Drugs in Pregnancy and Lactation: Tenth Edition

BETHANECHOL

Parasympathomimetic (Cholinergic)

PREGNANCY RECOMMENDATION: Limited Human Data—No Relevant Animal Data

BREASTFEEDING RECOMMENDATION: Limited Human Data—Potential Toxicity

PREGNANCY SUMMARY

Human pregnancy experience is too limited to assess the embryo–fetal risk.

FETAL RISK SUMMARY

Bethanechol is indicated for the treatment of nonobstructive urinary retention and neurogenic atony of the urinary bladder with retention. Reproduction studies in animals have not been conducted (1).

The use of bethanechol in human pregnancy has been reported, but too little data are available to analyze (2).

BREASTFEEDING SUMMARY

Specific data on the excretion of bethanechol into breast milk are lacking. The molecular weight (about 197) is low enough, however, that excretion into milk should be expected. One author cautioned that mothers receiving regular therapy with this drug should not breastfeed (3). Abdominal pain and diarrhea have been reported in a nursing infant exposed to bethanechol in milk (4).

References

1.Product information. Urecholine. Merck, 2000.

2.Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group, 1977:345–56.

3.Platzker ACD, Lew CD, Stewart D. Drug “administration” via breast milk. Hosp Pract 1980;15:111–22.

4.Shore MF. Drugs can be dangerous during pregnancy and lactations. Can Pharmaceut J 1970;103:358. As cited in: Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human breast milk. Pediatrics 1983;72:375–83.



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