Drug Interaction:
Concurent administration of bethanechol with other cholinergic agents can cause additive effects leading to toxicity
Co-administration of bethanechol with ganglion blockers produces a clinical fall in blood pressure
Concomittant administration of bethanechol with sympathomimetic amines like ephidrine antognozies the effect of bethanechol and produces opposite effects.
Bethanechol may be used with antacids, as an adjunct to the treatment of reflux oesophagitis and may prevent the adverse effects of tricyclic antidepressants
Indication:
Post operative and post-partum non-obstructive urinary retention
Adverse Reaction:
Adverse drug reactions are rare following oral administration and are more likely to occur when the usage is increased.
Nausea and vomitting may occur if the drug is taken immediately after food
Other reported adverse effects include Frequency of micturation,
Lower abdominal cramps, and blurred vision.
Contra-Indications:
Hypersensitivity to bethanechol , hypothroidism, peptic ulcer,
latent or active bronchial asthma, pronounced bradycardia or hypotension,
vasomotor instability, coronary artery disease.
epilepsy and Parkinsonism
Bethanechol should not be used when the strength and integrity of the gastrointestinal or bladder wall is in question or in the presence of mechanical obstruction, when increased muscular activity of the gastrointestinal tract or urinary bladder might prove harmful.
or when there is a possible gastrointestinal obstruction, in bladder neck obstruction, spastic gastrointestinal disturbances, acute inflammatory lesions of the gastrointestinal tract or peritonitis or in marked vagotonia
Special precautions:
In urinary retention, if the sphincter fails to relax, as bethanechol contracts the bladder, urine may be forced in the ureter into the kidney. If there is bacteruria, this may cause reflux infection.
The safety and effectivenss in pregnancy has not been established
It is not known whether the drug is secreted in human milk and because of the potential for serious adverse reactions from bethanechol in nursing infants , a decison should be taken whether to discontinue the drug or whether to discontinue nursing, taking into account the importance of the drug to the mother.
Safety and effectiveness in children not established
Dosages/ Overdosage Etc:
Indications:
Post and post-partum non-obstructive (funtional ) urinary retention Neutrogenic atony of the urinary bladder and retention
Dosage:
Adult- 10 to 50 mg three to four times a day. The drug can be administered 5-10 mg initially and the dose repeated at hourly intervals until a satisfactory response occurs or until a maximum of 50mg is reached
Patient Information:
Bethanechol - systemic
1.To avoid nausea and vomiting, take on an empty stomach. If taken soon after eating
nausea and vomiting may occur
2 May cause abdominal discomfort, salivation, sweating or flushing, notify physician
if these effects are pronounced
3. Dizziness, lightheadedness or fainting may occur, especially when getting up from
lying or sitting position
4.Allergies-
Tell your doctor if you are have ever had any unusual or allergic reaction to
bethanechol. Also tell your healthcare care professional if you are allergic to any other
substances such as foods. preservatives or dyes.
5.Pregnancy-
Studies have not been done in either humans or animals.
6. Breast-feeding-
It is known whether bethanechol passes into breast milk.
7.Children-
Although there is no specific information comparing bethanechol in children
with use in other age groups,this medicine is not expected to cause differnt side
effects or problems than it does in adults.
8.Older adults-
Many medicines have not been studied specifically in older people. Therefore,
it may not be known whether they work exactly the same way than they do in
younger adults, or if they cause different side effects or problems in older people.
Although there is no specific information comparing use of bethanechol
in the elderly with use in other age groups, it is not expected to cause different
side effects or problems in older people than it does in younger adults.
9. Other medicines-
Although certain medicines should not be used together at all, in other cases two
different medicines may be used together even if an interaction might occur. in such
cases your doctor may want to change the dose, or other precautions may be necessary.
Tell your doctor if you are using any other topical prescription of prescription or
non-prescription (Over-the counter) OTC medicine.
10. Other medical problems-
The presence of other medical problems may affect the use of bethanechol.
Make sure you tell your doctor if you have any other medical problems especially-
Asthma or
Epilepsy or
Heart or blood vessel disease or
Intestinal blockage or
Low blood pressure or
Parkinsons disease or
Recent bladder or intestinal surgery or
Stomach ulcer or other stomach problems or
Urinary tract blockage or difficult urination - bethanechol may make
these conditions
High blood pressure - bethanechol may cause a rapid fall in blood
pressure
Overactive thyroid- bethanechol may further increase the chance of
heart problems
Pharmacology/ Pharmacokinetics:
Pharmacology:
Bathanechol is a parasympathetic agent that is a quaternary ammonium compound usually formulated as the chloride It is the methyl analogue of carbachol. Bethanechol has a stimulant action on the muscarinic cholinergic receptors. It acts directly on the smooth muscle cells and is in contrast to acetylcholine (Ach) it is not hydrolysed by cholinesterases and is more stable in the blood or tissues. Its action in the urinary bladder and other cholinergic receptors sites include- bladder smooth muscle contration, reducton in bladder capacity, increase in the frequency ureteric peristalisis, increased esophageal peristalsis, increased pancreatic and gastrointestinal secretion of cholinergic stimulation are usually absent or minimal when orally or subcutaneously administered in therapeutic doses.
Pharmacokinetics:
Bethanechol is poorly absorbed from the gastrointestinal tract. Effects on the GI and the uribary tracts sometimes appear within 30 minutes after oral administration of bethanechol, but more often 60-90 minutes are required to reach maximum effectiveness. Following oral administration, the usual duration of action of bethanechol is one hour. High doses of bethanechol may release acetylcholine, which stimulate nicotinic receptors but the effect is minimal at the recommened therapeutic doses. The metabolic fate and mode of excretion of the drug have not been elucidated
Interaction with Food:
Nausea and vomitting may occur if the drug is taken immediately after food
Take on an empty 1 hr before or 2 hrs after meals
Pregnancy and lactation:
The safety and effectivenss in pregnancy has not been established Because of the potential for serious adverse reactions from bethanechol in nursing infants , a decison should be taken whether to discontinue the drug or whether to discontinue nursing, taking into account the importance of the drug to the mother. Safety and effectiveness in children not established
Manufacturer Details