Bethacol

Indications

Bethanechol Chloride is used to treat urinary retention, when the bladder cannot empty properly, especially after surgery or childbirth, or because of a weak (underactive) bladder muscle caused by nerve problems. It is used only when there is no blockage in the urinary tract.

How It Works

Bethanechol is a cholinergic medicine: it copies the action of acetylcholine, a natural chemical messenger of the parasympathetic nervous system. It stimulates muscarinic receptors in the bladder wall, making the bladder muscle contract more strongly so urine can be passed. It also increases movement of the stomach and bowel.

Dosage and Administration

The usual adult dose is 10 to 50 mg taken by mouth 3 or 4 times a day, as prescribed. The doctor may start with a low dose and increase it step by step. Take it on an empty stomach, 1 hour before or 2 hours after meals, to reduce nausea and vomiting. Children: only as prescribed.

Interactions

• Other cholinergic medicines such as Neostigmine, Pyridostigmine or Donepezil can increase side effects.
• Anticholinergic medicines such as Atropine, Oxybutynin, Tolterodine or some antihistamines and antidepressants can reduce its effect.
• Ganglion-blocking blood pressure medicines can cause a severe drop in blood pressure when taken with it.

Contraindications

• Blockage of the bladder outlet or bowel, or recent bladder or bowel surgery
• Asthma or chronic obstructive lung disease
• Slow heart rate, coronary heart disease, very low blood pressure
• Overactive thyroid, active peptic ulcer, epilepsy or Parkinson's disease
• Allergy to Bethanechol

Side Effects

• Sweating, flushing, increased saliva and watery eyes
• Stomach cramps, nausea, belching, diarrhoea
• Frequent urge to pass urine
• Headache, dizziness on standing, blurred vision

Get urgent medical help if you have wheezing or difficulty breathing, chest pain, fainting, a very slow heartbeat, or severe stomach pain.

Pregnancy and Lactation

Safety in pregnancy has not been established; use only if the doctor decides the benefit outweighs the risk. It is not known whether it passes into breast milk, so ask your doctor before breastfeeding.

Precautions and Warnings

• Your doctor should make sure there is no blockage in the urinary tract before starting.
• Stand up slowly, as it can cause dizziness on standing.
• Older adults may be more sensitive to side effects.
• Tell your doctor if urine is still not passing after a dose.

Overdose

Overdose causes strong cholinergic effects: heavy sweating, drooling, stomach cramps, vomiting, diarrhoea, slow heartbeat, low blood pressure and breathing difficulty. Seek emergency help; Atropine is used as the antidote in hospital.

Therapeutic Class

Cholinergic agonist (parasympathomimetic), urinary retention agent.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.