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Parasympathomimetic
Bethanechol is a synthetic muscarinic stimulant. Bethanechol exerts its parasympathomimetic effects by a direct action on muscarinic (cholinergic) receptors. Bethanechol primarily affects the urinary and GI tracts. Its effect on the bladder results from stimulation of muscarinic receptors in the detrusor muscle. The detrusor contracts, decreasing bladder capacity and producing urination.
urinary retention in adults:
Determine minimal effective dose initially by giving 5—10 mg and repeating at hourly intervals until therapeutic goals are attained or until maximum of 50 mg PO given. The usual dosage is 10_50 mg PO 3_4 times per day.
Hypersensitivity to bethanechol chloride, hyperthyroidism, peptic ulcer, latent or active bronchial asthma, pronounced bradycardia or hypotension, vasomotor instability, coronary artery disease, epilepsy and parkinsonism.
Bethanechol chloride should not be employed when the strength or 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, as following recent urinary bladder surgery, gastrointestinal resection and anastomosis or when there is possible gastrointestinal obstruction; in bladder neck obstruction, spastic gastrointestinal disturbances, acute inflammatory lesions of the gastrointestinal tract, or peritonitis; or in marked vagotonia.
Pregnancy: Category C
It is not known if bethanechol is excreted into breast milk. Because of the potential for serious adverse reactions from bethanechol chloride in nursing infants, a decision should be made whether to discontinue breast-feeding or to discontinue bethanechol, taking into account the importance of the drug to the mother.
Reflex infection: In urinary retention, if the sphincter fails to relax as bethanechol chloride contracts the bladder, urine may be forced up the ureter into the kidney pelvis. If there is bacteriuria, this may cause reflux infection.
Acetylcholinesterase inhibitors, Beta-blockers, Cimetropium.
A fall in blood pressure with reflex tachycardia; vasomotor response, Headache, Flushing producing a feeling of warmth; sensation of heat about the face; sweating, abdominal cramps or discomfort; colicky pain; nausea and belching, diarrhea; borborygmi (rumbling/gurgling of stomach); salivation, urinary urgency, bronchial constriction; asthmatic attacks,
Lacrimation; miosis, malaise.
If you accidentally take too many Bethanechol tablets or take a higher dose than recommended by your doctor, it is important that you tell your doctor at once. If you cannot contact your doctor, go to the nearest accident and emergency department.
Store below 30°C.
