Bethanechol

Oral
Urinary retention

Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.

Intestinal or urinary obstruction, recent MI, pronounced bradycardia or hypotension, recent intestinal anastomosis, hyperthyroidism, peptic ulcer, latent or active bronchial asthma, vasomotor instability, coronary artery disease, epilepsy, parkinsonism. Lactation.

Pregnancy.

Nausea, vomiting, sweating, intestinal colic, malaise, abdominal cramps or discomfort, belching, diarrhoea, borborygmi, salivation, urinary urgency, headache, hypotension, vasomotor response, hot flushes, sweating, lachrymation, miosis, seizure, reflux infection.

Parenteral/PO/SC: C

May impair ability to drive or operate machinery.

Assess bladder and sphincter adequacy prior to therapy.

Symptoms: Nausea, salivation, lachrymation, eructation, involuntary defecation and urination, transient dyspnoea, palpitation, bradycardia, peripheral vasodilation leading to HTN, transient heart block and feeling of constriction under sternum. Management: Perform gastric lavage and aspiration. Administer atropine sulfate 1-2 mg IV, IM or SC 2-4 hrly as necessary, to control muscarinic effects. Supportive treatment may include IV diazepam 5-10 mg; tubocurarine (w/ assisted respiration, to control muscle twitching); oxygen may be required.

Atropine, quinidine, procainamide, epinephrine and other sympathomimetic amines may antagonise the effect of bethanechol. Critical fall in blood pressure, usually preceded by severe abdominal symptoms, may occur when used w/ ganglionic blocking agents. Additive effects and increased toxicity w/ other cholinergic drugs or anticholinesterase agents (e.g. neostigmine).

Description: Bethanechol acts primarily by stimulating parasympathetic nervous system, hence releasing acetylcholine at the nerve endings. It increases the tone of detrusor urinary muscle, producing a contraction to initiate urination. It also stimulates gastric motility, restores impaired rhythmic peristalsis and increases gastric tone.
Onset: 30-90 min.
Duration: Approx 1 hr.
Pharmacokinetics:
Absorption: Poorly absorbed from the GI tract.

Source: National Center for Biotechnology Information. PubChem Database. Bethanechol, CID=2370, https://pubchem.ncbi.nlm.nih.gov/compound/Bethanechol (accessed on Jan. 21, 2020)

Store between 20-25°C.

Other Drugs Acting on the Genito-Urinary System

N07AB02 - bethanechol ; Belongs to the class of choline esters. Used as parasympathomimetics.

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Buckingham R (ed). Bethanechol chloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/08/2016.

Joint Formulary Committee. Bethanechol chloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 18/08/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Bethanechol Chloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 18/08/2016.

Myotonine 10 mg Tablets (Glenwood GmbH). eMC. https://www.medicines.org.uk/emc/. Accessed 18/08/2016.