From the FDA Drug Label
CONTRAINDICATIONS Hypersensitivity to bethanechol chloride, hyperthyroidism, peptic ulcer, latent or active bronchial asthma, pronounced bradycardia or hypotension, vasomotor instability, coronary artery disease, epilepsy and parkinsonism The effect of Bethanechol (Urecholine) on hyperthyroidism is that it is contraindicated in patients with this condition, as stated in the drug label 1.
- Key point: Bethanechol should not be used in patients with hyperthyroidism.
From the Research
Bethanechol is not recommended for use in hyperthyroidism. This medication is a cholinergic agonist primarily used to treat urinary retention and certain gastrointestinal disorders by stimulating the parasympathetic nervous system. In hyperthyroidism, the standard treatments include antithyroid medications (methimazole 5-30 mg daily or propylthiouracil 100-300 mg three times daily), radioactive iodine therapy, or surgical thyroidectomy, along with beta-blockers like propranolol (20-40 mg every 6-8 hours) for symptom control, as discussed in 2.
The most recent and highest quality study, 3, highlights the importance of preoperative preparation in hyperthyroidism and surgery in the hyperthyroid state, but does not mention the use of bethanechol. Instead, it emphasizes the use of antithyroid medications, beta-blockers, and other treatments to manage hyperthyroidism.
Key points to consider in the management of hyperthyroidism include:
- The use of antithyroid medications, radioactive iodine therapy, or surgical thyroidectomy as standard treatments, as noted in 4
- The importance of beta-blockers in managing symptoms, as discussed in 5
- The need to avoid treatments that may exacerbate hyperthyroidism, such as iodine-containing drugs or contrast agents, as mentioned in 6
Overall, the use of bethanechol in hyperthyroidism is not supported by the evidence, and alternative treatments should be considered to manage urinary retention or other conditions that may require bethanechol, with consultation from an endocrinologist to manage complex medication interactions.