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Cholinergic agonist (muscarinic)

Bethanechol chloride

Brand names: Myotonine

Adult dose

Dose: 10–25mg TDS–QDS PO
Route: Oral
Frequency: TDS–QDS

Clinical pearls

  • NICE NG123 OAB / urinary retention — limited UK use
  • Postoperative urinary retention; non-obstructive
  • Specialist supervision

Contraindications

  • Bowel obstruction
  • Bladder outflow obstruction
  • Asthma
  • Active peptic ulcer
  • Recent bowel/bladder surgery
  • Hyperthyroidism
  • Bradycardia / hypotension
  • Hypersensitivity

Side effects

  • Cholinergic effects (sweating, lacrimation, salivation, miosis, GI upset, bronchospasm, bradycardia, hypotension)

Interactions

  • Other cholinergics
  • Anticholinergics (antagonism)
  • Beta-blockers (bradycardia)

Monitoring

  • Voiding response
  • BP
  • HR
  • Bowel function

Reference: BNF; NICE NG123; BAUS; https://bnf.nice.org.uk/drugs/bethanechol-chloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.