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Adverse Reactions Cardiovascular: Hypotension, tachycardia, flushed skin Central nervous system: Headache, malaise, seizure Gastrointestinal: Abdominal cramps, belching, borborygmi, colicky pain, diarrhea, nausea, vomiting, salivation Genitourinary: Urinary urgency Ocular: Lacrimation, miosis Respiratory: Asthmatic attacks, bronchial constriction Miscellaneous: Diaphoresis Contraindications Hypersensitivity to bethanechol chloride or any component; do not use in patients with mechanical obstruction of the GI or GU tract; do not use in patients with hyperthyroidism, peptic ulcer, bronchial asthma, or cardiac disease Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) Acetylcholinesterase Inhibitors: May enhance the adverse/toxic effect of Cholinergic Agonists. Risk C: Monitor therapy Beta-Blockers: May enhance the adverse/toxic effect of Cholinergic Agonists. Of particular concern are the potential for cardiac conduction abnormalities and bronchoconstriction. Management: Administer these agents in combination with caution, and monitor for conduction disturbances. Avoid methacholine with any beta blocker due to the potential for additive bronchoconstriction. Risk C: Monitor therapy Pregnancy Risk Factor C ( show table ) Pregnancy Implications Reproduction studies have not been conducted. Mechanism of Action Stimulates cholinergic receptors in the smooth muscle of the urinary bladder and GI tract resulting in increased peristalsis, increased GI and pancreatic secretions, bladder muscle contraction, and increased ureteral peristaltic waves Pharmacodynamics Onset of action: Oral: 30-90 minutes Duration: Oral: Up to 6 hours Pharmacokinetics (Adult data unless noted) Absorption: Oral: Variable Metabolic fate and excretion have not been determined Patient Information (For additional information see "Bethanechol: Patient drug information" ) Dizziness, lightheadedness, or fainting may occur especially when getting up from a lying position

Duration: Oral: Up to 6 hours Pharmacokinetics (Adult data unless noted) Absorption: Oral: Variable Metabolic fate and excretion have not been determined Patient Information (For additional information see "Bethanechol: Patient drug information" ) Dizziness, lightheadedness, or fainting may occur especially when getting up from a lying position Extemporaneous Preparations A 1 mg/mL solution may be made with tablets. Crush twelve 10 mg tablets in a mortar and reduce to a fine powder. Add small portions of sterile water and mix to a uniform paste; mix while adding sterile water in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with sterile water, and add quantity of sterile water sufficient to make 120 mL. Label “shake well” and “refrigerate”. Stable for 30 days (Schlatter, 1997). A 5 mg/mL suspension may be made with tablets and either a 1:1 mixture of Ora-Plus® and Ora-Sweet® or Ora-Plus® and Ora-Sweet® SF or 1:4 concentrated cherry syrup and simple syrup, NF mixture. Crush twelve 50 mg tablets in a mortar and reduce to a fine powder. Add small portions of chosen vehicle and mix to a uniform paste; mix while adding the vehicle in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make 120 mL. Label “shake well” and “refrigerate”. Stable for 60 days refrigerated (preferred) or at room temperature (Allen, 1998; Nahata, 2004). Allen LV Jr and Erickson MA, "Stability of Bethanechol Chloride, Pyrazinamide, Quinidine Sulfate, Rifampin, and Tetracycline Hydrochloride in Extemporaneously Compounded Oral Liquids," Am J Health Syst Pharm , 1998, 55(17):1804-9. 9775343 Nahata MC, Pai VB, and Hipple TF, Pediatric Drug Formulations , 5th ed, Cincinnati, OH: Harvey Whitney Books Co, 2004. Schlatter JL and Saulnier JL, "Bethanechol Chloride Oral Solutions: Stability and Use in Infants," Ann Pharmacother , 1997, 31(3):294-6. 9066934 Use of UpToDate is subject to the Subscription and License Agreement . Topic 13061 Version 36.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [1005-122.72.76.133-90821EDB07-S244013.14]