From the Research
No, bethanechol is not typically administered as a slow intravenous (IV) drip for urinary retention. Bethanechol (brand names include Urecholine) is almost exclusively given orally in tablet form, typically at doses of 10-50 mg three to four times daily 1. IV administration of bethanechol is contraindicated due to the risk of severe adverse effects including profound hypotension, bradycardia, bronchospasm, and cardiovascular collapse. These risks occur because IV administration allows the drug to reach high systemic concentrations rapidly, potentially causing excessive parasympathetic stimulation throughout the body. Bethanechol works by stimulating muscarinic receptors, particularly in the urinary bladder, increasing detrusor muscle tone and promoting bladder emptying in patients with non-obstructive urinary retention. When treating urinary retention, healthcare providers should ensure there is no mechanical obstruction before initiating therapy, as bethanechol will not be effective for obstructive causes and could potentially worsen the condition by increasing pressure against an obstruction. Some studies have investigated the use of alpha-blockers for the treatment of urinary retention, and have found them to be effective in increasing the success rate of trial without catheter (TWOC) 2. However, the use of bethanechol as a slow IV drip is not supported by the evidence, and oral administration is the preferred route. In fact, a study from 2019 found that bethanechol is still prescribed for bladder dysfunction in women, primarily for detrusor atony, urinary retention, or incomplete bladder emptying, and is typically given orally 1. Therefore, oral administration of bethanechol is the recommended route for the treatment of urinary retention, and IV administration should be avoided due to the risk of severe adverse effects.