Bethanechol

Generic Name

bethanechol (beth AN ah col)

 

Trade Name

Urecholine

 

What is bethanechol?

Bethanechol is an older drug which is not used very much at present. The drug stimulates certain muscle nerve endings in the body, thereby causing muscle contractions in organs such as the stomach and urinary bladder.

 

What is it used for?

The drug is used for the treatment of gastroparesis (weak stomach) which is a condition where the stomach does not empty normally. It can also be used for gastroesophageal reflux disease (GERD) where the lower esophagus muscle valve is weak and allows stomach acid to reflux back into the esophagus. In urology, it is used to cause contraction and emptying of the urinary bladder.

 

How do I take it?

Follow your physician’s instructions carefully. Take this drug 1 hour before or 2 hours after meals. If taken soon after eating, nausea and vomiting may occur. Keep all medications away from children. Never share your medications with anyone else.

 

What do I do for a missed dose?

If you miss a dose of this medicine, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and return to your regular schedule. Do not double up on this medicine.

 

Are there interactions with other drugs?

An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction.

Interactions with this drug may occur with the following:

  • myasthenia gravis drugs (Mestinon, neostigmine)
  • blood pressure medications
  • quinidine (Quinidex)
  • procainamide (Procanbid)

 

Are there interactions with other drugs?

An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction.

Interactions with this drug may occur with the following:

  • cholestyramine (Questran)
  • isoniazid (Rifater)
  • phenytoin (Dilantin)
  • blood thinners (Coumadin)
  • zidovudine (Retrovir)
  • birth control pills
  • non-steroidal anti-inflammatory drugs-commonly called NSAIDs

 

Is there a problem if I have another disorder or disease?

At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease.

With this drug, the following disorders may be a problem:

  • hyperthyroidism
  • peptic ulcer disease
  • asthma
  • abnormal heart rhythms
  • coronary artery disease
  • fainting
  • hypertension (high blood pressure)
  • hypotension (low blood pressure)
  • Parkinson’s disease
  • convulsions or seizures
  • ulcerative colitis

 

What about allergies?

People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives, and itching. Of course, a person should not take bethanechol if there has been a previous reaction to this or a similar drug. The trade name drug, Myotonachol, contains tartrazine which may cause an allergic reaction in some individuals. The risk is greater if you are sensitive to aspirin.

 

What if I’m pregnant, considering pregnancy or breast-feeding?

Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Bethanechol is ranked C. Always consult your physician before taking any drug during or when planning pregnancy.

 

What are the effects on sexual function?

There are no known adverse effects of bethanechol on sexual function.

 

Are there other precautions?

  • Do not drive or engage in activities that require alertness until the effects of this drug have been determined.
  • Dizziness, lightheadedness or fainting may occur, especially when getting up from a lying or sitting position.

 

How long is it safe to take bethanechol?

There is no limitation on length of time one may take bethanechol. Always consult your physician regularly if taking any drug long-term.

 

How about side effects?

Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.

For bethanechol, the following are the observed side effects:

Minor:

  • headache
  • dizziness
  • faintness
  • flushing
  • blurred vision
  • nausea
  • belching
  • vomiting
  • stomach rumbling and cramps
  • salivation
  • diarrhea
  • bladder urgency
  • sweating

Major:

  • difficult breathing
  • wheezing (asthma)
  • chest tightness or pain
  • abdominal discomfort
  • bloody diarrhea
  • significant drop in blood pressure

 

A physician’s comment…

This was one of the first drugs available to treat gastroparesis and gastroesophageal reflux disease. There are now more effective drugs with fewer side effects for treating these conditions. Still, at times, this drug can be useful and it is available in the inexpensive generic form.