bethanechol (Rx)

Brand and Other Names:Urecholine
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Dosing & Uses

AdultPediatric

Dosage Forms & 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

Dosage Forms & 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

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Interactions

Interaction Checker

and bethanechol

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            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (66)

                • aclidinium

                  bethanechol increases and aclidinium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • amifampridine

                  amifampridine and bethanechol both increase cholinergic effects/transmission. Use Caution/Monitor.

                • amitriptyline

                  bethanechol increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

                • amoxapine

                  bethanechol increases and amoxapine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • anticholinergic/sedative combos

                  bethanechol increases and anticholinergic/sedative combos decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atracurium

                  bethanechol increases and atracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine

                  bethanechol increases and atropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • atropine IV/IM

                  bethanechol increases and atropine IV/IM decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • belladonna alkaloids

                  bethanechol increases and belladonna alkaloids decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • belladonna and opium

                  bethanechol increases and belladonna and opium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • carbachol

                  bethanechol and carbachol both increase cholinergic effects/transmission. Use Caution/Monitor.

                • cevimeline

                  bethanechol and cevimeline both increase cholinergic effects/transmission. Use Caution/Monitor.

                • cisatracurium

                  bethanechol increases and cisatracurium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • clomipramine

                  bethanechol increases and clomipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclizine

                  bethanechol increases and cyclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • cyclobenzaprine

                  bethanechol increases and cyclobenzaprine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • darifenacin

                  bethanechol increases and darifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • dicyclomine

                  bethanechol increases and dicyclomine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • diphenhydramine

                  bethanechol increases and diphenhydramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • donepezil

                  bethanechol and donepezil both increase cholinergic effects/transmission. Use Caution/Monitor.

                • dosulepin

                  bethanechol increases and dosulepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • doxepin

                  bethanechol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • echothiophate iodide

                  bethanechol and echothiophate iodide both increase cholinergic effects/transmission. Use Caution/Monitor.

                • fesoterodine

                  bethanechol increases and fesoterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • flavoxate

                  bethanechol increases and flavoxate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • galantamine

                  bethanechol and galantamine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • glycopyrrolate

                  bethanechol increases and glycopyrrolate decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • glycopyrrolate inhaled

                  bethanechol increases and glycopyrrolate inhaled decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • henbane

                  bethanechol increases and henbane decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • homatropine

                  bethanechol increases and homatropine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • huperzine A

                  bethanechol and huperzine A both increase cholinergic effects/transmission. Use Caution/Monitor.

                • hyoscyamine

                  bethanechol increases and hyoscyamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • hyoscyamine spray

                  bethanechol increases and hyoscyamine spray decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                • imipramine

                  bethanechol increases and imipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • ipratropium

                  bethanechol increases and ipratropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • lofepramine

                  bethanechol increases and lofepramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • maprotiline

                  bethanechol increases and maprotiline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • meclizine

                  bethanechol increases and meclizine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • methscopolamine

                  bethanechol increases and methscopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • neostigmine

                  bethanechol and neostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • nortriptyline

                  bethanechol increases and nortriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • onabotulinumtoxinA

                  bethanechol increases and onabotulinumtoxinA decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • orphenadrine

                  bethanechol increases and orphenadrine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin

                  bethanechol increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin topical

                  bethanechol increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • oxybutynin transdermal

                  bethanechol increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pancuronium

                  bethanechol increases and pancuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • physostigmine

                  bethanechol and physostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine

                  bethanechol and pilocarpine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pilocarpine ophthalmic

                  bethanechol and pilocarpine ophthalmic both increase cholinergic effects/transmission. Use Caution/Monitor.

                • pralidoxime

                  bethanechol increases and pralidoxime decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • propantheline

                  bethanechol increases and propantheline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • protriptyline

                  bethanechol increases and protriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • pyridostigmine

                  bethanechol and pyridostigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • rapacuronium

                  bethanechol increases and rapacuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • rivastigmine

                  bethanechol and rivastigmine both increase cholinergic effects/transmission. Use Caution/Monitor.

                  rivastigmine and bethanechol both increase cholinergic effects/transmission. Use Caution/Monitor.

                • rocuronium

                  bethanechol increases and rocuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • scopolamine

                  bethanechol increases and scopolamine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • solifenacin

                  bethanechol increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • succinylcholine

                  bethanechol and succinylcholine both increase cholinergic effects/transmission. Use Caution/Monitor.

                • tiotropium

                  bethanechol increases and tiotropium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • tolterodine

                  bethanechol increases and tolterodine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trimipramine

                  bethanechol increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • trospium chloride

                  bethanechol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                • umeclidinium bromide

                  bethanechol increases and umeclidinium bromide decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor when umeclidinium bromide is coadministered with cholinergic agents.

                • vecuronium

                  bethanechol increases and vecuronium decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                Minor (7)

                • desipramine

                  bethanechol increases and desipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

                • donepezil

                  donepezil increases effects of bethanechol by pharmacodynamic synergism. Minor/Significance Unknown.

                • galantamine

                  galantamine increases effects of bethanechol by pharmacodynamic synergism. Minor/Significance Unknown.

                • mecamylamine

                  mecamylamine, bethanechol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

                • pantothenic acid

                  pantothenic acid, bethanechol. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown.

                • procainamide

                  procainamide decreases effects of bethanechol by pharmacodynamic antagonism. Minor/Significance Unknown.

                • trazodone

                  bethanechol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

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                Adverse 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

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                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

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                Pregnancy & 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.

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                Pharmacology

                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

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                bethanechol chloride oral
                -
                10 mg tablet
                bethanechol chloride oral
                -
                50 mg tablet
                bethanechol chloride oral
                -
                25 mg tablet
                bethanechol chloride oral
                -
                25 mg tablet
                bethanechol chloride oral
                -
                5 mg tablet
                bethanechol chloride oral
                -
                50 mg tablet
                bethanechol chloride oral
                -
                5 mg tablet
                bethanechol chloride oral
                -
                10 mg tablet
                bethanechol chloride oral
                -
                25 mg tablet
                bethanechol chloride oral
                -
                5 mg tablet
                bethanechol chloride oral
                -
                50 mg tablet
                bethanechol chloride oral
                -
                25 mg tablet
                bethanechol chloride oral
                -
                10 mg tablet
                bethanechol chloride oral
                -
                50 mg tablet
                bethanechol chloride oral
                -
                10 mg tablet
                bethanechol chloride oral
                -
                5 mg tablet

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                bethanechol chloride oral

                BETHANECHOL - ORAL

                (be-THAN-e-kol)

                COMMON BRAND NAME(S): Urecholine

                USES: This medication is used to treat certain bladder problems such as the inability to urinate or empty the bladder completely due to certain causes (such as surgery, bladder muscle problems). It works by helping the bladder muscle to squeeze better, thereby improving your ability to urinate.

                HOW TO USE: Take this medication by mouth on an empty stomach (1 hour before or 2 hours after meals), usually 3 to 4 times daily or as directed by your doctor. Taking this medication on an empty stomach will help reduce nausea/vomiting.Dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.Tell your doctor if your condition persists or worsens.

                SIDE EFFECTS: Dizziness, lightheadedness, nausea, vomiting, abdominal cramps/pain, diarrhea, increased saliva/urination, sweating, flushing, watery eyes, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, fast heartbeat, severe abdominal pain.Seek immediate medical attention if any of these rare but very serious side effects occur: trouble breathing.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before taking bethanechol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: recent stomach/intestinal/bladder surgery, stomach/intestinal problems (such as ulcers, blockage, spasms), peritonitis, blockage of the bladder, a certain nerve problem (vagotonia), overactive thyroid (hyperthyroidism), lung disease (such as asthma, chronic obstructive pulmonary disease-COPD), heart problems (such as coronary artery disease, slow heartbeat), seizures, Parkinson's disease, blood pressure problems.Before using this medication, tell your doctor or pharmacist your medical history.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: medications for high blood pressure (such as mecamylamine).This medication may interfere with certain laboratory tests (including amylase/lipase levels), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: stomach/abdominal pain, flushing, increased saliva, sweating, nausea, vomiting.

                NOTES: Do not share this medication with others.

                MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.