Side Effects of orphenadrine: A Synthesis of Findings from 30 Studies

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Original Abstract of the Article

Main Research Findings

Orphenadrine is an anticholinergic drug often used to treat neurological conditions like Parkinson's disease and antipsychotic-induced dyskinesia. 28 points out a lack of thorough pharmacokinetic data for orphenadrine, particularly in elderly patients, which might hinder its safe and effective use. The study suggests that orphenadrine is absorbed quickly after oral administration, distributes widely in the body, and is extensively metabolized. 14 raises concerns about long-term anticholinergic use, indicating that it might contribute to tardive dyskinesia caused by antipsychotics. suggests potential benefits of orphenadrine in treating muscle cramps experienced by patients with cirrhosis, while 20 further supports this with pilot study results demonstrating orphenadrine's effectiveness for muscle cramps in this patient group. 23 emphasizes the seriousness of orphenadrine intoxication, warning that it can lead to severe adverse effects with life-threatening consequences. 16 identifies a potential mechanism for cardiac complications, showing that orphenadrine inhibits HERG channels, potentially leading to QT prolongation and torsades de pointes tachycardia.

Reasons for Side Effects

Orphenadrine's anticholinergic properties are the root cause of its diverse side effects. 28 highlights the concern that insufficient pharmacokinetic information about orphenadrine might impede its safe and effective use in the elderly. 14 suggests a possible link between long-term use of anticholinergics and tardive dyskinesia induced by antipsychotics. 16 reveals that orphenadrine can inhibit HERG channels, potentially contributing to QT prolongation and torsades de pointes tachycardia. Orphenadrine's central nervous system activity also contributes to side effects like drowsiness and decreased consciousness. 23 stresses the severe consequences of orphenadrine poisoning, which can be life-threatening.

Common Side Effects

Dry Mouth

Orphenadrine's effect on salivary secretion, reducing its production, can lead to dry mouth. reports dry mouth as a potential side effect of orphenadrine.

Constipation

Orphenadrine's ability to slow down intestinal movement can result in constipation. lists constipation as a possible side effect associated with orphenadrine.

Blurred Vision

Orphenadrine can cause blurred vision due to its effect of constricting the pupils of the eyes. 19 reports blurred vision as a side effect of orphenadrine.

Dizziness

Orphenadrine's action on the central nervous system can lead to dizziness. 19 reports dizziness as a possible side effect of orphenadrine.

Drowsiness

Orphenadrine's impact on the central nervous system can result in drowsiness and other side effects. 27 mentions sedation as a potential side effect associated with antispastic drugs, including orphenadrine. 17 presents research findings showing a pain-relieving effect from combining orphenadrine with diclofenac.

Decreased Level of Consciousness

Orphenadrine's effects on the central nervous system can lead to a decreased level of consciousness and other side effects. 1 reports decreased consciousness as a side effect of prochlorperazine (a drug used as an antipsychotic similar to orphenadrine).

QT Prolongation

Orphenadrine can cause QT prolongation by inhibiting HERG channels. 16 discovers that orphenadrine can inhibit HERG channels, potentially leading to QT prolongation and torsades de pointes tachycardia.

Torsades de Pointes Tachycardia

Orphenadrine can cause QT prolongation and torsades de pointes tachycardia by inhibiting HERG channels. 16 discovers that orphenadrine can inhibit HERG channels, potentially leading to QT prolongation and torsades de pointes tachycardia.

Toxicity

Orphenadrine can lead to toxicity. 23 emphasizes the potential severity of orphenadrine poisoning, which can have life-threatening consequences.

Measures to Counteract Side Effects

Measures for Dry Mouth

Managing dry mouth can involve drinking plenty of fluids. Chewing xylitol-containing gum or tablets can also be helpful.

Measures for Constipation

Constipation can be addressed by increasing dietary fiber intake and engaging in regular exercise. Laxatives may be used if necessary.

Measures for Blurred Vision

Addressing blurred vision might involve reducing or discontinuing orphenadrine dosage. Wearing glasses or contact lenses can also be beneficial.

Measures for Dizziness

Managing dizziness can involve reducing or discontinuing orphenadrine dosage. Getting up slowly to avoid falls is essential.

Measures for Drowsiness

Managing drowsiness might involve reducing or discontinuing orphenadrine dosage. It's crucial to avoid driving or operating machinery.

Measures for Decreased Level of Consciousness

Decreased level of consciousness is a serious side effect and requires immediate medical attention.

Measures for QT Prolongation

QT prolongation can increase the risk of arrhythmias and should be reported to a doctor immediately.

Measures for Torsades de Pointes Tachycardia

Torsades de pointes tachycardia is a serious arrhythmia that necessitates immediate medical attention.

Measures for Toxicity

If any symptoms of orphenadrine toxicity arise, it is crucial to seek medical help immediately.

Comparison Between Studies

Commonalities in Studies

Numerous studies have highlighted the anticholinergic nature of orphenadrine, which can lead to side effects like dry mouth, constipation, blurred vision, dizziness, and drowsiness.

Differences in Studies

Studies have shown variations in the severity and frequency of orphenadrine's side effects. Results on interactions between orphenadrine and other drugs also differ across studies. 22 indicates that orphenadrine effectively reduces extrapyramidal symptoms caused by haloperidol, 3 shows similar results for fluphenazine decanoate, and 25 highlights orphenadrine's effectiveness in reducing both extrapyramidal symptoms and depressive symptoms associated with fluphenazine decanoate. These studies collectively suggest that orphenadrine might be beneficial in managing extrapyramidal symptoms, but its efficacy may vary based on drug combinations and dosages.

Points to Note for Real-Life Applications

Orphenadrine is a medication with a range of potential side effects. Therefore, it's essential to adhere to your doctor's instructions and prescribed dosage when taking this medication. Promptly consult your doctor if any side effects emerge.

Limitations of Current Research

Research on the pharmacokinetics of orphenadrine is limited, especially concerning its pharmacokinetics in elderly patients and individuals with impaired renal or hepatic function. Furthermore, research on the long-term effects of orphenadrine is insufficient. 28 emphasizes the need for more pharmacokinetic data, particularly in the elderly, to ensure safe and effective use of orphenadrine.

Future Research Directions

Continued research on the pharmacokinetics of orphenadrine is crucial, with a particular focus on the elderly and patients with impaired renal or hepatic function. Additionally, research on the long-term effects of orphenadrine is necessary. Furthermore, elucidating the mechanisms underlying orphenadrine's side effects and developing novel medications to mitigate these side effects are essential research areas.

Conclusion

Orphenadrine, an anticholinergic medication, carries the potential for various side effects. Adhering to your doctor's instructions and prescribed dosage is crucial when taking orphenadrine. Consult your doctor immediately if any side effects develop. Further research on the safety of orphenadrine is essential to ensure its safe and effective use.

Literature analysis of 30 papers
Positive Content
18
Neutral Content
4
Negative Content
8
Article Type
6
2
3
7
30
1.

Prochlorperazine in childhood: side-effects.

Author: LankampD J, WillemseJ, PikaarS A, van HeystA N

Neurological side effects

Prochlorperazine (CompazineR StemetilR) was found to cause neurological side effects in 36 children up to the age of 16. The most common side effect was dyskinesia, followed by impaired consciousness, pyramidal signs, and hypertonus. These side effects are not related to dosage and disappear after stopping the drug. Orphenadrine (DisipalR) can be used for instant relief.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

A comparative trial of haloperidol decanoate and fluphenazine decanoate in chronic schizophrenic patients.

Author: WistedtB

Schizophrenic symptom improvement
Extrapyramidal side effects
Weight gain

Haloperidol decanoate was more effective than fluphenazine decanoate in treating schizophrenic symptoms. However, patients taking fluphenazine decanoate were more likely to gain weight.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Multidrug toxicity involving sumatriptan.

Author: KnittelJessica L, VorceShawn P, LevineBarry, HughesRhome L, BosyThomas Z

Acute mixed drug toxicity
Multidrug fatality

This report describes a multidrug fatality involving sumatriptan, highlighting the potential risks associated with high doses of the medication.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Anticholinergic medication for neuroleptic-induced tardive dyskinesia.

Author: SoaresK V, McGrathJ J

Movement disorder treatment
Neuroleptic side effects

Neuroleptic medication is widely used for chronic mental illnesses but can cause movement disorders. Anticholinergic drugs are often given to acutely psychotic patients on neuroleptics to reduce these side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

An experimental evaluation of the euphoric properties of antiparkinson drugs on psychotic patients.

Author: VågenR, GötestamK G

Euphoric effects
Extrapyramidal side effects

In a double-blind study comparing procyclidine, orphenadrine, and trihexyphenidyl hydrochloride to placebo, no significant differences in extrapyramidal side effects were observed. All drugs were well tolerated.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Droperidol in the management of hyperactivity, self-mutilation and aggression in mentally handicapped patients.

Author: BurnsM E

Droperidol efficacy
Parkinsonism

Droperidol was effective in treating hyperactivity, self-mutilation, aggression, and temper tantrums in mentally handicapped patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Cardiotoxicity from orphenadrine intoxication in humans.

Author: MaliziaE, SarcinelliL, PascarellaM, AmbrosiniM, SmeriglioM, RussoA

Cardiovascular side effects

Orphenadrine intoxication is a serious condition that can lead to coma and cardiovascular side effects, including arrhythmias. Treatment focuses on supportive care and forced diuresis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Muscle relaxants for pain management in rheumatoid arthritis.

Author: RichardsBethan L, WhittleSamuel L, BuchbinderRachelle

Pain management

Muscle relaxants are widely used as adjuncts in managing chronic musculoskeletal pain, but evidence supporting their effectiveness is limited.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

[The use of a fixed combination of diclofenac and orphenadrine for postoperative pain relief in orthopedic patients].

Author: GukalovA A, KlypaT V, Mandel'I A, MinetsA I

Postoperative pain relief

A fixed combination of orphenadrine and diclofenac was more effective in reducing postoperative pain following hip replacement surgery compared to morphine monotherapy. The combination was well-tolerated with no significant side effects.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Russian

11.

Opiate sparing effect of fixed combination of diclophenac and orphenadrine after unilateral total hip arthroplasty: A double-blind, randomized, placebo-controlled, multi-centre clinical trial.

Author: GombotzHans, LochnerRegina, SiglRudolf, BlaslJohann, HerzerGünther, TrimmelHelmut

Adequate analgesia
Patient safety
Reduced PCA analgesic requirements

A fixed combination of diclophenac and orphenadrin significantly reduced patient-controlled analgesia (PCA) analgesic requirements in patients after unilateral total hip arthroplasty (THA) while maintaining adequate analgesia and patient safety.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Evaluation of the phencyclidine-like discriminative stimulus effects of novel NMDA channel blockers in rats.

Author: NicholsonKatherine L, BalsterRobert L

Therapeutic effects
Motor impairment
PCP-like effects

This study reviewed the use of N-methyl-D-aspartate (NMDA) receptor antagonists for clinical use. While these antagonists have potential therapeutic effects, they can also cause significant side effects, including motor impairment and PCP-like subjective effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Anticholinergic medication for antipsychotic-induced tardive dyskinesia.

Author: BergmanHanna, Soares-WeiserKarla

Tardive dyskinesia

Antipsychotic medication is associated with movement disorders. Anticholinergic drugs are used to reduce these side effects, but there is evidence that chronic anticholinergic use may cause tardive dyskinesia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Anticholinergic antiparkinson drug orphenadrine inhibits HERG channels: block attenuation by mutations of the pore residues Y652 or F656.

Author: ScholzEberhard P, KonradFranziska M, WeissDaniel L, ZitronEdgar, KieseckerClaudia, BloehsRamona, KulzerMartin, ThomasDierk, KathöferSven, BauerAlexander, MaurerMartin H, SeemannGunnar, KatusHugo A, KarleChristoph A

Proarrhythmic

Orphenadrine, an anticholinergic drug, has been linked to QT prolongation and Torsade-de-Pointes tachycardia. The study found that orphenadrine directly blocks HERG channels, providing a molecular basis for its proarrhythmic side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

[Diclofenac/orphenadrine as a combined analgetic in post-operative relief of pain].

Author: BorsodiMarianna, NagyEdina, DarvasKatalin

Pain relief
Nausea
Vomiting

This study compared the potency, safety, and tolerability of diclofenac-orphenadrine infusion with tramadol HCl for postoperative pain relief.

Clinical Trial, Phase IVPost-marketing surveillance. Monitors long-term safety/efficacy after approval.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Hungarian

20.

Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

Author: Abd-ElsalamSherief, El-KallaFerial, AliLobna A, MosaadSamah, AlkhalawanyWalaa, ElemaryBerihan, BadawiRehab, ElzeftawyAsmaa, HanafyAmr, ElfertAsem

Muscle cramp reduction
Safe treatment

Orphenadrine was found to be safe and effective in treating muscle cramps in patients with liver cirrhosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Death caused by orphenadine poisoning.

Author: SørensenH C, Munk-JørgensenP

Cardiac poisoning
Neurologic poisoning

The number of deaths due to orphenadine poisoning appears to be increasing, particularly among severely psychotic males. The lethal dose corresponds to the average weekly dose used for treating neuroleptic extrapyramidal side effects. Early recognition and prompt treatment are crucial due to the serious and rapidly developing cardiac and neurological symptoms.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

[Clinical pharmacology of anticholinergic antiparkinson agents. A review with emphasis on acute toxicity].

Author: GjerdenP, SlørdalL

Drug overdose

Orphenadrine, an anticholinergic antiparkinsonian drug, carries a higher risk of abuse and overdose compared to biperiden and benztropine, and its use should be discouraged.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Norwegian

25.

A comparative trial of orphenadrine and tofenacin in the control of depression and extrapyramidal side-effects associated with fluphenazine decanoate therapy.

Author: CapstickN, PudneyH

Depression control
Parkinsonism control

Both orphenadrine hydrochloride and its metabolite, tofenacin hydrochloride, effectively controlled Parkinsonian side effects in patients receiving fluphenazine decanoate. However, orphenadrine was significantly better (p < 0.05) at controlling depressive side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

Salicylic acid plasma levels following multiple doses of Norgesic Forte and aspirin.

Author: HarrisonL I, KeheC R, GoldlustM B, KvamD C, BianchineJ R

Anti-inflammatory effect
No increased side effects

Norgesic Forte, containing orphenadrine citrate, aspirin, and caffeine, provided equivalent anti-inflammatory levels of salicylic acid as plain aspirin without any increased or unusual side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

27.

Traditional pharmacological treatments for spasticity. Part II: General and regional treatments.

Author: GraciesJ M, NanceP, ElovicE, McGuireJ, SimpsonD M

Spasticity treatment
Muscle weakness
Reduction of global performance
Sedation

This chapter reviews the pharmacology, physiology of action, dosage, and results from controlled clinical trials on side effects, efficacy, and indications for 21 antispastic drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

28.

Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective.

Author: BrocksD R

Treat Parkinson's disease
Peripheral side effects

Anticholinergic drugs are still used for the treatment of Parkinson's disease. These drugs are rapidly absorbed after oral administration with a bioavailability ranging from 30% to over 70%. While there is a lack of pharmacokinetic data for multiple dose administration and in the elderly, this may hinder the safe and effective use of these drugs in patients with Parkinson's disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

29.

[Diclofenac 75mg. and 30 mg. orfenadine (Neodolpasse) versus placebo and piroxicam in postoperative analgesia after arthroscopy].

Author: MálekJ, NedĕlováI, LopourováM, StefanM, KostálR

Postoperative analgesia

This study evaluates a new analgesic agent, Neodolpasse, based on diclophenac and orphenadine, as a substitute for pethidine, a commonly used opioid for postoperative pain relief after arthroscopy. The study compares the efficacy of Neodolpasse to piroxicam and placebo.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Czech

30.

Orphenadrine in treatment of muscle cramps in cirrhotic patients: a randomized study.

Author: Abd-ElsalamSherief, EbrahimShaimaa, SolimanShaimaa, AlkhalawanyWalaa, ElfertAsem, HawashNehad, ElkadeemMahmoud, BadawiRehab

Muscle cramps relief

This study purposed to evaluate efficacy and safety of orphenadrine in the treatment of muscle cramps in cirrhotic patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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