrochloride is and how it works

Procyclidine is a prescription-only anticholinergic (antimuscarinic) medicine used to treat Parkinson's disease and to control movement side effects (extrapyramidal symptoms) caused by certain antipsychotic (neuroleptic) medicines. (1)

Procyclidine works by blocking the action of a brain chemical called acetylcholine, which helps rebalance brain chemistry involved in tremor, stiffness, and abnormal movements. It carries typical anticholinergic side effects such as a dry mouth and blurred vision, needs caution in people with certain eye, bowel, urinary, or muscle conditions, and -- like other anticholinergic medicines -- has a real, though uncommon, potential for misuse at higher-than-prescribed doses because of a euphoric effect.

Mechanism of action: how procyclidine hydrochloride works

Procyclidine is a synthetic anticholinergic (antimuscarinic) compound that reduces the relative cholinergic excess associated with dopamine deficiency in Parkinson's disease and with dopamine-receptor blockade from antipsychotic drugs, improving tremor, rigidity, and drug-induced extrapyramidal symptoms. (1)

What procyclidine hydrochloride is used for

Parkinson's disease

Used for the treatment and symptomatic relief of all forms of Parkinson's disease, including postencephalitic, arteriosclerotic, and idiopathic types. (1) (3)

Drug-induced extrapyramidal symptoms

Used to control extrapyramidal symptoms (abnormal movements, stiffness, or restlessness) caused by antipsychotic (neuroleptic) medicines. (1) (3)

Before taking procyclidine hydrochloride

Do not take / not appropriate for

  • Do not take procyclidine if you have had a hypersensitivity reaction to it or any ingredient in the tablet or solution. (all patients) (1)
  • Do not take procyclidine if you have closed-angle (narrow-angle) glaucoma. (all patients) (1) (3)
  • Do not take procyclidine if you have untreated urinary retention or a gastrointestinal obstruction (including a bowel-motility condition called megacolon). (all patients) (1)
  • Procyclidine should not be taken if you have myasthenia gravis, as anticholinergic medicines can worsen the muscle weakness that defines this condition. (all patients) (4)

Tell your clinician about

  • Any history of glaucoma, enlarged prostate, urinary difficulty, or bowel motility problems.
  • Any history of confusion, memory problems, or hallucinations, particularly if you are an older adult.
  • Any history of heart disease, seizures, or psychiatric illness.
  • Any kidney or liver problems.
  • Every other medicine you take, especially other anticholinergic medicines, antihistamines, tricyclic antidepressants, MAOIs, paroxetine, levodopa, or domperidone/metoclopramide.
  • Any past problem with misuse of this or a similar medicine.
(1)

How to take procyclidine hydrochloride

  • Take exactly as prescribed. Your prescriber will usually start you on a low dose and increase it gradually based on your response.
  • For Parkinson's disease, a typical starting dose is 2.5 mg three times daily, increased gradually; usual maintenance is 15-30 mg daily, taken in divided doses.
  • For antipsychotic-induced movement symptoms, a typical starting dose is also 2.5 mg three times daily, increased gradually; most people respond to 10-30 mg daily.
  • Older adults are usually started at the lower end of the dosing range.
  • Do not stop taking procyclidine suddenly without your prescriber's guidance -- stopping abruptly can cause a rebound return of Parkinson's-type symptoms; any change should be planned with your prescriber.
(1) (3)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

If you miss a dose, ask your pharmacist or prescriber how to handle it. Do not take a double dose to make up for a missed one.

Overdose

Seek emergency medical help or contact a poison-control service if an overdose is suspected. Reported overdose symptoms include agitation, confusion, hallucinations, dilated pupils, a fast heartbeat, and (in some cases) euphoria, anxiety, or aggression. Treatment may include activated charcoal if the overdose was recent, and medicines such as diazepam for seizures, under medical supervision. (1)

Side effects

Dry mouth, blurred vision, and constipation are common anticholinergic effects. Confusion, memory problems, or hallucinations are less common but need prompt attention, especially in older adults.

Dry mouth

What to notice: A common anticholinergic effect.

What to do: Tell your prescriber if severe or bothersome; sipping water or sugar-free lozenges may help. (1)

Blurred vision or dilated pupils

What to notice: Commonly reported.

What to do: Tell your prescriber if it affects daily activities such as driving. (1)

Dizziness or lightheadedness

What to notice: Commonly reported, especially when standing up.

What to do: Stand up slowly; tell your prescriber if it persists or causes falls. (1)

Nausea, vomiting, or constipation

What to notice: Commonly reported digestive effects.

What to do: Tell your prescriber if severe or persistent. (1)

Confusion or hallucinations

What to notice: New confusion, memory difficulty, seeing or hearing things that are not there, or unusual anxiety or agitation -- more common in older adults or at higher doses.

What to do: Contact your prescriber promptly; a clinician will assess whether your dose needs to be adjusted. (1)

Urinary retention

What to notice: Difficulty or inability to pass urine.

What to do: Seek prompt medical attention, especially if you have an enlarged prostate or existing urinary symptoms. (1)

Signs of misuse or dependence

What to notice: Taking more than the prescribed dose to achieve a euphoric or 'high' feeling.

What to do: Tell your prescriber -- procyclidine, like other anticholinergic medicines, has a recognised though uncommon potential for misuse; your prescriber can help monitor and manage this safely. (1)

Serious warnings

Anticholinergic toxicity / severe confusion — high caution

Symptoms: Marked confusion, agitation, disorientation, or hallucinations, particularly in older adults or at higher-than-prescribed doses.

Action: Contact your prescriber promptly, or seek emergency care if severe; a clinician will decide whether the dose needs to be reduced. (1)

Acute angle-closure glaucoma — emergency

Symptoms: Sudden eye pain, redness, blurred vision, or seeing halos around lights.

Action: Seek emergency medical help immediately; procyclidine is contraindicated in closed-angle glaucoma. (1) (3)

Urinary retention or bowel obstruction — high caution

Symptoms: Inability to pass urine, or severe constipation with abdominal distension and pain.

Action: Seek prompt medical attention; procyclidine is contraindicated in untreated urinary retention and GI obstruction. (1)

Misuse / supratherapeutic dosing — high caution

Symptoms: Euphoria, anxiety, or aggression at doses above those prescribed.

Action: Tell your prescriber if you or someone else is taking more than prescribed; this is a recognised, regulator-documented risk with anticholinergic medicines including procyclidine. (1)

Interactions

Medicine or testEffectAction
Other anticholinergic medicines (e.g. amantadine, sedating antihistamines, tricyclic antidepressants)Combined anticholinergic effects can add up, increasing dry mouth, blurred vision, confusion, and urinary retention.Tell your prescriber about every medicine you take. (1)
ParoxetineSignificantly increases procyclidine blood levels.Tell your prescriber if you take paroxetine; your dose may need adjusting. (1)
LevodopaProcyclidine may reduce the effectiveness of levodopa.Tell your prescriber if you take levodopa for Parkinson's disease. (1)
Domperidone or metoclopramideProcyclidine's anticholinergic action may reduce the effect of these gut-motility medicines.Tell your prescriber if you take either of these. (1)
Monoamine oxidase inhibitors (MAOIs)May interact with procyclidine's anticholinergic effects.Tell your prescriber if you take an MAOI. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Older adults

Older adults are more likely to experience confusion, memory problems, or hallucinations, so treatment is usually started at a low dose and increased slowly. (1) (3)

Pregnancy

Safety in pregnancy has not been formally established, though extensive clinical use has not shown clear evidence of harm. Discuss the balance of benefits and risks with your prescriber if you are pregnant or planning pregnancy. (1) (3)

Breastfeeding

There is no data on whether procyclidine passes into breast milk. Discuss with your prescriber before breastfeeding. (1)

Children

Safety and effectiveness in children have not been established. (3)

Monitoring

Before starting

  • Assessment for glaucoma, urinary retention, bowel obstruction, myasthenia gravis, and other anticholinergic-sensitive conditions.
  • Review of all other medicines for additive anticholinergic effects.

During treatment

  • Watch for confusion, memory changes, or hallucinations, especially in older adults.
  • Watch for urinary difficulty or severe constipation.
  • Periodic review of ongoing need and dose, since anticholinergic burden can accumulate with other medicines.
(1)

Storage

Store below 25C, in the original packaging, protected from light and moisture, out of reach of children.

Study the drug class: Antiparkinsonian agents

Professional information

Clinician-facing context only. Use the current local product information in full. The Kemadrin brand and all generic procyclidine products are discontinued in the United States; FDA approval remains on record but the product is not currently marketed there. EU central (EMA) authorisation status could not be confirmed with a live source and should be checked against the relevant national authority before relying on it.

United Kingdom

Indication: Parkinson's disease / drug-induced extrapyramidal symptoms

Dose summary: Parkinson's disease: initial 2.5 mg three times daily, titrated by 2.5-5 mg every 2-3 days; usual maintenance 15-30 mg/day (up to 60 mg/day in some patients). Drug-induced symptoms: initial 2.5 mg three times daily, titrated by 2.5 mg/day; usual maintenance 10-30 mg/day.

Renal context: Not detailed in the source reviewed; use current local product information for renal impairment. (1)

Mechanism of action

Hepatic guidance

Not extensively characterised in the sources reviewed; use current local product information.

Overdose note

Anticholinergic toxidrome: agitation, confusion, hallucinations, mydriasis, tachycardia; manage supportively, consider activated charcoal if recent ingestion, and benzodiazepines for seizures, per local toxicology guidance. (1)

Frequently asked questions

Is procyclidine available in the United States?

No, not currently. The Kemadrin brand and all generic procyclidine products have been discontinued in the United States, although the FDA approval remains on record. It continues to be available in the UK, Canada, Australia, and New Zealand. (3)

Can procyclidine be misused?

Yes, uncommonly. Like other anticholinergic medicines, procyclidine can produce a euphoric effect at doses higher than prescribed, and the UK product information specifically documents this potential for abuse. Tell your prescriber if you or someone else is taking more than the prescribed amount. (1)

Why can't I stop procyclidine suddenly?

Stopping abruptly can cause a rebound return of Parkinson's-type symptoms. Any change to your dose or a decision to stop should be planned together with your prescriber. (1)

What is the mechanism of action of procyclidine hydrochloride?

Procyclidine is a synthetic anticholinergic (antimuscarinic) compound that reduces the relative cholinergic excess associated with dopamine deficiency in Parkinson's disease and with dopamine-receptor blockade from antipsychotic drugs, improving tremor, rigidity, and drug-induced extrapyramidal symptoms. (1)

What is the generic name of Procyclidine?

The generic name is procyclidine hydrochloride. It is sold under brand names including Kemadrin (United Kingdom, Australia, New Zealand), Pendo-Procyclidine (Canada). (1) (3)

What class of drug is procyclidine hydrochloride?

Procyclidine is classed as: Anticholinergic (antimuscarinic) antiparkinsonian agent. (1) (3)

References

  1. Kemadrin Tablets 5 mg -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Kyowa Kirin · United Kingdom · accessed 2026-07-29 · source 1
  2. Procyclidine Rosemont 2.5mg/5ml Oral Solution -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Rosemont Pharmaceuticals · United Kingdom · accessed 2026-07-29 · source 2
  3. KEMADRIN (procyclidine hydrochloride) 5 mg Scored Tablets -- FDA labelU.S. Food and Drug Administration, approved labeling (accessdata.fda.gov) · United States · accessed 2026-07-29 · source 3
  4. Procyclidine: patient-facing contraindications summaryDrugs.com consumer medication information (derived from FDA-approved labeling) · United States · accessed 2026-07-29 · source 4
  5. PENDO-PROCYCLIDINE (procyclidine hydrochloride) -- Drug Product Database listingHealth Canada Drug Product Database · Canada · accessed 2026-07-29 · source 5
  6. KEMADRIN procyclidine hydrochloride 5mg tablet -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 6
  7. KEMADRIN New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-29 · source 7

Brand names by country

Single-ingredient procyclidine hydrochloride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Kemadrin (3)FDA approved historically brand and generics discontinued · 5 mg · historical: Alliance Pharmaceuticals / GSK

United Kingdom

  • Kemadrin (1)MHRA licensed emc smpc confirmed · 5 mg · Kyowa Kirin
  • Procyclidine (Rosemont oral solution) (2)MHRA licensed emc smpc confirmed · 2.5 mg/5 mL, 5 mg/5 mL · Rosemont Pharmaceuticals

Canada

  • Pendo-Procyclidine (5)Health Canada DIN confirmed · 5 mg · Pendopharm, Division of Pharmascience Inc.

Australia

  • Kemadrin (6)TGA ARTG registered confirmed · 5 mg · Amdipharm (Australia) Pty Ltd / successor sponsor

New Zealand

  • Kemadrin (7)Medsafe datasheet confirmed · 5 mg · Aspen (or successor NZ sponsor)
View brands in additional countries.

This page provides general medicine information, not a diagnosis, prescription, or substitute for a neurologist, psychiatrist, prescriber, pharmacist, or the current local product information.

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