U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C20H31NO
Molecular Weight 301.4662
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of TRIHEXYPHENIDYL

SMILES

OC(CCN1CCCCC1)(C2CCCCC2)C3=CC=CC=C3

InChI

InChIKey=HWHLPVGTWGOCJO-UHFFFAOYSA-N
InChI=1S/C20H31NO/c22-20(18-10-4-1-5-11-18,19-12-6-2-7-13-19)14-17-21-15-8-3-9-16-21/h1,4-5,10-11,19,22H,2-3,6-9,12-17H2

HIDE SMILES / InChI

Molecular Formula C20H31NO
Molecular Weight 301.4662
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 0
Optical Activity ( + / - )

Description
Curator's Comment: Description was created based on several sources, including http://www.accessdata.fda.gov/drugsatfda_docs/nda/2003/006773_s036_artane.pdf

Trihexyphenidyl (Artane, Apo-Trihex, Parkin, Pacitane), also known as benzhexol and trihex has been in clinical usage for decades.It is an anticholinergic used in the symptomatic treatment of all etiologic groups of parkinsonism and drug induced extrapyramidal reactions (except tardive dyskinesia). Trihexyphenidyl possesses both anticholinergic and antihistaminic effects, although only the former has been established as therapeutically significant in the management of parkinsonism. Trihexyphenidyl is a selective M1 muscarinic acetylcholine receptor antagonist. It is able to discriminate between the M1 (cortical or neuronal) and the peripheral muscarinic subtypes (cardiac and glandular). Trihexyphenidyl partially blocks cholinergic activity in the CNS, which is responsible for the symptoms of Parkinson's disease. It is also thought to increase the availability of dopamine, a brain chemical that is critical in the initiation and smooth control of voluntary muscle movement. Trihexyphenidyl is indicated for the treatment of parkinson's disease and extrapyramidal reactions caused by drugs.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
Trihexyphenidyl hydrochloride

Approved Use

Trihexyphenidyl HCl tablets are indicated as an adjunct in the treatment of all forms of parkinsonism (postencephalitic, arteriosclerotic, and idiopathic). It is often useful as adjuvant therapy when treating these forms of parkinsonism with levodopa. Additionally, it is indicated for the control of extrapyramidal disorders caused by central nervous system drugs such as the dibenzoxazepines, phenothiazines, thioxanthenes, and butyrophenones.

Launch Date

1949
Secondary
Trihexyphenidyl hydrochloride

Approved Use

Trihexyphenidyl HCl tablets are indicated as an adjunct in the treatment of all forms of parkinsonism (postencephalitic, arteriosclerotic, and idiopathic). It is often useful as adjuvant therapy when treating these forms of parkinsonism with levodopa. Additionally, it is indicated for the control of extrapyramidal disorders caused by central nervous system drugs such as the dibenzoxazepines, phenothiazines, thioxanthenes, and butyrophenones.

Launch Date

1949
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
24.4 ng/mL
5 mg 2 times / day multiple, oral
dose: 5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
14.9 ng/mL
5 mg single, oral
dose: 5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
334 ng × h/mL
5 mg 2 times / day multiple, oral
dose: 5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
294 ng × h/mL
5 mg single, oral
dose: 5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
8.67 h
5 mg 2 times / day multiple, oral
dose: 5 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
10.1 h
5 mg single, oral
dose: 5 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
TRIHEXYPHENIDYL serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Disc. AE: Constipation, Gastrointestinal disorders...
AEs leading to
discontinuation/dose reduction:
Constipation (2 patients)
Gastrointestinal disorders (4 patients)
Behaviour disorder (2 patients)
Movements involuntary (1 patient)
Drowsiness (1 patient)
Skin rash (1 patient)
Sources:
40 mg multiple, oral
Higher than recommended
Dose: 40 mg
Route: oral
Route: multiple
Dose: 40 mg
Sources:
unhealthy, 25 years
Health Status: unhealthy
Age Group: 25 years
Sex: M
Sources:
Other AEs: Dependence...
Other AEs:
Dependence (1 patient)
Sources:
5 mg 28 times / day multiple, oral
Higher than recommended
Dose: 5 mg, 28 times / day
Route: oral
Route: multiple
Dose: 5 mg, 28 times / day
Sources:
unhealthy, 35 years
Health Status: unhealthy
Age Group: 35 years
Sex: F
Sources:
Other AEs: Dependence...
Other AEs:
Dependence (1 patient)
Sources:
0.75 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.75 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.75 mg/kg, 1 times / day
Sources:
unhealthy, 4-15 years
Health Status: unhealthy
Age Group: 4-15 years
Sex: M+F
Sources:
Disc. AE: Chorea, Rash...
AEs leading to
discontinuation/dose reduction:
Chorea (1 patient)
Rash (1 patient)
Hyperactivity (1 patient)
Sources:
24 mg 1 times / day multiple, oral
Highest studied dose
Dose: 24 mg, 1 times / day
Route: oral
Route: multiple
Dose: 24 mg, 1 times / day
Sources:
unhealthy, adult
Health Status: unhealthy
Age Group: adult
Sex: unknown
Sources:
41 mg 1 times / day multiple, oral
Highest studied dose
Dose: 41 mg, 1 times / day
Route: oral
Route: multiple
Dose: 41 mg, 1 times / day
Sources:
unhealthy, children
Health Status: unhealthy
Age Group: children
Sex: unknown
Sources:
8 mg 1 times / day multiple, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy, mean 49.7 years
Health Status: unhealthy
Age Group: mean 49.7 years
Sex: M+F
Sources:
Other AEs: Extrapyramidal symptoms...
Other AEs:
Extrapyramidal symptoms (77%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Drowsiness 1 patient
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Movements involuntary 1 patient
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Skin rash 1 patient
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Behaviour disorder 2 patients
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Constipation 2 patients
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Gastrointestinal disorders 4 patients
Disc. AE
0.55 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.55 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.55 mg/kg, 1 times / day
Sources:
unhealthy, 1-18 years
Health Status: unhealthy
Age Group: 1-18 years
Sex: M+F
Sources:
Dependence 1 patient
40 mg multiple, oral
Higher than recommended
Dose: 40 mg
Route: oral
Route: multiple
Dose: 40 mg
Sources:
unhealthy, 25 years
Health Status: unhealthy
Age Group: 25 years
Sex: M
Sources:
Dependence 1 patient
5 mg 28 times / day multiple, oral
Higher than recommended
Dose: 5 mg, 28 times / day
Route: oral
Route: multiple
Dose: 5 mg, 28 times / day
Sources:
unhealthy, 35 years
Health Status: unhealthy
Age Group: 35 years
Sex: F
Sources:
Chorea 1 patient
Disc. AE
0.75 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.75 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.75 mg/kg, 1 times / day
Sources:
unhealthy, 4-15 years
Health Status: unhealthy
Age Group: 4-15 years
Sex: M+F
Sources:
Hyperactivity 1 patient
Disc. AE
0.75 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.75 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.75 mg/kg, 1 times / day
Sources:
unhealthy, 4-15 years
Health Status: unhealthy
Age Group: 4-15 years
Sex: M+F
Sources:
Rash 1 patient
Disc. AE
0.75 mg/kg 1 times / day multiple, oral
Highest studied dose
Dose: 0.75 mg/kg, 1 times / day
Route: oral
Route: multiple
Dose: 0.75 mg/kg, 1 times / day
Sources:
unhealthy, 4-15 years
Health Status: unhealthy
Age Group: 4-15 years
Sex: M+F
Sources:
Extrapyramidal symptoms 77%
8 mg 1 times / day multiple, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: multiple
Dose: 8 mg, 1 times / day
Sources:
unhealthy, mean 49.7 years
Health Status: unhealthy
Age Group: mean 49.7 years
Sex: M+F
Sources:
PubMed

PubMed

TitleDatePubMed
Anti-nicotinic properties of anticholinergic antiparkinson drugs.
1998-11
Risperidone-induced rabbit syndrome.
1998-09
Electromyography in cervical dystonia: changes after botulinum and trihexyphenidyl.
1998-09
Chronic haloperidol produces a time- and dose-related slowing of lick rhythm in rats: implications for rodent models of tardive dyskinesia and neuroleptic-induced parkinsonism.
1998-05
Antiparkinsonian drugs causing inappropriate antidiuretic hormone secretion.
1998-01
Trihexyphenidyl withdrawal encephalopathy.
1997-01
Anticholinergic overdose induced torsade de pointes successfully treated with verapamil.
1996-11
Trihexyphenidyl as a possible therapeutic option in clozapine-induced nocturnal enuresis.
1996-03
Positron emission tomography of reversible intellectual impairment induced by long-term anticholinergic therapy.
1995-09
[A 75-year-old man with parkinsonism and delirium].
1994-01
Memory and cognitive impairments in a case of long-term trihexyphenidyl abuse.
1993-03
Successful treatment of levodopa-induced myoclonus and levodopa withdrawal-induced neuroleptic malignant syndrome. A case report.
1988-06
[Parkinson's disease associated with trihexyphenidyl (THP) induced dysphonia plicae ventricularis].
1988-04
Dystonic reactions with metoclopramide: is there a risk population?
1987-06
Parkinson's disease and myasthenia gravis: adverse effect of trihexyphenidyl on neuromuscular transmission.
1987-05
Lithium-induced akathisia.
1987-02
Anticholinergic-induced chorea in the treatment of focal dystonia.
1987
Bradycardia due to trihexyphenidyl hydrochloride.
1986-10
[Trihexyphenidyl (THP)-induced respiratory dyskinesia].
1986-02
Pharmacological modification of DDT-induced tremor and hyperthermia in rats: distributional factors.
1986
Withdrawal of trihexyphenidyl.
1985-03
Trihexyphenidyl dependence.
1984-06
Intravenous lorazepam in neuroleptic-induced catatonia.
1983-12
Malignant neuroleptic syndrome due to haloperidol. (A case report).
1983-01
Sexual dysfunction in women using major tranquilizers.
1982-09
Catalepsy produced by long-acting neuroleptics, fluphenazine enanthate and fluphenazine decanoate, in mice.
1982
Akathisia: an overlooked, distressing, but treatable condition.
1981-09
Reversibility of long-term tardive dyskinesia associated with antiparkinsonian medication: a case report.
1981-08
Neuroleptic malignant syndrome.
1980-07
Extrapyramidal syndrome with sodium valproate.
1979-10-27
Choreiform movements induced by anticholinergic therapy.
1979-05-19
Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac C capsule.
1978-10-07
Mood elevating effect of trihexyphenidyl and biperiden in individuals taking antipsychotic medication.
1977-05
Anticholinergic exacerbation of phenothiazine-induced extrapyramidal syndrome.
1976-09
Amodiaquine-induced involuntary movements.
1976-07-24
Skeletal muscle necrosis following membrane-active drugs plus serotonin.
1976-05
[Outcome of Parkinsonism after two years of levodopa plus R04-4602 (author's transl)].
1975-07-01
Comparative trial of benzhexol, amantadine, and levodopa in the treatment of Parkinson's disease.
1974-04
Abnormal involuntary movements induced by anticholinergic therapy.
1974
Toxic liver injuries.
1973-08
Neuroleptics and neurologic reactions.
1973-03
Depot phenothiazine treatment in acute psychosis: a sequential comparative clinical study.
1973-01
An unusual response to chlorpromazine therapy.
1972-10
Benzhexol-induced blindness in Parkinson's disease.
1972-03-04
Benzhexol and side effects with long-acting fluphenazine therapy.
1972-01-29
Benzhexol-induced hallucinosis.
1971-03-06
Toxic psychosis induced by benzhexol hydrochloride.
1970-10-10
Reversal of central anticholinergic syndrome in man by physostigmine.
1968-11-25
Phenothiazines in early labour.
1967-02-11
Drug-induced extrapyramidal symptoms: their incidence and treatment.
1967-01
Patents

Sample Use Guides

Usual Adult Dose for Extrapyramidal Reaction 4 to 10 mg orally each day. The total daily dose is best tolerated when administered in 2 or three equally separated doses. Usual Adult Dose for Parkinson's Disease Initial: 1 mg/day; increase by 2 mg increments at intervals of 3 to 5 days Usual dose: 6 to 10 mg/day in 3 to 4 divided doses; doses of 12 to 15 mg/day may be required Drug-induced extrapyramidal symptoms: Initial: 1 mg/day; increase as necessary to usual range of 5 to 15 mg/day in 3 to 4 divided doses Use in combination with levodopa: Usual range: 3 to 6 mg/day in divided doses
Route of Administration: Oral
In Vitro Use Guide
Trihexyphenidyl 10, 50, and 100 umol/L depressed the maximal upstroke velocity (Vmax) and the action potential amplitude (APA) of SAP in guinea pig papillary muscles.
Substance Class Chemical
Created
by admin
on Wed Apr 02 06:53:49 GMT 2025
Edited
by admin
on Wed Apr 02 06:53:49 GMT 2025
Record UNII
6RC5V8B7PO
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
TRIHEXYPHENIDYL
HSDB   INN   VANDF   WHO-DD  
INN  
Official Name English
APO-TRIHEX
Preferred Name English
NSC-12268
Code English
Trihexyphenidyl [WHO-DD]
Common Name English
TRIHEXYPHENIDYL [VANDF]
Common Name English
TRIHEXYPHENIDYL [HSDB]
Common Name English
1-CYCLOHEXYL-1-PHENYL-3-(1-PIPERIDYL)PROPAN-1-OL
Systematic Name English
trihexyphenidyl [INN]
Common Name English
BENZHEXOL
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C38149
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
WHO-ATC N04AA01
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
LIVERTOX NBK547977
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
NCI_THESAURUS C29704
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
WHO-VATC QN04AA01
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
Code System Code Type Description
IUPHAR
7315
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
EVMPD
SUB11295MIG
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
LACTMED
Trihexyphenidyl
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
HSDB
3196
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
DRUG CENTRAL
2745
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
FDA UNII
6RC5V8B7PO
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
PUBCHEM
5572
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
RXCUI
10811
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY RxNorm
CAS
144-11-6
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
MESH
D014282
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
ECHA (EC/EINECS)
205-614-4
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
EPA CompTox
DTXSID4023705
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
INN
1318
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
SMS_ID
100000076937
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
ChEMBL
CHEMBL1490
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
NSC
12268
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
NCI_THESAURUS
C61988
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
DAILYMED
6RC5V8B7PO
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
DRUG BANK
DB00376
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
WIKIPEDIA
TRIHEXYPHENIDYL
Created by admin on Wed Apr 02 06:53:49 GMT 2025 , Edited by admin on Wed Apr 02 06:53:49 GMT 2025
PRIMARY
Related Record Type Details
TARGET -> INHIBITOR
SALT/SOLVATE -> PARENT
ENANTIOMER -> RACEMATE
Related Record Type Details
ACTIVE MOIETY