Bethanechol (Urecholine, Duvoid)

Category:

• Cholinergic Stimulant

Description:

• Stimulates gastric motility and micturition

Indications:

• Acute postoperative and postpartum nonobstructive (functional) urinary retention

• Neurogenic atony of the urinary bladder with retention

• Gastroesophageal reflux

Contraindications:

• Severe bradycardia, asthma, severe hypotension, hypertension, hyperthyroidism, seizure disorders, coronary artery disease, coronary occlusion, possible GI obstruction

• Mechanical bladder neck obstruction, peritonitis, ventricular conduction defects

Precautions:

• Pregnancy category C; use caution, abdominal pain and diarrhea reported in exposed infants

• Child <8 years, urinary retention due to obstruction; not for IM or IV administration (severe cholinergic overstimulation)

Adverse Reactions (Side Effects):

• CNS: dizziness, headache, lightheadedness or fainting

• CV: fall in blood pressure with reflex tachycardia, vasomotor response

• EENT: lacrimation, miosis

• GI: abdominal cramps, belching, borborygmi, colicky pain, diarrhea, nausea, salivation

• GU: urinary urgency

• RESP: bronchospasm, may precipitate asthmatic attack

• MISC: flushing, malaise, sweating

Dosage:

Administered orally and subcutaneously

• Adult:   PO 10-15mg 2-4 times daily; SC 2.5-5mg 3-4 times daily, up to 7.5-1-mg every 4 hours for neurogenic bladder

• Child:            

  • Abdominal distension or urinary retention: PO 0.6 mg/kg/day divided 3-4 times daily

  • Gastroesophageal reflux: PO 0.1-0.2 mg/kg/dose given 30 minutes to 1 hour before each meal, max 4 times daily; SC 0.12-0.2 mg/kg/day divided 3-4 times daily