l, the alcoholic, those who have central nervous system disease, and those who do manual labor in a hot environment. anhidrosis may occur more readily when some disturbance of sweating already exists. if there is evidence of anhidrosis, the possibility of hyperthermia should be considered. dosage should be decreased at the discretion of the physician so that the ability to maintain body heat equilibrium by perspiration is not impaired. severe anhidrosis and fatal hyperthermia have occurred.

patients, and thin patients cannot tolerate large doses. most patients with postencephalitic parkinsonism need fairly large doses and tolerate them well. patients with a poor mental outlook are usually poor candidates for therapy. in idiopathic parkinsonism, therapy may be initiated with a single daily dose of 0.5 to 1 mg at bedtime. in some patients, this will be adequate; in others 4 to 6 mg a day may be required. in postencephalitic parkinsonism, therapy may be initiated in most patients with 2 mg a day in one or more doses. in highly sensitive patients, therapy may be initiated with 0.5 mg at bedtime, and increased as necessary. some patients experience greatest relief by taking the entire dose at bedtime; others react more favorably to divided doses, two to four times a day. frequently, one dose a day is sufficient, and divided doses may be unnecessary or undesirable. the long duration of action of this drug makes it particularly suitable for bedtime medication when its effects may last throughout the night, enabling patients to turn in bed during the night more easily, and to rise in the morning. when benztropine mesylate is started, do not terminate therapy with other antiparkinsonian agents abruptly. if the other agents are to be reduced or discontinued, it must be done gradually. many patients obtain greatest relief with combination therapy. benztropine mesylate may be used concomitantly with carbidopa-levodopa, or with levodopa, in which case periodic dosage adjustment may be required in order to maintain optimum response. drug-induced extrapyramidal disorders - in treating extrapyramidal disorders due to neuroleptic drugs (e.g., phenothiazines), the recommended dosage is 1 to 4 mg once or twice a day orally, or parenterally. dosage must be individualized according to the need of the patient. some patients require more than recommended; others do not need as much. in acute dystonic reactions, 1 to 2 ml of the injection usually relieves the condition quickly. after that, the tablets, 1 to 2 mg twice a day, usually prevents recurrence. when extrapyramidal disorders develop soon after initiation of treatment with neuroleptic drugs (e.g., phenothiazines), they are likely to be transient. one to 2 mg of benztropine mesylate tablets two or three times a day usually provides relief within one or two days. after one or two weeks, the drug should be withdrawn to determine the continued need for it. if such disorders recur, benztropine mesylate can be reinstituted. certain drug-induced extrapyramidal disorders that develop slowly may not respond to benztropine mesylate. call your doctor for medical advice about side effects. you may report side effects to the fda at 1-800-fda-1088 or leading pharma, llc at 1-844-740-7500.

g., skin rash, develops. if this cannot be controlled by dosage reduction, the medication should be discontinued. other heat stroke, hyperthermia, fever.