Delpark1 mg

Delpark is an anticholinergic (antimuscarinic) medicine used for the following indications:

Established / FDA-approved uses

• Idiopathic Parkinson's disease (including postencephalitic and arteriosclerotic forms of parkinsonism) - to help control tremor, rigidity, and muscle stiffness.
• Adjunct therapy with levodopa in the management of all forms of parkinsonism - Delpark may add further improvement when used together with levodopa.
• Drug-induced extrapyramidal symptoms (EPS) caused by antipsychotic medicines such as phenothiazines, butyrophenones, thioxanthenes, and dibenzoxazepines (e.g. drug-induced parkinsonism, akathisia, and acute dystonic reactions).

Not recommended / off-label caution

Delpark is generally not recommended as a sole treatment for tardive dyskinesia (a late-onset movement disorder from long-term antipsychotic use) unless the patient also has coexisting Parkinson's disease, since anticholinergics can sometimes worsen tardive dyskinesia.

Each tablet contains Trihexyphenidyl Hydrochloride as the active ingredient, commonly available in strengths such as 2 mg and 5 mg. Excipients typically include microcrystalline cellulose, magnesium stearate, and sodium starch glycolate. An oral solution/syrup formulation (e.g. 2 mg/5 mL) is also available in some markets. Exact composition and available strengths/forms may vary by manufacturer; refer to the specific product label.

Delpark is a synthetic antimuscarinic (anticholinergic) agent chemically related to atropine but with a more selective action and generally milder peripheral side effects at therapeutic doses. It is used to help control the tremor and rigidity associated with Parkinson's disease and with drug-induced extrapyramidal reactions. It is available as tablets and, in some markets, as an oral solution.

Delpark belongs to the antiparkinsonian, anticholinergic (antimuscarinic) agents therapeutic class.

Trihexyphenidyl Hydrochloride exerts a direct inhibitory (antimuscarinic/anticholinergic) effect on the parasympathetic nervous system, similar in action to atropine but generally with a lower incidence of peripheral autonomic side effects at usual doses. In the central nervous system, it is believed to help restore the balance between depleted dopaminergic activity and relatively excessive cholinergic activity in the basal ganglia that occurs in Parkinson's disease and in drug-induced extrapyramidal syndromes, thereby reducing tremor, rigidity, and associated muscular stiffness. It also has a mild direct relaxant effect on smooth muscle.

Pharmacokinetics: Absorbed from the gastrointestinal tract; onset of action typically occurs within 1 hour of an oral dose, with peak effect around 2-3 hours and a duration of action of approximately 6-12 hours. It is metabolized in the liver, and excreted mainly via the kidneys.

Delpark is administered orally as a tablet or oral solution, usually 3-4 times a day with meals. Tablets should be swallowed with water. If dry mouth occurs, taking the dose after meals may help; if excessive salivation occurs, taking it before meals may help. Do not exceed the dose prescribed by the physician, and do not discontinue abruptly without medical advice.

Delpark has the following clinically significant drug interactions:

• Other anticholinergic/antimuscarinic drugs (e.g. antihistamines, tricyclic antidepressants, monoamine oxidase inhibitors, some antipsychotics): additive anticholinergic effects, increasing the risk of dry mouth, blurred vision, constipation, urinary retention, confusion, and heat intolerance.
• Alcohol and other CNS depressants (sedatives, opioids, benzodiazepines): additive sedative/CNS-depressant effects.
• Levodopa: when co-administered, the effects of both drugs may be altered; doses of both may need adjustment, and involuntary movements (dyskinesias) may increase.
• Antipsychotics (neuroleptics): concurrent use for drug-induced EPS may be associated with an increased risk of tardive dyskinesia with long-term use; anticholinergics do not prevent and may worsen tardive dyskinesia.
• Digoxin: anticholinergics may increase digoxin absorption/plasma levels in some formulations.

Inform the physician about all other medicines being taken before starting Delpark.

Side effects of Delpark are mostly related to its anticholinergic action and are dose-dependent; they often lessen with continued use as tolerance develops.

Common (anticholinergic) effects

• Dry mouth
• Blurred vision
• Dizziness or lightheadedness
• Mild nausea
• Nervousness
• Constipation
• Urinary hesitancy or retention
• Drowsiness

Less common / serious effects

• Confusion, memory impairment, hallucinations, delusions, or paranoia (more likely in elderly patients)
• Tachycardia (fast heart rate)
• Increased intraocular pressure/angle-closure glaucoma (see Contraindications)
• Suppurative parotitis (severe salivary gland infection due to reduced saliva flow)
• Paralytic ileus or abdominal distension
• Skin rash; reduced sweating (anhidrosis), which can raise the risk of heatstroke in hot weather
• Worsening of pre-existing tardive dyskinesia

Report any severe or persistent side effect to a physician promptly.

Pregnancy: Adequate and well-controlled studies of Delpark in pregnant women are lacking, and animal reproduction/teratogenicity data are limited. Delpark should be used during pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the fetus; consult a physician before use.

Lactation: It is not known whether Delpark is excreted in human breast milk. Anticholinergic agents may also suppress lactation. Delpark should be used during breastfeeding only if the expected maternal benefit outweighs the potential risk to the infant, and only under medical supervision.

Use Delpark with caution and under close medical supervision in the following situations:

• Elderly patients (especially over 60 years): increased sensitivity to anticholinergic effects, including confusion, memory impairment, and other cognitive effects; start with the lowest effective dose and observe closely.
• Glaucoma risk / undiagnosed narrow anterior chamber angle: ophthalmologic (gonioscopic) evaluation and intraocular pressure monitoring are recommended before and during therapy; see Contraindications for narrow-angle glaucoma.
• Cardiac disease, hypertension, hepatic or renal impairment: use with caution and close monitoring.
• Obstructive disease of the gastrointestinal or genitourinary tract (short of frank obstruction) and prostatic hypertrophy: anticholinergic action may worsen urinary retention or bowel motility issues.
• Hot weather or strenuous physical activity: Delpark can reduce sweating (anhidrosis), increasing the risk of heat exhaustion or fatal hyperthermia; avoid overheating and excessive exertion in hot environments.
• Do not stop abruptly after prolonged use - sudden discontinuation may cause acute worsening of parkinsonian symptoms or a neuroleptic malignant syndrome-like reaction; taper only under medical guidance.
• Potential for misuse/abuse: at supratherapeutic doses, Delpark has stimulant and euphoriant properties and has been misused for its hallucinogenic/euphoric effects; use only as prescribed and avoid exceeding the recommended dose.
• Driving/operating machinery: may cause dizziness, blurred vision, or drowsiness; use caution with such activities until effects are known.

Overdose of Delpark produces a central and peripheral anticholinergic (antimuscarinic) toxic syndrome, which may include dilated pupils, warm dry flushed skin, dry mouth, reduced secretions, fever, fast heart rate, urinary retention, and neuropsychiatric symptoms such as confusion, agitation, disorientation, hallucinations, and incoherence, which can progress to seizures, coma, and (rarely) death, particularly with very high doses or when combined with other CNS depressants.

If overdose is suspected, seek immediate medical attention or contact emergency services/a poison control center right away. Do not attempt to manage a suspected overdose at home. Treatment in a medical facility is supportive and may include measures to limit further drug absorption, control agitation, and support breathing, circulation, and body temperature, as determined by the treating physician.

Store at room temperature (below 30°C), away from light and moisture. Keep out of reach of children.

Pediatric use: The safety and effectiveness of Delpark in children have not been established. Use in children should only be under specialist medical supervision, when the physician judges the benefit outweighs the risk; reported adverse effects in children include hyperkinesia, behavioural changes, and sleep disturbance.

Elderly patients: Patients over 60 years of age are more sensitive to the anticholinergic effects of Delpark, including confusion and memory impairment; treatment should start at the lowest effective dose with close observation.

Renal/hepatic impairment: No well-established formal dose-adjustment guidelines exist; use with caution and close monitoring, as impaired clearance may increase the risk of anticholinergic toxicity.

Pregnancy and lactation: See Pregnancy and Lactation section above.

Duration of treatment with Delpark is determined by the treating physician based on the underlying condition (e.g. chronic Parkinson's disease management versus temporary control of drug-induced extrapyramidal symptoms following an antipsychotic dose change). Treatment is often long-term in Parkinson's disease. Do not stop treatment abruptly without medical advice, even if symptoms improve, as sudden discontinuation can cause rebound worsening of symptoms.

Trihexyphenidyl Hydrochloride is classified as an anticholinergic / antimuscarinic antiparkinsonian agent.

Trihexyphenidyl Hydrochloride works by blocking muscarinic acetylcholine receptors, producing an antimuscarinic (anticholinergic) effect similar to atropine. In Parkinson's disease and drug-induced extrapyramidal syndromes, dopaminergic activity in the basal ganglia is reduced relative to cholinergic activity; by inhibiting central cholinergic transmission, Trihexyphenidyl Hydrochloride helps restore this balance, reducing tremor and rigidity. It also has a mild direct antispasmodic action on smooth muscle.

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The safety and effectiveness of Delpark in pediatric patients have not been formally established. Its use in children (e.g. for drug-induced extrapyramidal symptoms) should occur only under close specialist supervision, with the lowest effective dose used and the child monitored for anticholinergic adverse effects such as hyperkinesia, behavioural change, and sleep disturbance.