Adult Dosing

Peptic ulcer

• 25 or 50 mg PO qid with meals and at bedtime
• Note: Begin with the lowest effective dose and then adjust as per the patient's clinical response

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Adjunctive therapy in the treatment of peptic ulcer

• Hypersensitivity to any of the ingredients of the product
• Glaucoma
• Obstructive uropathy
• Obstructive disease of the GI tract
• Paralytic ileus
• Intestinal atony of the elderly or debilitated patient
• Unstable cardiovascular status in acute GI hemorrhage
• Toxic megacolon complicating ulcerative colitis
• Myasthenia gravis

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined; caution advised

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined; caution advised

See Supplemental Patient Information

• Heat prostration may occur during mepenzolate therapy in the presence of high environmental temperature
• Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment with mepenzolate in such cases would be inappropriate and possibly harmful
• Drowsiness or blurred vision may occur during therapy; inform patients not to engage in activities requiring mental alertness such as operating heavy machinery or driving a motor vehicle
• Curare-like action i.e., neuromuscular blockage leading to muscular weakness and possible paralysis may occur with the overdose of mepenzolate
• Anticholinergics used in the treatment of gastric ulcer may delay gastric emptying time and complicate such therapy (antral stasis)
• Psychosis and other CNS signs and symptoms may occur in patients sensitive to anticholinergic drugs; the CNS signs and symptoms usually resolve within 12-24 hrs of discontinuation of the drug

Cautions: Use cautiously in

• Renal disease
• Hepatic disease
• Autonomic neuropathy
• Ulcerative colitis
• Hiatal hernia associated with reflux esophagitis
• Coronary heart disease
• Congestive heart failure
• Cardiac arrhythmias
• Tachycardia
• Hypertension
• Prostatic hypertrophy
• Hyperthyroidism
• Elderly patients

Supplemental Patient Information

• Advise patients to refrain from performing hazardous tasks such as operating heavy machinery, driving a vehicle, and other activities that require mental alertness

Pregnancy Category:B

Breastfeeding: Mepenzolate is not likely to be absorbed and reach the bloodstream of the infants because it is a quaternary ammonium compound. Long-term use of the drug may decrease milk production. Monitor for signs of decreased lactation during long-term use (e.g., insatiety, poor weight gain). This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 03 May 2011). Manufacturer advises caution.

• CNS: Mental confusion, dizziness, weakness, drowsiness, headache, insomnia, disorientation, short-term memory loss, ataxia, dysarthria
• PSYCHIATRIC: Hallucination, euphoria, nervousness, agitation, decreased anxiety
• GI: Vomiting, nausea, constipation, loss of taste, bloated feeling, dry mouth
• CV: Tachycardia, palpitations
• EENT: Increased ocular tension, cycloplegia, blurred vision, dilation of the pupil
• GU: Urinary retention, urinary hesitancy, impotence
• ENDO: Suppression of lactation
• DERM: Decreased sweating
• HYPERSENSITIVITY: Anaphylaxis, urticaria
• MISC: Heat prostration

• Post-ganglionic parasympathetic inhibitor; diminishes gastric acid and pepsin secretion and also suppresses spontaneous contractions of the colon
• Metabolism: Unknown
• Excretion: Urine, feces
• Half-life: Unknown

US Trade Name(s)

• Cantil

US Availability

Cantil

• TABS: 25 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Gastrointestinal

Anticholinergics/Antispasmodics (GI)

Drug Name: Cantil 25 MG Oral Tablet

Ingredient(s): Mepenzolate

Imprint: MERRELL;37

Color(s): Yellow

Shape: Round

Size (mm): 7.00

Score: 1

Inactive Ingredient(s): confectioners' sugar / corn starch / corn syrup solids / fd&c yellow no. 5 / lactose / magnesium stearate / microcrystalline cellulose

Drug Label Author:
sanofi-aventis U.S. LLC

DEA Schedule:
Non-Scheduled