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(Date of issue: September 2017, Version: 3)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.


Procyclidine is an anticholinergic agent used mainly for the treatment of idiopathic or drug-induced dystonic reactions and Parkinson’s disease. There are no published data regarding the fetal effects of procyclidine use in human pregnancy. UKTIS have collected over 50 prospective pregnancy outcomes, but due to the small sample size and maternal co-exposure to other medications no conclusions can be drawn regarding the fetal safety of procyclidine exposure in pregnancy.

Where maternal treatment with procyclidine is clinically indicated it should be offered, provided the woman is carefully counselled regarding the limited available human pregnancy safety data, or the prescriber considers the risk of not treating the maternal condition too great to withhold treatment on the basis of the undetermined fetal risk.

Drug-induced dystonic reactions are commonly associated with antipsychotic use, and use of procyclidine in such patients may be considered necessary. An increased incidence of neonatal complications has been reported in the offspring of patients with psychotic illnesses; however the relative contributions of the underlying maternal condition and specific drug treatments have not been clearly defined. Use of centrally acting drugs throughout pregnancy or around the time of delivery is associated with an increased risk of poor neonatal adaptation syndrome (PNAS). Maternal exposure to procyclidine prior to delivery may also result in anticholinergic side effects such as urinary retention, constipation, increased heart rate and neurological disturbance in the newborn. Monitoring of the neonate post-delivery is advised.

Given the lack of pregnancy safety data, a detailed fetal anomaly scan, where exposure to procyclidine has occurred in the first trimester of pregnancy, is recommended. Other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when considering the need for additional pregnancy monitoring. Discussion with UKTIS is recommended in all cases.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from or to ensure you are using the most up-to-date version.