Urecholine


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Related to Urecholine: bethanechol

bethanechol chloride

Duvoid (CA), Myotonachol (CA), Myotonine (UK), PMS-Bethanecol Chloride (CA), Urecholine

Pharmacologic class: Cholinergic

Therapeutic class: Urinary and GI tract stimulant

Pregnancy risk category C

Action

Stimulates parasympathetic nervous system and cholinergic receptors, leading to increased muscle tone in bladder and increased frequency of ureteral peristaltic waves. Also stimulates gastric motility, increases gastric tone, and restores rhythmic GI peristalsis.

Availability

Tablets: 5 mg, 10 mg, 25 mg, 50 mg

Indications and dosages

Postpartal and postoperative non-obstructive urinary retention; urinary retention caused by neurogenic bladder

Adults: 10 to 50 mg P.O. three to four times daily; dosage may be determined by giving 5 or 10 mg q hour until response occurs or a total of 50 mg has been given.

Contraindications

• Hypersensitivity to drug

• GI or GU tract obstruction

• Hyperthyroidism

• Active or latent asthma

• Bradycardia

• Hypotension

• Atrioventricular conduction defects

• Coronary artery disease

• Seizure disorders

• Parkinsonism

• Peptic ulcer disease

Precautions

Use cautiously in:

• sensitivity to cholinergics or their effects and tartrazine (some products)

• pregnant or breastfeeding patients

• children.

Administration

• Give drug on empty stomach 1 hour before or 2 hours after a meal to help prevent nausea and vomiting.

Adverse reactions

CNS: headache, malaise, seizures

CV: bradycardia, hypotension, heart block, syncope with cardiac arrest

EENT: excessive lacrimation, miosis

GI: nausea, vomiting, diarrhea, abdominal discomfort, belching

GU: urinary urgency

Respiratory: increased bronchial secretions, bronchospasm

Skin: diaphoresis, flushing

Other: hypothermia

Interactions

Drug-drug. Anticholinergics: decreased bethanechol efficacy

Cholinesterase inhibitors: additive cholinergic effects

Depolarizing neuromuscular blockers: decreased blood pressure

Ganglionic blockers: severe hypotension

Procainamide, quinidine: antagonism of cholinergic effects

Drug-herbs. Angel's trumpet, jimson-weed, scopolia: antagonism of cholinergic effects

Patient monitoring

• Monitor blood pressure. Be aware that hypertensive patients may experience sudden blood pressure drop.

• Stay alert for orthostatic hypotension, a common adverse effect.

• Monitor fluid intake and output and residual urine volume.

Patient teaching

• Tell patient that drug is usually effective within 90 minutes of administration.

• Advise patient to take drug on empty stomach 1 hour before or 2 hours after a meal to avoid GI upset.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from blood pressure decrease.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

Urecholine

(yo͞o′rə-kō′lĭn)
A trademark for the drug bethanechol chloride.

bethanechol chloride

A cholinergic agent with muscarinic effects, which stimulates the parasympathetic system, increasing smooth muscle activity of the gastrointestinal (GI) and genitourinary (GU) tracts.
 
Indications
GI and GU atony—e.g., neurogenic bladder, atony of stomach after vagotomy, postoperative gastric retention, acute postoperative and postpartum urinary retention, reflux esophagitis, GERD/GORD.

Adverse effects
Dizziness, lightheadedness, nausea, vomiting, abdominal pain, diarrhoea, increased saliva, urinary urgency, sweating, flushing, watery eyes, or headache.
References in periodicals archive ?
Sales of the branded and generic versions of Urecholine tablets were about $33 million in the 12 months ended August 31, 2006, according to Wolters Kluwer Health.
The aim of this study was to evaluate the usefulness of transvaginal electrical stimulation at 200 Hertz in women with symptomatic, nonobstructive urinary retention and compare the results to transvaginal electrical stimulation at 200 Hertz with concomitant Urecholine administration.
Nine subjects took Urecholine 25 to 50 mg, orally 3 times per day.
Average PVR measured in the group taking Urecholine decreased from 164 to 56.7 ml; average PVR in the group not taking Urecholine was 144 ml pretreatment and fell to 36.3 ml following treatment (see Table 5).
The early response to the availability of Urecholine has been impressive, says Bur.
"We've received literally hundreds of phone calls from patients thanking us for the availability of Urecholine," he says.
Sidmak has purchased the trademark and active ingredient of Urecholine (bethanechol chloride tablets, USP) as well as the product's active pharmaceutical ingredient from the product innovator company.
Paul Cottone, president and chief executive officer, says that in the short term Odyssey will be able to fill a "distinct void," since Urecholine was in limited supply through much of 1999 and into this year.
scored tablets (in bottles of 100) of Urecholine as its initial product launch.