In the U.S.—

In Canada—

• Cholinergic

Bethanechol (be-THAN-e-kole ) is taken to treat certain disorders of the urinary tract or bladder. It helps to cause urination and emptying of the bladder. Bethanechol may also be used for other conditions as determined by your doctor.

Bethanechol is available only with your doctor's prescription in the following dosage forms:

Oral
• Tablets (U.S. and Canada)

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bethanechol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to bethanechol. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals.

Breast-feeding—It is not known whether bethanechol passes into the breast milk.

Children—Although there is no specific information comparing use of bethanechol in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of bethanechol in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Asthma or
• Epilepsy or
• Heart or blood vessel disease or
• Intestinal blockage or
• Low blood pressure or
• Parkinson's disease or
• Recent bladder or intestinal surgery or
• Stomach ulcer or other stomach problems or
• Urinary tract blockage or difficult urination—Bethanechol may make these conditions worse

• High blood pressure—Bethanechol may cause a rapid fall in blood pressure

• Overactive thyroid—Bethanechol may further increase the chance of heart problems

Take this medicine on an empty stomach (either 1 hour before or 2 hours after meals) to lessen the possibility of nausea and vomiting, unless otherwise directed by your doctor.

Take this medicine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Dosing—

The dose of bethanechol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of bethanechol. If your dose is different, do not change it unless your doctor tells you to do so.

• To empty the bladder:
  • For oral dosage form (tablets):
    • Adults—25 to 50 milligrams (mg) three or four times a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 0.6 mg per kilogram (kg) (0.27 mg per pound) of body weight a day. This dose is divided into smaller doses and taken three or four times a day.
  • For injection dosage form:
    • Adults—5 mg injected under the skin three or four times a day.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 0.2 mg per kg (0.09 mg per pound) of body weight a day. This dose is divided into smaller doses, which are injected under the skin three or four times a day.

Missed dose—

If you miss a dose of this medicine and you remember within an hour or so of the missed dose, take it right away. However, if you do not remember until 2 or more hours after, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help lessen this problem.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Rare--more common with the injection
  • Shortness of breath, wheezing, or tightness in chest 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Less common or rare--more common with the injection
  • Belching;  blurred vision or change in near or distance vision;  diarrhea;  dizziness or lightheadedness;  feeling faint;  frequent urge to urinate ;  headache;  increased watering of mouth or sweating;  nausea or vomiting;  redness or flushing of skin or feeling of warmth;  seizures;  sleeplessness, nervousness, or jitters;  stomach discomfort or pain 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, bethanechol is used in certain patients with the following medical conditions:

• Certain stomach problems
• Gastroesophageal reflux (caused by acid in the stomach washing back up into the esophagus)
• Megacolon (an abnormally large or dilated colon)

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.