What you need to know about Anticholinergic Medicine
Why have you been given this leaflet?
• You are taking an anticholinergic medicine
• Your doctor has suggested you start taking one
• To let you know about possible side effects of the medicine
• To help you decide whether to take this medicine
• Always talk to your doctor, nurse or pharmacist before stopping or changing any medicine
What are anticholinergic medicines?
Some medicines work by blocking a chemical in your body called acetylcholine so they are referred to as anticholinergic.
Acetylcholine is used in many parts of your body and helps you stay alert, keep a steady heart rate, breathe, digest food, sweat and empty your bladder. When you take an anticholinergic medicine, it acts on many parts of your body at the same time.
Anticholinergic medicines can be found in both prescription medicines and over the counter medicines bought in pharmacies:
• Bladder control medicines e.g. oxybutynin, tolterodine, solifenacin, trospium
• Medication to reduce stomach cramping e.g. dicycloverine, hyoscine (Buscopan®)
• Allergy medications e.g. chlorphenamine (Piriton®), hydroxyzine
• Antidepressants e.g. paroxetine, sertraline
• Medication for nerve pain e.g. amitriptyline, nortriptyline
• Some over the counter medicines containing diphenhydramine (Nytol®), promethazine, (Phenergan®, Sominex®, Night Nurse®), hyoscine (Kwells®, Joy-Rides®, Buscopan-IBS®)
Are there any side effects and what are my risks?
You can get side effects when you take anticholinergic medicine, and some things increase your risk of experiencing them. These include:
• You are taking higher doses
• You take the medicine for a long time
• You are taking more than one anticholinergic medicine
• You are older i.e. >65 years
As we get older, our liver and kidneys aren’t able to process medicines as well, so we become more sensitive to the adverse effects of them.
Also, many older adults have more than one health condition and may take many medicines, including one or more anticholinergics. The more medicines a person takes, the more likely it is that he or she will have unwanted side effects.
Do anticholinergic medicines increase the risk of dementia?
In the last few years studies have suggested that older adults who use anticholinergic medicines for a long time, or at higher doses, may have a higher risk of dementia.
Research has not proven that anticholinergic medicines cause dementia, but it does recommend that older adults limit the number of anticholinergic medicines they take and use the lowest dose for the shortest length of time.
What are the possible side effects from anticholinergic medicines?
When you take an anticholinergic medicine, it can act on many different parts of your body.
Brain-drowsiness, dizziness, confusion
Eyes-blurred vision, dry eyes
Heart-rapid heart rate
Falls-broken bones and other injuries
You and your doctor or other healthcare professional might decide together that the benefits of using these medicines outweigh the potential risks.
Steps to lower the risk of side effects from anticholinergic medicines
Step 1- Ask your doctor, pharmacist or nurse: “Am I taking any anticholinergic medicines?”
Step 2- There are many online tools available that can provide an anticholinergic burden score which will allow your health care professional to assess your risk of side-effects.
Step 3- Continue to check with your doctor, pharmacist or nurse about the anticholinergic side-effects of any new medication you buy over the counter or are prescribed
Always talk to your doctor, nurse or pharmacist before stopping or changing any medicine.