Bethanechol
- Atc Codes:N07AB02
- CAS Codes:590-63-6#674-38-4
- PHARMGKB ID:590-63-6#674-38-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Myocholine; Belgium: Myocholine; Germany: Myocholine; Italy: Myocholine; Luxembourg: Muscaran; UK: Myotonine.
North America
Canada: Duvoid, Bethanechol; USA: Urecholine.
Latin America
Brazil: Liberan-Apsen.
Asia
Japan: Besacolin.
Drug combinations
Chemistry
Bethanechol Chloride: C~7~H~17~ClN~2~O~2~. Mw: 196.68. (1) 1-Propanaminium, 2-[(aminocarbonyl)oxy]-N,N,N-trimethyl-, chloride, (±)-; (2)(±)-(2-Hydroxypropyl)trimethylammonium chloride carbamate. CAS-590-63-6; CAS-674-38-4 (bethanechol).
Pharmacologic Category
Parasympathomimetic (Cholinergic) Agents. (ATC-Code: N07AB02).
Mechanism of action
Directly stimulates cholinergic receptors (stimulates ganglia to a lesser extent). Effects are almost exclusively muscarinic. Increases tone and peristaltic activity in the stomach and intestines. Increases esophageal peristalsis and the resting pressure of the lower esophageal sphincter. Increases pancreatic and gastrointestinal secretion. Contracts detrusor muscle of urinary bladder. Decreases bladder capacity, and increases frequency of ureteral peristaltic waves.
Therapeutic use
Treatment of acute postoperative and postpartum nonobstructive urinary retention and neurogenic atony of the bladder with retention. Has been used to prevent and treat phenothiazine-induced bladder dysfunction and to antagonize the bladder and salivary gland inhibition caused by tricyclic antidepressants. Increases eye moisture, reduces gastric distention and vomiting, and improves esophageal motility and bladder control in a limited number of children with familial dysautonomia. Diagnostic test for cystic infantile fibrosis and for neurogenic bladder. Diagnosing flaccid or atonic neurogenic bladder disease and restoring bladder function.
Pregnancy and lactiation implications
It is not known whether the drug can cause fetal harm when administered to pregnant women. Bethanechol should be used during pregnancy only when clearly needed. It is not known whether bethanechol is distributed into milk.
Unlabeled use
Gastroesophageal reflux.
Contraindications
Hypersensitivity to bethanechol or any component of the formulation. Mechanical obstruction of the gastrointestinal or genitourinary tract or when the strength or integrity of the gastrointestinal or bladder wall is in question, hyperthyroidism, peptic ulcer disease, epilepsy, asthma, bradycardia, vasomotor instability, coronary artery disease, hypotension, or parkinsonism. Contraindicated for intramuscular or intravenous use (a severe cholinergic reaction is likely to occur). Severe cholinergic reactions also have occurred rarely after subcutaneous injection and in cases of hypersensitivity or overdosage.
Warnings and precautions
Risk of infection in urinary retention and bacteriuria. May produce a slight, transient decrease in diastolic blood pressure with mild reflex tachycardia. Patients with hypertension may react with a precipitous fall in blood pressure. Periods of atrial fibrillation reported in hyperthyroid patients. Hypothermia and seizures also reported. Never use intramuscularly or intravenously. May cause an increase in serum amylase, lipase, bilirubin, aspartate aminotransferase, and sulfobromophthalein retention (increases pancreatic secretion, constricts the hepatopancreatic ampulla, and causes a spasm in the sphincter of Oddi).