Bethanechol chloride oral
- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Tablets containing bethanechol chloride
Neurogenic bladder disorder
Urinary retention (adjunctive treatment)
Treatment of acute postoperative/postpartum non-obstructive urinary retention
Neurogenic atony of the urinary bladder with retention
Treatment of reflux oesophagitis due to decreased pressure of the lower oesophageal sphincter or delayed gastric emptying
10mg to 25mg to be taken three or four times a day.
An initiation dose of 50mg may be necessary in some cases.
To be taken orally 30 minutes before food.
Children under 18 years
Obstructive pulmonary disease
Recent gastrointestinal anastomosis
Recent myocardial infarction
Precautions and Warnings
Patients over 70 years
Advise ability to drive/operate machinery may be affected by side effects
Monitor closely for signs of overdosage:possible risk of cholinergic crisis
Some sources suggest that patients with autonomic neuropathy should be started on lower initial dosage.
Pregnancy and Lactation
Bethanechol chloride is contraindicated in pregnancy.
Schaefer (2007) states that there is insufficient data available published concerning the use of bethanechol during pregnancy. However, inadvertent use does not require termination of pregnancy or invasive diagnostic procedures. Animal reproduction study data is also lacking and the manufacturer advises to avoid during pregnancy.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Bethanechol chloride is contraindicated in breastfeeding.
There is limited information available on the use of bethanechol during breastfeeding. The molecular weight (about 197) is low enough that excretion into milk should be expected. Effects such as abdominal pain and diarrhoea have been reported in nursing infants exposed to bethanechol in milk, therefore treatment during nursing is not recommended.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: December 2014
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.
Summary of Product Characteristics: Myotonine 10 mg. Glenwood Laboratories UK Ltd. Revised October 2014.
Summary of Product Characteristics: Myotonine 25 mg. Glenwood Laboratories UK Ltd. Revised October 2014.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 17 August 2017
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Bethanechol chloride. Last revised: 07 September 2013
Last accessed: 11 December 2014
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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