Bethanechol
URECHOLINE
What it isMuscarinic agonist resistant to cholinesterase; urinary retention and neurogenic bladder.
Why this oneIt stimulates detrusor contraction without nicotinic effects.
What limits itContraindicated in bladder outlet obstruction, where it can cause rupture. Bronchospasm, bradycardia and cramping.
FDA-approved for
- urinary retention (~1955)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Urinary retention / neurogenic bladder | Adults | 5-10 mg, repeat hourly until response or max 50 mg reached | 10-50 mg TID-QID | 50 mg per test dose sequence |
Renal Undefined
Hepatic Undefined
Minimum effective dose determined by giving 5-10 mg and repeating same amount at hourly intervals until response or 50 mg total
Instructions
- Give on an empty stomach; taking soon after eating may cause nausea/vomiting
- Effects may abolished promptly by atropine if needed
Contraindications
- Hyperthyroidism
- Peptic ulcer
- Latent or active bronchial asthma
- Pronounced bradycardia or hypotension
- Vasomotor instability
- Coronary artery disease
- Epilepsy
- Parkinsonism
- Mechanical GI/urinary obstruction, or questionable GI/bladder wall integrity (e.g. recent surgery/anastomosis)
- Bladder neck obstruction, spastic GI disturbances, acute inflammatory GI lesions, peritonitis
- Marked vagotonia
Cautions
- Cholinergic overstimulation: more likely with dose increases and with subcutaneous route
- Bronchoconstriction/asthmatic attacks
- Hypotension with reflex tachycardia
Adverse reactions
- GI: abdominal cramps, colicky pain, nausea, belching, diarrhea, salivation
- Flushing, sweating, feeling of warmth
- Headache, malaise
- Urinary urgency
- Bronchial constriction, lacrimation, miosis
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskContraindicated in outlet obstruction; bronchospasm
Cost, est. cash$5–$150/month
Generic entry1983
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Bethanechol ballicule
Open Bethanechol in the interactive console ↗
Memory aids: mascots and interaction avatars
baby blue theme → muscarinic
