Propantheline Bromide

Indications

Propantheline Bromide is used for: Hyperhidrosis, Peptic ulcer, Urinary incontinence, GI tract spasm, Adult enuresis

Adult Dose

Oral Adjunct in peptic ulcer; Gastrointestinal tract spasm Adult: 15 mg tid and 30 mg at bedtime. Doses up to 120 mg daily may be needed. Elderly: 7.5 mg tid. May increase to a max of 30 mg tid. Urinary incontinence; Adult enuresis; Hyperhidrosis Adult: 15-30 mg bid/tid.

Child Dose

Oral Adjunct in peptic ulcer; Gastrointestinal tract spasm Child: For relief of GI spasm: 1 mth - 12 yr: 300 mcg/kg (max 15 mg), given 3-4 times daily.

Renal Dose

Administration

Should be taken on an empty stomach. Take ½ hr before meals.

Contra Indications

Glaucoma, obstructive diseases of GI or urinary tract, severe ulcerative colitis or toxic megacolon, intestinal atony, hiatus hernia associated with reflux oesophagitis, unstable cardiovascular adjustment in acute bleeding, prostatic enlargement, myasthenia gravis, paralytic ileus, pyloric stenosis, angle-closure glaucoma.

Precautions

Hyperthyroidism, congestive heart failure, coronary heart disease, cardiac arrhythmias, acute MI, cardiac insufficiency, hypertension. Pregnancy and lactation; elderly. Patients with fever, diarrhoea, GI reflux disease or ulcerative colitis. Hepatic or renal impairment. Increased risk of fever or heat stroke in patients exposed to high environmental temperature. Caution when used in patients with Down's syndrome.

Pregnancy-Lactation

Pregnancy Category: C Lactation: not known whether excreted into breast milk

Interactions

Additive anticholinergic effect with MAOIs, TCAs, phenothiazines, antihistamines and disopyramide. Delayed gastric emptying causes delayed absorption of other drugs. May antagonise the GI effects of domperidone, cisapride and metoclopramide. May reduce absorption of ketoconazole and levodopa. May increase absorption of nitrofurantoin. May increase serum levels of digoxin. May reduce effects of haloperidol and sublingual tablets of nitrates. May antagonise effects of parasympathomimetics.

Adverse Effects

Side effects of Propantheline Bromide : >10% Constipation, Dry mouth, Dry skin, Decreased sweating Frequency Not Defined Blurred vision, Sedation, Tachycardia, Dysphagia, Urinary retention Potentially Fatal: Toxic megacolon due to preexisting ulcerative colitis.

Mechanism of Action

Propantheline bromide is a quarternary ammonium antimuscarinic with antisecretory and antispasmodic effects.