Anticholinergics can treat various health conditions, including urinary incontinence and certain types of poisoning. They can cause side effects due to decreased urination, digestion, and secretion of mucus and saliva.

Anticholinergics are drugs that block the action of acetylcholine. Acetylcholine is a neurotransmitter, or a chemical messenger. It transfers signals between certain cells to affect how your body functions.

Anticholinergics can treat a variety of conditions, including:

They also help block involuntary muscle movements associated with certain diseases such as Parkinson’s disease. Sometimes, they’re used before surgery to help maintain body functions while a person is treated with anesthesia.

Read on for:

  • a list of anticholinergic drugs
  • information about how they work
  • what you should know about their risks and side effects

Anticholinergics are only available with a doctor’s prescription. Examples of these drugs include:

  • atropine (Atropen)
  • belladonna alkaloids
  • benztropine mesylate (Cogentin)
  • clidinium
  • cyclopentolate (Cyclogyl)
  • darifenacin (Enablex)
  • dicylomine
  • fesoterodine (Toviaz)
  • flavoxate (Urispas)
  • glycopyrrolate
  • homatropine hydrobromide
  • hyoscyamine (Levsinex)
  • ipratropium (Atrovent)
  • orphenadrine
  • oxybutynin (Ditropan XL)
  • propantheline (Pro-banthine)
  • scopolamine
  • methscopolamine
  • solifenacin (VESIcare)
  • tiotropium (Spiriva)
  • tolterodine (Detrol)
  • trihexyphenidyl
  • trospium

On March 21, 2022, Sandoz issued a voluntary recall of 13 lots of the drug orphenadrine citrate 100mg ER tablets due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the acceptable daily intake (ADI) as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all orphenadrine tablets made by Sandoz. If you take orphenadrine citrate 100mg ER tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

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Although classified as an antihistamine to be taken for allergies and as a sleep aid, diphenhydramine (Benadryl) also has anticholinergic effects.

Each of these drugs works to treat specific conditions. Your doctor will choose the best drug for your condition.

DID YOU KNOW?

Some anticholinergics are derived from plants of the deadly nightshade family called Solanaceae. Burning the roots, stems, and seeds of these plants releases the anticholinergics. Inhalation of the smoke has been used for hundreds of years to treat obstructive airway disease.

Anticholinergics block acetylcholine from binding to its receptors on certain nerve cells. They inhibit actions called parasympathetic nerve impulses.

These nerve impulses are responsible for involuntary muscle movements in the:

The nerve impulses help control functions such as:

  • salivation
  • digestion
  • urination
  • mucus secretion

Blocking acetylcholine signals can decrease:

  • involuntary muscle movement
  • digestion
  • mucus secretion

That’s why these drugs can cause certain side effects, such as:

  • retaining urine
  • having a dry mouth

Anticholinergics are used to treat a variety of conditions. These include:

Anticholinergics can also be used as muscle relaxants during surgery to assist with anesthesia. They help:

  • keep the heartbeat normal
  • relax the person
  • decrease saliva secretions

Some doctors prescribe anticholinergics for off-label use to help decrease excessive sweating. The anticholinergics used most for this treatment are:

As do many drugs, anticholinergics come with several warnings.

Heat exhaustion and heat stroke

Anticholinergics decrease how much you sweat, which can cause your body temperature to rise. While taking one of these drugs, be extra careful not to become overheated during:

  • exercise
  • hot baths
  • hot weather

Decreased sweating can put you at risk of heat stroke.

Overdose and alcohol

Using too much of an anticholinergic drug can result in unconsciousness or even death. These effects can also happen if you take anticholinergics with alcohol. Signs of an overdose include:

If you think you or someone you know has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool.

If your symptoms are severe, call 911 or go to the nearest emergency room right away.

Conflicting conditions

Anticholinergics can be used to treat many conditions, but they aren’t for everyone. For example, these drugs aren’t usually prescribed for older people.

Anticholinergics are known to cause confusion, memory loss, and worsening mental function in people who are older than 65 years. In fact, recent studies have linked use of anticholinergics with increased risk of dementia.

Also, people with the following conditions shouldn’t use anticholinergics:

Tell your doctor if you have any of these conditions. Also, tell your doctor if you have a history of allergies to anticholinergics.

AVOIDING USE IN OLDER ADULTS

The American Geriatrics Society strongly recommends avoiding the use of anticholinergic medications in older adults. This is because seniors may be more likely to experience unwanted side effects than younger people.

Even when using this drug properly, side effects can happen. The possible side effects of anticholinergics depend on the specific drug and dosage you take.

Side effects can include:

  • dry mouth
  • blurry vision
  • constipation
  • drowsiness
  • sedation
  • hallucinations
  • memory problems
  • trouble urinating
  • confusion
  • delirium
  • decreased sweating
  • decreased saliva
DEMENTIA WARNING

Long-term use of anticholinergics, as well as use of these drugs in older people, has been linked with an increased risk of dementia. If you’ve been prescribed one of these drugs and have concerns about this risk, be sure to talk to your doctor.

Anticholinergics can be used to treat a variety of conditions. If you think one of these drugs could help you, talk to your doctor.

Your doctor can determine if treatment with an anticholinergic would be a good option for you. They can also answer any questions you have about:

  • risks
  • side effects
  • what to expect with treatment

Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions.

These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder.