bethanechol

REMS

Postpartum and postoperative nonobstructive urinary retention or urinary retention caused by neurogenic bladder.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity;
Mechanical obstruction of the GI or GU tract.

Use Cautiously in:

History of asthma;
Ulcer disease;
Cardiovascular disease;
Epilepsy;
Hyperthyroidism;
Sensitivity to cholinergic agents or effects;
OB: Lactation: Safety not established.

Adv. Reactions/Side Effects ⬆ ⬇

CV: bradycardia, HEART BLOCK, hypotension, SYNCOPE/CARDIAC ARREST

EENT: lacrimation, miosis

GI: vomiting, abdominal discomfort, diarrhea, nausea, salivation

GU: urgency

Neuro: headache, malaise

Resp: bronchospasm

Misc: sweating, flushing, hypothermia

Interactions ⬆ ⬇

Drug-drug:

Quinidine and procainamide may antagonize cholinergic effects.
Additive cholinergic effects with cholinesterase inhibitors.
Use with ganglionic blocking agents may result in severe hypotension.
Do not use with depolarizing neuromuscular blocking agents.
Effectiveness will be decreased by anticholinergics.

Drug-Natural Products:

Cholinergic effects may be antagonized by angel's trumpet, jimson weed, or scopolia.

Availability ⬆ ⬇

(Generic available)

Tablets: 5 mg; 10 mg; 25 mg; 50 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 25–50 mg 3 times daily. Dose may be determined by administering 5–10 mg every 1–2 hr until response is obtained or total of 50 mg administered or by starting with 10 mg, giving 25 mg 6 hr later, then, if needed, 50 mg 6 hr later.
PO (Children ): 0.2 mg/kg 3 times daily or 0.15 mg/kg 4 times daily.

US Brand Names ⬆ ⬇

Duvoid, ~~Urecholine~~

Action ⬆ ⬇

Stimulates cholinergic receptors. Effects include:
- Contraction of the urinary bladder,
- Decreased bladder capacity,
- Increased frequency of ureteral peristaltic waves,
- Increased tone and peristalsis in the GI tract,
- Increased pressure in the lower esophageal sphincter,
- Increased gastric secretions.

Therapeutic effects:

Bladder emptying.

Classifications ⬆ ⬇

Therapeutic Classification: urinary tract stimulant

Pharmacologic Classification: cholinergics

Pharmacokinetics ⬆ ⬇

Absorption: Poorly absorbed after oral administration.

Distribution: Does not cross the blood-brain barrier.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(response on bladder muscle)

ROUTE	ONSET	PEAK	DURATION
PO	30–90 min	1 hr	6 hr

Patient/Family Teaching ⬆ ⬇

Instruct patient to take medication exactly as directed. Missed doses should be taken as soon as possible within 2 hr; otherwise, return to regular dosing schedule. Do not double doses.
Caution patient to change positions slowly to minimize orthostatic hypotension.
Advise patient to report abdominal discomfort, salivation, sweating, or flushing to health care professional.
Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

section name header

Indications ⬇