Class | Drugs | Relative anticholinergic potency |
Antihistamines | H1 receptor antagonists, first-generation: brompheniramine, carbinoxamine, chlorpheniramine, clemastine, cyproheptadine, dimenhydrinate, diphenhydramine, doxepin, doxylamine, hydroxyzine, meclizine, triprolidine, others | High |
H1 receptor antagonists, second-generation: fexofenadine, cetirizine*, loratadine, desloratadine, levocetirizine, others | Low | |
Antiparkinson | Benztropine, trihexyphenidyl | High |
Amantadine, bromocriptine, entacapone | Low | |
Analgesic | Opioids: codeine, hydrocodone, fentanyl, meperidine, methadone, morphine, oxycodone, tramadol, others | Low |
Antimuscarinic, overactive bladder | Darifenacin, fesoterodine, flavoxate, oxybutynin, solifenacin, tolterodine, trospium | High |
Antimuscarinic, spasmolytic | Atropine, belladonna-containing medications, clidinium-chlordiazepoxide, dicyclomine, hyoscyamine, glycopyrrolate, homatropine, methscopolamine, propantheline, scopolamine (hyoscine) | High |
Antimuscarinic, inhaled bronchodilator | Ipratropium, tiotropium | High (local effect) |
Antimuscarinic, ophthalmic drops (mydriatic/cycloplegic) | Atropine, cyclopentolate, homatropine, scopolamine | High (local effect) |
Cardiovascular | Disopyramide | Low |
Gastrointestinal | Antiemetics (eg, hydroxyzine, meclizine, promethazine, scopolamine); also refer to first-generation antihistamines above | High |
Domperidone, loperamide, prochlorperazine | Low | |
H2 receptor antagonists (cimetidine, famotidine¶) | Low | |
Muscle relaxant | Orphenadrine, tizanidine | High |
Cyclobenzaprine*, baclofen, methocarbamol | Low | |
Psychotropic | Antipsychotics, first-generation: chlorpromazine, fluphenazine, loxapine, methotrimeprazine (levomepromazine), thioridazine, trifluoperazine | High |
Antipsychotics, first-generation: haloperidol, perphenazine*, others | Low | |
Antipsychotics, second-generation: clozapine | High | |
Antipsychotics, second-generation: olanzapine*, quetiapine*, iloperidone, risperidone, others | Low | |
Benzodiazepines: chlordiazepoxide, clonazepam, temazepam, triazolam | Low | |
Selective serotonin reuptake inhibitor (SSRI) antidepressants: citalopram, fluoxetine, fluvoxamine, paroxetine* | Low | |
Tricyclic antidepressants: amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, others | High | |
Other neurologic | Carbamazepine, lithium, nefazodone, oxcarbazepine, phenelzine, trazodone | Low |
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