Bethanechol Chloride (bethanechol chloride)

Dosage of bethanechol chloride must be individualized according to the type and severity of the condition being treated.

Bethanechol chloride is administered orally. Bethanechol chloride should be administered on an empty stomach (e.g., 1 hour before or 2 hours after a meal) to minimize nausea and vomiting.

Bethanechol chloride also has been administered by subcutaneous injection. However, a parenteral dosage form no longer is commercially available in the US.

Bethanechol chloride tablets should be stored in tight, light-resistant containers at a temperature of 20-25degreesC (excursions permitted between 15-30degreesC).

Bethanechol should not be used concomitantly with other cholinergic drugs or anticholinesterase agents (e.g., neostigmine), because of the possibility of additive effects and increased toxicity. In combination with ganglionic blocking agents, bethanechol may produce a critical fall in blood pressure, usually preceded by severe abdominal symptoms.

Atropine antagonizes the effects of bethanechol and this interaction is used to therapeutic advantage to counteract the symptoms of bethanechol toxicity. Epinephrine and other sympathomimetic amines antagonize the effects of bethanechol at sites where adrenergic and cholinergic stimulation produce opposing effects. Quinidine and procainamide also may antagonize the effects of bethanechol.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

Moderate Interaction: Assess the risk to the patient and take action as needed.

Cholinergics/Quinidine

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: The anticholinergic properties of quinidine may oppose cholinergic drug effects.

CLINICAL EFFECTS: Quinidine may antagonize the effects of cholinergic drugs in the treatment of myasthenia gravis. Cardiac slowing secondary to cholinergic drugs would tend to be prevented by quinidine.

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: If both drugs are administered, observe the myasthenic patient for signs and symptoms of the disease.

DISCUSSION: Caution is warranted in co-administration of these drugs due to their opposing pharmacologic properties.

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• Abnormal vasomotor function
• Bladder outflow obstruction
• Bladder surgery
• Coronary artery disease
• Gastrointestinal obstruction
• Gastrointestinal tract surgery
• Hyperthyroidism
• Hypotension
• Increased gastric tonus
• Inflammatory bowel disease
• Intestinal anastomosis
• Irritable bowel syndrome
• Parkinsonism
• Peptic ulcer
• Peritonitis
• Seizure disorder
• Urinary tract obstructive uropathy

• Asthma
• Bradycardia
• Orthostatic hypotension

• Atrioventricular block
• Hypertension

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Rare or Very Rare

• Chest tightness
• Dyspnea
• Wheezing

Rare or Very Rare

• Blurred vision
• Diarrhea
• Eructation
• Increased urinary frequency
• Visual changes

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No enhanced messaging available.

Animal reproduction studies have not been performed with bethanechol chloride, and 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. Because many drugs are distributed into milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or bethanechol, taking into account the importance of the drug to the woman.

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