Bethanechol Chloride

By Rania Gollakner, BS, DVM, MPH

What is bethanechol chloride?

Bethanechol chloride (brand names: Urecholine®, Duvoid®, Myotonachol®, Muscaran®, Myo Hermes®, Myocholine®, Myotonine®, Ucholine®, Urocarb®, Urotonine®) is a cholinergic used to increase bladder contractions when the bladder has been weakened or when the bladder cannot completely empty. It may also be effective in increasing the movement of the esophagus.

Its use in cats, dogs, or horses to increase urinary or intestinal movement/activity is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is bethanechol chloride given?

Bethanechol chloride is given by mouth in the form of a tablet or a compounded liquid suspension. It may also be given as an injection in the hospital setting. It should be given on an empty stomach; however, if vomiting occurs when dosed on an empty stomach, give future doses with food. Measure liquid forms carefully.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

The most common side effects include vomiting, diarrhea, drooling, and lack of appetite. In horses, side effects include watery eyes, drooling, or colic. Serious side effects include abnormal or slow heart rhythms, weakness, collapse, wheezing, difficulty breathing, or coughing.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Do not use this medication in pets that are allergic to it. Do not use in pets with urinary obstruction, stomach ulcers, gastrointestinal obstructions, intestinal inflammation, or recent intestinal, stomach, or bladder surgery. Bethanechol chloride should be used cautiously in pets that have overactive thyroid, seizures, asthma, bronchitis, or low blood pressure. Use cautiously in pregnant or lactating animals as safety has not been established.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with bethanechol chloride: anticholinergic drugs, cholinergic drugs, ganglionic blocking drugs, procainamide, or quinidine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your veterinarian may monitor your pet to be sure that the medication is working by monitoring urination frequency, urine amounts, and bladder size via palpation. Monitor your pet at home for serious side effects.

How do I store bethanechol chloride?

Store the tablets at room temperature between 68°F and 77°F (20°C and 25°C) in a tight container. Store the compounded liquid form according to the label and protect from light.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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