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

    

 
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