(be THAN e kole)
Neurogenic bladder: Treatment of neurogenic atony of the urinary bladder with retention
Urinary retention: Treatment of acute postoperative and postpartum nonobstructive (functional) urinary retention
Hypersensitivity to bethanechol or any component of the formulation; hyperthyroidism, peptic ulcer disease, epilepsy, asthma, pronounced bradycardia or hypotension, vasomotor instability, coronary artery disease, or parkinsonism; mechanical obstruction of the GI or GU tract or when the strength or integrity of the GI or bladder wall is in question; when increased muscular activity of the GI tract or bladder might prove harmful (eg, following urinary bladder surgery, GI resection and anastomosis, possible GI obstruction); bladder neck obstruction, spastic GI disturbances, acute inflammatory lesions of the GI tract, peritonitis, marked vagotonia.
Urinary retention, neurogenic bladder: Oral: Initial (to determine minimal effective dose): 5 to 10 mg; repeat the same dose hourly until effective response or a maximum of 50 mg is reached; usual dose: 10 to 50 mg 3 to 4 times daily. Cholinergic effects at higher oral dosages may be cumulative.
Refer to adult dosing.
There are no dosage adjustments provided in the manufacturer 's labeling.
There are no dosage adjustments provided in the manufacturer 's labeling.
Oral: Should be administered 1 hour before meals or 2 hours after meals (to avoid nausea and vomiting).
Store at 20 � �C to 25 � �C (68 � �F to 77 � �F).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral, as chloride:
Urecholine: 5 mg, 10 mg [scored]
Urecholine: 25 mg, 50 mg [scored; contains fd&c yellow #10 (quinoline yellow), fd&c yellow #6 (sunset yellow)]
Generic: 5 mg, 10 mg, 25 mg, 50 mg
A 1 mg/mL solution may be made with tablets. Crush twelve 10 mg tablets in a mortar and reduce to a fine powder. Add small portions of sterile water and mix to a uniform paste; mix while adding sterile water in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with sterile water, and add quantity of sterile water sufficient to make 120 mL. Label "shake well " � and "refrigerate " �. Stable for 30 days (Schlatter, 1997).
A 5 mg/mL suspension may be made with tablets and either a 1:1 mixture of Ora-Plus � � and Ora-Sweet � � or Ora-Plus � � and Ora-Sweet � � SF or 1:4 concentrated cherry syrup and simple syrup, NF mixture. Crush twelve 50 mg tablets in a mortar and reduce to a fine powder. Add small portions of chosen vehicle and mix to a uniform paste; mix while adding the vehicle in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make 120 mL. Label "shake well " � and "refrigerate " �. Stable for 60 days refrigerated (preferred) or at room temperature (Allen, 1998; Nahata, 2004).
Allen LV Jr and Erickson MA, Stability of Bethanechol Chloride, Pyrazinamide, Quinidine Sulfate, Rifampin, and Tetracycline Hydrochloride in Extemporaneously Compounded Oral Liquids," Am J Health Syst Pharm, 1998, 55(17):1804-9.[PMID: 9775343]Nahata MC, Pai VB, and Hipple TF, Pediatric Drug Formulations, 5th ed, Cincinnati, OH: Harvey Whitney Books Co, 2004.Schlatter JL and Saulnier JL, "Bethanechol Chloride Oral Solutions: Stability and Use in Infants," Ann Pharmacother, 1997, 31(3):294-6. [PMID: 9066934]Acetylcholinesterase Inhibitors: May enhance the adverse/toxic effect of Cholinergic Agonists. Monitor therapy
Beta-Blockers: May enhance the adverse/toxic effect of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Management: Administer these agents in combination with caution, and monitor for conduction disturbances. Avoid methacholine with any beta blocker due to the potential for additive bronchoconstriction. Monitor therapy
Cimetropium: Cholinergic Agonists may diminish the anticholinergic effect of Cimetropium. Monitor therapy
Frequency not defined.
Cardiovascular: Flushing, hypotension, tachycardia
Central nervous system: Colic, headache, malaise, seizure
Dermatologic: Diaphoresis
Gastrointestinal: Abdominal cramps, borborygmi, diarrhea, eructation, nausea, salivation, vomiting
Genitourinary: Urinary urgency
Ophthalmic: Lacrimation, miosis
Respiratory: Asthma, bronchoconstriction
Concerns related to adverse effects:
- Reflux infection: If patient has bacteriuria, there is potential for reflux infection if the sphincter fails to relax as bethanechol contracts the bladder.
C
Animal reproduction studies have not been conducted.
Due to stimulation of the parasympathetic nervous system, bethanechol increases bladder muscle tone causing contractions which initiate urination. Bethanechol also stimulates gastric motility, increases gastric tone and may restore peristalsis.
30 to 90 minutes
~1 hour (with therapeutic doses); up to 6 hours with large doses
- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
- Have patient report immediately to prescriber severe dizziness, passing out, tachycardia, or shortness of breath (HCAHPS).
- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.