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Bethanechol (Carbamyl-β-methylcholine chloride), a parasympathomimetic choline carbamate and an analog of acetylcholine, is a selective muscarinic receptor agonist without any effect on nicotinic receptors. In addition to treating dry mouth, bethanechol can also be administered subcutaneously or orally to treat gastrointestinal lack of muscular tone, diabetic neuropathy of the bladder, and urinary retention brought on by general anesthesia.
| Targets |
mAChR
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|---|---|
| ln Vitro |
Bethanechol (0.3-300 μM) decreases ileal pacemaker potentials noticeably[2].
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| ln Vivo |
Bethanechol (2-12 mg/kg; i.p.) causes rats to drink more and produce more urine in a dose-dependent fashion[4].
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| Animal Protocol |
Female rats of the Blue Spruce Farms (Sprague-Dawley) (280-330 g)
2 mg/kg, 4 mg/kg, 8 mg/kg, 12 mg/kg Intraperitoneal injection |
| ADME/Pharmacokinetics |
Absorption, Distribution and Excretion
Following oral administration of betannicol, the maximum therapeutic effect in the bladder and gastrointestinal tract typically occurs after 60–90 minutes; however, it can appear as early as 30 minutes after administration. The duration of action of a typical oral dose of betannicol is approximately 1 hour, while higher doses (300–400 mg) can last up to 6 hours. Subcutaneous injection of betannicol has a rapid onset of action within 5–15 minutes, reaching maximum efficacy after 15–30 minutes. The effects of subcutaneous betannicol dissipate within 2 hours after administration. |
| Toxicity/Toxicokinetics |
Toxicity Summary
Betanidine directly stimulates cholinergic receptors in the parasympathetic nervous system, with minimal stimulation of ganglia. Its effects are primarily muscarinic, with minimal impact on nicotine receptors and negligible cardiovascular effects. Effects During Pregnancy and Lactation ◉ Overview of Use During Lactation There is currently no information regarding the use of betanidine during lactation. If used during lactation, infants should be closely monitored for signs of cholinergic overdose (diarrhea, lacrimation, excessive salivation, or excessive urination), especially in younger, exclusively breastfed infants. ◉ Effects on Breastfed Infants No published information found as of the revision date. ◉ Effects on Lactation and Breast Milk No published information found regarding lactating mothers as of the revision date. In animal studies, cholinergic drugs increase oxytocin release, and the effects on serum prolactin levels vary. Prolactin levels in mothers who have established lactation may not affect their ability to breastfeed. |
| References | |
| Additional Infomation |
Bethanechol is a carbamate of 2-methylcholine. It is a slowly hydrolyzed muscarinic receptor agonist and does not have nicotine-like effects. Bethanechol, in its chloride form, is used to increase smooth muscle tone, for example, in the gastrointestinal tract after abdominal surgery, in the treatment of gastroesophageal reflux disease, and as an alternative to catheterization in the treatment of non-obstructive urinary retention. It is a muscarinic receptor agonist. It is a quaternary ammonium ion and carbamate.
Bethanechol is a synthetic ester, originally synthesized in 1935. As a cholinergic drug, Bethanechol has a structure and pharmacological function similar to acetylcholine and is used in specific situations requiring stimulation of the parasympathetic nervous system. For example, Bethanechol is often used to treat postoperative or postpartum urinary retention. The advantage of Bethanechol is that, unlike acetylcholine, it is not degraded by cholinesterase, thus its duration of action is longer. Bethanechol is a cholinergic muscarinic receptor agonist. Betanidine's mechanism of action is as a cholinergic muscarinic receptor agonist. Betanidine is a synthetic ester whose structure and pharmacological action are related to acetylcholine. It is a slowly hydrolyzed muscarinic receptor agonist without nicotine-like effects and is commonly used to increase smooth muscle tone, for example, for gastrointestinal issues after abdominal surgery or for unobstructed urinary retention. It may cause hypotension, heart rate changes, and bronchospasm. [PubChem] A slowly hydrolyzed muscarinic receptor agonist without nicotine-like effects. Betanidine is commonly used to increase smooth muscle tone, for example, for gastrointestinal issues after abdominal surgery or for unobstructed urinary retention. It may cause hypotension, heart rate changes, and bronchospasm. See also: Betanidine chloride (salt form). Drug Indications Betanidine is indicated for the treatment of acute functional postpartum and postoperative urinary retention. It is also suitable for treating neurogenic bladder insufficiency with urinary retention. Mechanism of Action Betanidine is a direct muscarinic receptor agonist that stimulates the parasympathetic nervous system by binding to postganglionic muscarinic receptors. Although there are five types of muscarinic receptors (M1, M2, M3, M4, M5), the binding of betanidine to the M3 receptor is the most clinically important because M3 receptors are present in intestinal smooth muscle and the bladder. The cholinergic effects of betanidine increase detrusor muscle tone, promote bladder emptying, and increase smooth muscle tone, thereby restoring gastrointestinal motility and peristalsis. Due to its selectivity for muscarinic receptors, betanidine produces almost no nicotine-like effects. Pharmacodynamics Betanidine is selective for muscarinic receptors and has almost no effect on nicotine receptors. The charged quaternary ammonium group in the betanidine structure prevents it from crossing the blood-brain barrier, thereby minimizing central nervous system-related adverse reactions. |
| Molecular Formula |
C₇H₁₇N₂O₂
|
|---|---|
| Molecular Weight |
161.22
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| Exact Mass |
161.129
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| CAS # |
674-38-4
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| Related CAS # |
Bethanechol chloride; 590-63-6
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| PubChem CID |
2370
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| Appearance |
Typically exists as solid at room temperature
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| Melting Point |
217 - 221 °C (chloride salt)
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| LogP |
0.876
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| Hydrogen Bond Donor Count |
1
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| Hydrogen Bond Acceptor Count |
2
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| Rotatable Bond Count |
4
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| Heavy Atom Count |
11
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| Complexity |
140
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| Defined Atom Stereocenter Count |
0
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| SMILES |
CC(OC(N)=O)C[N+](C)(C)C
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| InChi Key |
NZUPCNDJBJXXRF-UHFFFAOYSA-O
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| InChi Code |
InChI=1S/C7H16N2O2/c1-6(11-7(8)10)5-9(2,3)4/h6H,5H2,1-4H3,(H-,8,10)/p+1
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| Chemical Name |
2-carbamoyloxypropyl(trimethyl)azanium
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| Synonyms |
Bethanechol; Carbamyl-β-methylcholine
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| HS Tariff Code |
2934.99.9001
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| Storage |
Powder -20°C 3 years 4°C 2 years In solvent -80°C 6 months -20°C 1 month |
| Shipping Condition |
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
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| Solubility (In Vitro) |
May dissolve in DMSO (in most cases), if not, try other solvents such as H2O, Ethanol, or DMF with a minute amount of products to avoid loss of samples
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| Solubility (In Vivo) |
Note: Listed below are some common formulations that may be used to formulate products with low water solubility (e.g. < 1 mg/mL), you may test these formulations using a minute amount of products to avoid loss of samples.
Injection Formulations
Injection Formulation 1: DMSO : Tween 80: Saline = 10 : 5 : 85 (i.e. 100 μL DMSO stock solution → 50 μL Tween 80 → 850 μL Saline)(e.g. IP/IV/IM/SC) *Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH ₂ O to obtain a clear solution. Injection Formulation 2: DMSO : PEG300 :Tween 80 : Saline = 10 : 40 : 5 : 45 (i.e. 100 μL DMSO → 400 μLPEG300 → 50 μL Tween 80 → 450 μL Saline) Injection Formulation 3: DMSO : Corn oil = 10 : 90 (i.e. 100 μL DMSO → 900 μL Corn oil) Example: Take the Injection Formulation 3 (DMSO : Corn oil = 10 : 90) as an example, if 1 mL of 2.5 mg/mL working solution is to be prepared, you can take 100 μL 25 mg/mL DMSO stock solution and add to 900 μL corn oil, mix well to obtain a clear or suspension solution (2.5 mg/mL, ready for use in animals). View More
Injection Formulation 4: DMSO : 20% SBE-β-CD in saline = 10 : 90 [i.e. 100 μL DMSO → 900 μL (20% SBE-β-CD in saline)] Oral Formulations
Oral Formulation 1: Suspend in 0.5% CMC Na (carboxymethylcellulose sodium) Oral Formulation 2: Suspend in 0.5% Carboxymethyl cellulose Example: Take the Oral Formulation 1 (Suspend in 0.5% CMC Na) as an example, if 100 mL of 2.5 mg/mL working solution is to be prepared, you can first prepare 0.5% CMC Na solution by measuring 0.5 g CMC Na and dissolve it in 100 mL ddH2O to obtain a clear solution; then add 250 mg of the product to 100 mL 0.5% CMC Na solution, to make the suspension solution (2.5 mg/mL, ready for use in animals). View More
Oral Formulation 3: Dissolved in PEG400  (Please use freshly prepared in vivo formulations for optimal results.) |
| Preparing Stock Solutions | 1 mg | 5 mg | 10 mg | |
| 1 mM | 6.2027 mL | 31.0135 mL | 62.0270 mL | |
| 5 mM | 1.2405 mL | 6.2027 mL | 12.4054 mL | |
| 10 mM | 0.6203 mL | 3.1014 mL | 6.2027 mL |
*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.
Calculation results
Working concentration: mg/mL;
Method for preparing DMSO stock solution: mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.
Method for preparing in vivo formulation::Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.
(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
(2) Be sure to add the solvent(s) in order.
| NCT Number | Recruitment | interventions | Conditions | Sponsor/Collaborators | Start Date | Phases |
| NCT05299008 | Recruiting | Drug: Bethanechol | Tracheobronchomalacia | Arkansas Children's Hospital Research Institute |
August 11, 2022 | N/A |
| NCT05241249 | Recruiting | Drug: Bethanechol Drug: Gemcitabine |
Pancreas Cancer | Susan E. Bates | February 1, 2022 | Phase 2 |
| NCT03572283 | Recruiting | Drug: Bethanechol | Pancreas Cancer | Columbia University | April 8, 2018 | Early Phase 1 |
| NCT01031043 | Completed | Drug: Bethanechol | Esophageal Dysmotility | Augusta University | November 2009 | Phase 1 |
| NCT01434901 | Completed | Drug: Placebo Drug: Bethanechol (25 mg) |
Type 2 Diabetes Mellitus | Washington University School of Medicine |
August 15, 2011 | Phase 1 |
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