Extranil 5 Tablet contains Procyclidine Hydrochloride 5 mg. It is manufactured by General Pharmaceuticals Ltd. in Bangladesh.

Indications: Extranil is used for the adjunctive treatment of all forms of Parkinsonian syndrome, including:

• Idiopathic parkinsonism (paralysis agitans)
• Post-encephalitic parkinsonism
• Arteriosclerotic parkinsonism

It is also used to control troublesome extrapyramidal symptoms induced by neuroleptic drugs such as phenothiazine derivatives, including:

• Pseudo-parkinsonism
• Acute dystonic reactions
• Akathisia

Pharmacology: Procyclidine hydrochloride is a synthetic antimuscarinic antiparkinsonian agent with relatively low toxicity. It exerts its anti-Parkinson's effect by correcting the relative cholinergic excess believed to be caused by dopamine deficiency in Parkinson's disease. It is absorbed from the gastrointestinal tract and disappears rapidly from tissues. After intravenous administration, it takes effect within 5 to 20 minutes and lasts up to 4 hours.

Dosage and Administration: The tablets are administered orally, preferably after meals.

• Parkinsonism: Initially 2.5 mg three times a day, which may be increased to 5 mg three times a day and occasionally 5 mg at bedtime. The dosage is adjusted as tolerated or until the total daily dose reaches 20 to 30 mg divided into 3 to 4 doses. The usual maximum dose is 30 mg daily in divided doses and may be increased up to 60 mg daily in divided doses. 
• Drug-induced extrapyramidal symptoms: Initially 2.5 mg three times a day. The dosage may be increased by 2.5 mg per day as needed and tolerated, with a maximum of 20 mg daily.

Side Effects: At usual dosage levels, dryness of the mouth is generally the most common adverse effect. Other occasionally occurring side effects include:

• Mydriasis (dilation of the pupil)
• Blurred vision
• Gastrointestinal disturbances (nausea, vomiting, epigastric distress, constipation)

Allergic reactions (e.g., rash)Muscular weakness  

High doses may cause vertigo and possible confusion and hallucinations. Side effects may usually be minimized by adjustment of dosage and administration after meals. 

Precautions: It should be given with caution in children and geriatric patients. Caution is advised in patients with:

• Diarrhea
• Cardiovascular diseases
• Glaucoma
• Urinary retention
• Hepatic or renal impairment

Patients with mental disorders may occasionally experience a precipitation of a psychotic episode when Extranil is administered for the treatment of the extrapyramidal side effects of neuroleptics.  

Contraindications: Extranil is contraindicated in patients with:

• Tardive dyskinesia
• Hypersensitivity to procyclidine

Drug Interactions: The anticholinergic activity of procyclidine may be increased by agents having anticholinergic properties, such as amantadine. The absorption of ketoconazole may be reduced by concomitant administration of procyclidine.

Pregnancy & Lactation: There is no adequate data on the safe use of this drug in pregnancy and lactation.

Storage Conditions: Store in a cool and dry place, away from light. Keep out of the reach of children.

Important Note: This information is for general knowledge and informational purposes only and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.