Dosing and uses of Urecholine (bethanechol)
Adult dosage forms and strengths
tablet
- 5mg
- 10mg
- 25mg
- 50mg
Urinary Retention
10-50 mg PO three/four times daily
Some patients may require doses of 50-100 mg PO twice daily
Take 1 hour AC or 2 hours PC
GERD (Off-label)
25 mg PO four times daily
Take 1 hour AC or 2 hours PC
Pediatric dosage forms and strengths
tablet
- 5mg
- 10mg
- 25mg
- 50mg
Urinary Retention (Off-label)
0.3-0.6 mg/kg/day PO divided three/four times daily
Take 1 hour AC or 2 hours PC
GERD (Off-label)
0.3-0.6 mg/kg/day PO divided four times daily
Take 1 hour AC or 2 hours PC
Urecholine (bethanechol) adverse (side) effects
Frequency not defined
Abdominal cramps
Belching
Borborygmi colicky pain
Bronchial constriction
Diarrhea
Flushing
Increased gastric motility
Headache
Hypotension
Lacrimation
Miosis
Nausea
Vomiting
Salivation
Urinary urgency
Warnings
Contraindications
Hypersensitivity, hyperthyroidism, peptic ulcer, asthma, bradycardia, hypotension, AV conduction defects, CAD vasomotor instability, vagotonia, epilepsy, Parkinsonism, GI of GU obstruction, weak bladder wall, recent urinary bladder surgery, GI resection or anastomosis, spastic GI disturbances, HTN, obstructive pulmonary disease, tartrazine sensitivity
Cautions
Since bethanechol contracts the bladder there is potential for influx infection if the sphincter fails to relax
Pregnancy and lactation
Pregnancy category: C
Lactation: It is not known whether this drug 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.
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Urecholine (bethanechol)
Mechanism of action
Stimulates parasympathetic receptors to increase bladder muscle tone, which in turn causes contraction and stimulates micturition
Pharmacokinetics
Onset: 30-60 min
Duration: Up to 6 hr
Abasorption: Variable
