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Anticholinergics can help with asthma, COPD, bladder conditions, GI disorders, and more. Book an appointment today with one of our board-certified doctors online. Get a new prescription for anticholinergics or refill an existing prescription today.*

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About anticholinergics

Anticholinergics are medications designed to block the actions produced by a specific type of neurotransmitter known as acetylcholine. They’re often prescribed to help treat many conditions, including asthma and gastrointestinal disorders, but they’re also used for other conditions. There are two main types of prescription anticholinergics. It is essential to understand the differences between these anticholinergic drugs.

What anticholinergics treat

The most common conditions treated with anticholinergics are urinary problems and specific conditions that affect the respiratory system, such as chronic obstructive pulmonary disorder.

These drugs are designed to block the transmission of signals between specific cells due to the functionality of acetylcholine, a neurotransmitter naturally present in the human body.

The neurotransmitter acetylcholine binds to a select number of nerve cells. When acetylcholine binds to these cells, it causes what is known as parasympathetic nerve impulses. These effects occur within the parasympathetic nervous system.

Other conditions are also treated with anticholinergic drugs. Sometimes, a healthcare professional will use an anticholinergic drug to treat certain poisonings. Additionally, due to its effect on the nervous system, anticholinergic medications are sometimes also used to treat Parkinson's disease. In cases where an anticholinergic drug is used for Parkinson's disease, it may help to reduce the involuntary muscle movements that patients experience when they have this disease.

Types of anticholinergics available online

The two types of anticholinergic medications are called antimuscarinic agents and antinicotinic agents.

Antimuscarinic agents

Antimuscarinic agents are most often used to treat an overactive bladder. Anticholinergics, classified as antimuscarinic agents, affect specific muscle and nerve cells in the bladder. In particular, these drugs with anticholinergic properties affect the detrusor muscle of the bladder, which is thought to impact bladder control. This may help reduce the risk of leakages and assist individuals with frequent nighttime urination.

Examples of antimuscarinic agents include:

Ditropan (oxybutynin)

Sanctura (trospium)

Enablex (darifenacin)

Spiriva® inhaler

Antinicotinic agents

Antinicotinic agents are often used for symptoms generally associated with Parkinson's disease. These drugs are sometimes also referred to as nicotinic antagonists. They work by inhibiting the neurotransmitter acetylcholine's actions at the nicotinic acetylcholine receptors found in the body.

Parkinson's disease is not the only condition treated with these anticholinergic medications. There are cases where this type of anticholinergic drug is used to help in the treatment of nicotine addiction.

Examples of antinicotinic agents include:

Benztropine

Biperiden

Ethopropazine

Trihexyphenidyl

Procyclidine

How anticholinergics work

Anticholinergic drugs function by inhibiting the action of a certain neurotransmitter that naturally circulates in the body. The neurotransmitter acetylcholine binds to certain nerve cells, which can affect the central nervous system. This is not the only nervous system that these neurotransmitters can affect. When you take an anticholinergic drug, it stops the acetylcholine neurotransmitter from binding to these specific cells.

Side effects of anticholinergics

When taken as prescribed, anticholinergics are generally well tolerated. However, they can still cause some side effects.

The more common side effects of anticholinergics include:

Blurred vision

Sedated effects

Drowsiness

Problems with memory

Urination difficulties

Constipation

Confusion

A reduction in sweating

Reduced saliva production

There are also certain cases where individuals experience hallucinations and delirium as side effects when they use an anticholinergic drug.

In rare cases, anticholinergics may cause serious side effects. These can include:

Severe drowsiness

A high fever

More severe hallucinations

Breathing difficulties

Slurred speech

A fast heartbeat

Flushing

It is important that patients note anticholinergic drugs reduce the amount of sweat the body produces. While effective for a condition like chronic obstructive pulmonary disease or even Parkinson's disease, anticholinergic drugs do cause an increased risk of heat stroke and overheating of the body. This is why individuals who take drugs with anticholinergic properties should be careful about sun exposure and exercise.

You should also avoid taking anticholinergic agents with alcohol. This can cause a more severe range of side effects. It is also possible for an interaction between anticholinergic medications and alcohol to result in unconsciousness. In rare cases, the alcohol and anticholinergic drug interactions have also resulted in death.

Anticholinergics risks

Anticholinergics are generally safe, but there are some risks if you have other medical conditions or take certain medications.

Before you take a prescribed anticholinergic, be sure to tell your doctor if you have any of the following conditions or issues:

Hyperthyroidism

Blockage in the urinary tract

Tachycardia

Heart failure

Liver disease

Hiatal hernia

Myasthenia gravis

Glaucoma

An enlarged prostate

People who have a history of severe constipation should also talk to their doctor about the potential complications that drugs with anticholinergic properties may produce. Additionally, people with down syndrome are also not advised to take anticholinergic agents.

Older adults also need to be monitored closely for adverse events. There is a higher risk of a decline in cognitive function among these older adults. Thus, the anticholinergic risk scales need to be considered. The doctor needs to weigh the therapeutic effects to the potential adverse events that could occur with the use of anticholinergics in older adults.

Anticholinergics drug interactions

When you begin a new medication, make sure to tell your doctor about any other medications, supplements, or herbs you’re taking. Some medications that might interact with anticholinergics include:

MAOIs

TCAs

Antihistamines

Antiparkinsonisms

Some of these drugs also exhibit anticholinergic effects. When taken in combination with anticholinergic medications, there is a significantly increased risk for more serious side effects. Combining multiple anticholinergic drugs can also have a more significant impact on the central nervous system. Thus, patients should carefully discuss these factors with their doctor to determine the potentially inappropriate medication that they should not take with the drugs.

Anticholinergics FAQs

How should I take anticholinergics?

Your doctor will provide you with extensive details regarding the dosage and administration of anticholinergic drugs. It is important to carefully follow these instructions when you use anticholinergic medications. This can help to make the process of using drugs with anticholinergic properties safer and also reduce the potential risks that may occur. The dosage will depend on the condition that are being treated.

The doctor will use an anticholinergic drug scale to determine the most appropriate dose for your scenario. The dosage may be different for chronic obstructive pulmonary disease and an overactive bladder, for example. Taking more of the drugs that are prescribed may result in increased anticholinergic activity. This can cause more severe adverse effects.

Who shouldn’t take anticholinergics?

There are some individuals who may be at an increased risk of experiencing serious side effects when they use anticholinergic medications. If you already use medications that affect your central nervous system, then mention this to your doctor. They can determine if these drugs will interact with the anticholinergic medications.

If more than one drug causes similar effects, then it can lead to anticholinergic toxicity. This causes an anticholinergic burden in the body. While it may still produce improvements in symptoms like urinary incontinence, the risk of cognitive impairment and other complications is significantly increased. People with certain existing conditions, such as digestive and kidney disease, should also be careful when they have prescribed drugs with anticholinergic properties. Tell your doctor if you have digestive and kidney diseases before you start to take these drugs.

How long does it take for anticholinergics to work?

Anticholinergic medications are not meant to provide immediate relief of urinary incontinence, an overactive bladder, respiratory disorders, or other symptoms that the patient experiences. It usually takes a while for the anticholinergic drugs to work. Some patients may experience some improvements in their symptoms after a few hours when they take their first dose. For most people, however, it takes a couple of days before they can notice real improvements.

What should I avoid with anticholinergics?

Never combine anticholinergic drugs with alcohol. This can cause severe adverse effects that can result in death in certain cases. Anticholinergic effects can also interact with other drugs that have similar properties. Thus, make sure you consider how each prescription and over-the-counter drug you take affects the cholinergic system in your body.

What is an anticholinergic drug used for?

There are several uses for drugs that have anticholinergic properties. These drugs affect cholinergic receptors and can help to improve symptoms of certain conditions, such as urinary incontinence, an overactive bladder, and a few other problems that affect the urinary tract. There are also cases where people who have Parkinson's disease experience improvements in their symptoms when they use drugs that affect the cholinergic receptors in the body. This is due to the anticholinergic activity that these drugs are able to produce.

What is an example of an anticholinergic?

There are two main types of drugs that help to increase serum anticholinergic activity in the human body. These include antimuscarinic agents and antinicotinic agents. Examples of drugs that affect muscarinic receptors include Ditropan, Sanctura, and Enablex. Benztropine, Ethopropazine, Trihexyphenidyl, and Procyclidine are examples of antinicotinic agents.

Do you need a prescription for anticholinergics?

You are unable to obtain drugs that produce an anticholinergic activity in the body without a prescription from a licensed doctor.

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