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

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300