Bethanechol

Urinary Retention

Oral Acute postoperative nonobstructive urinary retention, Acute postpartum nonobstructive urinary retention, Neurogenic atony of the bladder with retention Adult: Initially, 5-10 mg Repeat the initial dose at hourly intervals until an effective response is achieved or until the Maximum of 50 mg is given. Usual dose: 10-50 mg 3-4 times daily. Dose must be individualized based on response, type and severity of the condition.

Should be taken on an empty stomach.

Hypersensitivity, hyperthyroidism, peptic ulcer, latent or active bronchial asthma; coronary artery disease, recent MI, pronounced bradycardia or hypotension, vasomotor instability; epilepsy, parkinsonism; conditions when increased muscular activity of the gastrointestinal tract or urinary bladder may prove harmful (e.g. following recent urinary bladder surgery, gastrointestinal resection and anastomosis, possible gastrointestinal obstruction); conditions wherein the strength or integrity of the gastrointestinal or bladder wall is questionable; mechanical obstruction of the gastrointestinal and genitourinary tract; bladder neck obstruction, acute inflammatory lesions of the gastrointestinal tract, spastic gastrointestinal disturbances, peritonitis, marked vagotonia.

Since bethanechol contracts the bladder there is potential for influx infection if the sphincter fails to relax. Patient with bacteriuria. Pregnancy and lactation

C Pregnancy Category: C Lactation: It is not known whether this drug is excreted in milk. Because of the potential for serious adverse reactions from bethanechol chloride in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Additive effects and increased toxicity with other cholinergic drugs or anticholinesterase agents (e.g. neostigmine). May cause a critical fall in blood pressure (usually preceded by severe abdominal symptoms) when given with ganglionic blocking agents. Atropine, procainamide, quinidine, epinephrine, and other sympathomimetic amines may antagonise the effects of bethanechol.

Frequency Not Defined Abdominal cramps Belching Borborygmi colicky pain Bronchial constriction Diarrhea Flushing Increased gastric motility Headache Hypotension Lacrimation Miosis Nausea Vomiting Salivation Urinary urgency

Bethanechol, a choline ester, is a quaternary ammonium parasympathomimetic agent that exhibits the muscarinic activity of acetylcholine. It acts by directly stimulating the parasympathetic nervous system, thereby releasing acetylcholine at the nerve endings. It increases bladder muscle tone resulting in contractions which initiate urination. Additionally, it stimulates gastric motility, enhances gastric tone, and restores impaired rhythmic peristalsis.