Bethanechol

Bethanechol is used to treat certain bladder problems such as the inability to urinate or empty the bladder completely due to certain causes (e.g., surgery, bladder muscle problems). It works by helping the bladder muscle to squeeze better, thereby improving your ability to urinate.

• Bethanechol may also be used to treat heartburn. It works by helping the stomach muscles move food down out of the stomach faster and by increasing the strength of the muscle between the esophagus and stomach (lower esophageal sphincter). This helps prevent food/acid in the stomach from rising back into the esophagus.
• Bethanechol is available under the following different brand names: Urecholine.

Adult and Pediatric Dosage Forms and Strengths

Tablet

• 5 mg
• 10 mg
• 25 mg
• 50 mg

Dosage Considerations – Should be Given as Follows:

Urinary Retention

Adult:

• 10-50 mg orally three/four times daily
• Some patients may require doses of 50-100 mg orally twice daily
• Take 1 hour before meals or 2 hours after meals

Pediatric (off-label):

• 0.3-0.6 mg/kg/day orally divided three/four times daily
• Take 1 hour before meals or 2 hours after meals

GERD (Off-label)

Adult:

• 25 mg orally four times daily
• Take 1 hour before meals or 2 hours after meals

Pediatric:

• 0.3-0.6 mg/kg/day orally divided four times daily
• Take 1 hour before meals or 2 hours after meals

Common side effects of bethanechol include:

• Abdominal cramps/pain
• Belching
• Borborygmi
• Colicky pain
• Bronchial constriction
• Constricted pupils
• Diarrhea
• Dizziness
• Drowsiness
• Flushing
• Flushing or warmth about the face
• Headache
• Increased gastric motility
• Increased urination
• Lightheadedness
• Low blood pressure (hypotension)
• Nausea
• Salivation
• Slow heartbeats followed by fast heartbeats
• Sweating
• Urinary urgency
• Vomiting
• Watery eyes

Serious side effects of bethanechol include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Bethanechol has no known severe interactions with other drugs.
• Serious interactions of bethanechol include:
  • ambenonium
• Bethanechol has moderate interactions with at least 74 different drugs.
• Mild interactions of bethanechol include:
  • desipramine
  • donepezil
  • galantamine
  • mecamylamine
  • pantothenic acid
  • procainamide
  • trazodone

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains bethanechol. Do not take Urecholine if you are allergic to bethanechol or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity,
• hyperthyroidism,
• peptic ulcer,
• asthma,
• bradycardia,
• hypotension,
• AV conduction defects,
• CAD vasomotor instability,
• vagotonia,
• epilepsy,
• Parkinsonism,
• gastrointestinal (GI) or genitourinary obstruction,
• weak bladder wall,
• recent urinary bladder surgery,
• GI resection or anastomosis,
• spastic GI disturbances,
• high blood pressure (hypertension),
• obstructive pulmonary disease,
• tartrazine sensitivity

Effects of Drug Abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Bethanechol?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Bethanechol?"

Cautions

• Benign prostatic hyperplasia (BPH), urinary/GI retention, hyperthyroidism, seizure disorder, brain tumor, respiratory impairment.
• The risk of dilated pupils (mydriasis); may trigger angle closure attack in patients with angle-closure glaucoma with anatomically narrow angles without a patent iridectomy.
• Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 years).
• Potentially life-threatening serotonin syndrome is reported when coadministered with drugs that impair serotonin metabolism (in particular, monoamine oxidase inhibitors (MAOIs), including non-psychiatric MAOIs, such as linezolid and intravenous [IV] methylene blue).
• Risk of anticholinergic side effects.

Pregnancy and Lactation

• Use bethanechol during pregnancy with caution if the benefits outweigh the risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• It is not known whether bethanechol 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.