Bethanechol
Brand names: Myotonine
Bethanechol is a muscarinic cholinergic agonist used to stimulate bladder emptying in urinary retention without obstruction.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It directly stimulates muscarinic receptors on the detrusor muscle, increasing bladder smooth muscle tone and contraction to promote voiding.
Prescribing in practice
- Contraindicated where increased cholinergic activity is hazardous, including mechanical bladder outflow or gastrointestinal obstruction, and in asthma, peptic ulcer disease and certain cardiac conditions.
- Cholinergic adverse effects such as sweating, salivation, bradycardia, abdominal cramps and bronchospasm can occur.
- Atropine should be available to reverse severe cholinergic reactions.
Monitoring
Monitor heart rate, gastrointestinal and respiratory symptoms, and bladder response to treatment.
Counselling the patient
- Report sweating, flushing, cramping, breathlessness or palpitations.
- Take on an empty stomach to reduce nausea and vomiting.
Evidence & guidelines
Use reflects established cholinergic pharmacology and the SPC; mechanical obstruction must be excluded before treatment.
Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.