Last update March 17, 2019

Biperiden

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

A centrally-acting anticholinergic indicated chronically in Parkinson's disease and for occasional use in parkinsonian syndromes induced by drugs that can cause extrapyramidal side effects (Desma 2016, AEMPS 2014, Hagen 2001).
Oral or parenteral administration 2 to 4 times a day.

Since the last update we have not found any published data on its excretion in breast milk.

Its pharmacokinetic data (very large volume of distribution and high percentage of protein binding: Desma 2016, AEMPS 2014, Brocks 1999) makes it unlikely it will transfer into breastmilk in significant amounts.

Its low oral bioavailability (Desma 2016, AEMPS 2014, Grimaldi 1986) hinders transfer to infant plasma from breastmilk, except in premature infants and the immediate neonatal period when there may be increased intestinal permeability.

Although levels in milk could not be measured after administration of biperiden, plasma levels in a mother were 4.4 micrograms/L (Kuniyoshi 1985). Assuming that 100% of the breastmilk is excreted, the dose received by the infant would be 0.0007 mg/kg/day, which would mean a negligible relative dose, between 0.4 and 1.3%.

Expert authors believe that the use of this medication is probably safe during breastfeeding (Schaefer 2007, p733).

Despite its anticholinergic and dopaminergic effects, changes in prolactin levels have not been observed (Yisak 1993).

Alternatives

We do not have alternatives for Biperiden.

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Biperiden is also known as


Biperiden in other languages or writings:

Group

Biperiden belongs to this group or family:

Tradenames

Main tradenames from several countries containing Biperiden in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 30 - 33 %
Molecular weight 311 daltons
Protein Binding 95 %
VD 24 ± 4 l/Kg
pKa 13,8 -
Tmax 1 - 2 hours
T1/2 11 - 24 hours

References

  1. Desma. Biperideno (Akineton). Drug Summary. 2016 Full text (in our servers)
  2. AEMPS - SIT. Biperideno (Akinetón). Ficha técnica. 2014 Full text (in our servers)
  3. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  4. Hagen EM, Farbu E, Bindoff L. [Acute dystonia caused by metoclopramide (Afipran) therapy]. Tidsskr Nor Laegeforen. 2001 Abstract
  5. Brocks DR. Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective. J Pharm Pharm Sci. 1999 Abstract Full text (link to original source)
  6. Yisak W, Farde L, von Bahr C, Nilsson LB, Fredriksson G, Ogenstad S. Interaction study between remoxipride and biperiden. Psychopharmacology (Berl). 1993 Abstract
  7. Grimaldi R, Perucca E, Ruberto G, Gelmi C, Trimarchi F, Hollmann M, Crema A. Pharmacokinetic and pharmacodynamic studies following the intravenous and oral administration of the antiparkinsonian drug biperiden to normal subjects. Eur J Clin Pharmacol. 1986 Abstract
  8. Kuniyoshi M, Inanaga K. Haloperidol and biperiden plasma levels in a pregnant atypical psychotic woman and a neonate--a case report. Kurume Med J. 1985 Abstract Full text (link to original source) Full text (in our servers)

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