Propantheline Bromide
Pronouncation: (pro-PAN-thuh-leen BROE-mide)Class: Quaternary anticholinergic
Trade Names:
Pro-Banthine
- Tablets 7.5 mg
- Tablets 15 mg
Pharmacology
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Exerts anticholinergic effects, resulting in GI smooth muscle relaxation and diminished volume and acidity of GI secretions.
Pharmacokinetics
Absorption
Poor GI absorption, only 10% to 25% of oral dose is absorbed. T max is approximately 1 h.
Distribution
Not fully determined.
Metabolism
Extensively metabolized by hydrolysis to inactive metabolites.
Elimination
Renal (70%, mostly as metabolites and 3% as propantheline). Half-life is 1.6 h.
Duration
6 h.
Indications and Usage
Adjunctive therapy in treatment of peptic ulcer.
Unlabeled Uses
Treatment of secretory and spastic disorders of GI tract, biliary tract, urinary tract, and bladder.
Contraindications
Hypersensitivity to anticholinergic drugs; narrow-angle glaucoma; adhesions between iris and lens; obstructive uropathy; obstructive disease of GI tract; paralytic ileus; intestinal atony of elderly or debilitated patient; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; hepatic or renal disease; tachycardia; myocardial ischemia; unstable cardiovascular status in acute hemorrhage; myasthenia gravis.
Dosage and Administration
Peptic UlcerAdults
PO 15 mg 30 min before meals and 30 mg at bedtime.
Patients with Mild Manifestations, Elderly Patients, or Those of Small StaturePO 7.5 mg 3 times daily.
Secretory DisordersAdults
PO 1.5 mg/kg/day in 3 to 4 divided doses.
Spastic DisordersAdults
PO 2 to 3 mg/kg/day in divided doses every 4 to 6 h and at bedtime.
General Advice
- Do not crush or allow patient to chew tablets.
- Administer antacids 1 h before or after propantheline.
Storage/Stability
Store at room temperature in tight container.
Drug Interactions
AntacidsDecreased absorption of propantheline if given together.
Drugs with anticholinergic effects (eg, antihistamines, antiparkinson drugs, tricyclic antidepressants)Additive peripheral anticholinergic adverse reactions.
HaloperidolMay cause decreased serum haloperidol levels, worsened schizophrenic symptoms, and tardive dyskinesia.
PhenothiazinesMay decrease antipsychotic effectiveness of phenothiazines; may produce additive anticholinergic effects.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Palpitations; tachycardia.
CNS
Headache; flushing; nervousness; drowsiness; weakness; dizziness; confusion; insomnia; fever; mental confusion or excitement; restlessness; tremor.
Dermatologic
Severe allergic reactions including anaphylaxis, urticaria, and dermal manifestations.
EENT
Blurred vision; mydriasis; photophobia; cycloplegia; increased IOP; dilated pupils; nasal congestion; altered taste perception.
GI
Dry mouth; nausea; vomiting; dysphagia; heartburn; constipation; bloated feeling; paralytic ileus.
Genitourinary
Urinary hesitancy and retention; impotence.
Miscellaneous
Suppression of lactation; decreased sweating.
Precautions
Pregnancy
Category C .
Lactation
Undetermined.
Children
Safety and efficacy not established.
Elderly
For elderly or debilitated patients, drug may cause excitement, agitation, drowsiness, and other untoward manifestations, even in small doses.
Special Risk Patients
Use drug with caution in patients with glaucoma, autonomic neuropathy, hepatic or renal disease, ulcerative colitis, hyperthyroidism, coronary artery disease, CHF, cardiac tachyarrhythmias, tachycardia, hypertension, prostatic hypertrophy, and hiatal hernia associated with reflux esophagitis.
Diarrhea
May be symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Treatment of diarrhea with drug is inappropriate and possibly harmful.
Gastric ulcer
May delay gastric emptying rate and complicate therapy.
Heat prostration
Can occur in presence of high environmental temperature.
Overdosage
Symptoms
Dry mouth, thirst, vomiting, nausea, abdominal distention, paralytic ileus, difficulty swallowing, muscular weakness, paralysis, CNS stimulation (restlessness, anxiety), delirium (disorientation, hallucinations), drowsiness, stupor, fever, dizziness, headache, seizures, ataxia, coma, circulatory failure, rapid pulse and respiration, vasodilation, tachycardia with weak pulse, hypertension, hypotension, respiratory depression, palpitations, urinary urgency with difficulty in micturition, blurred vision, photophobia, dilated pupils, leukocytosis, flushed hot dry skin, rash.
Patient Information
- Advise patient to take drug 30 min before meals and at bedtime unless directed otherwise by health care provider.
- Instruct patient not to chew or crush tablets.
- Warn patient that drug increases risk of heat prostration and caution patient to avoid becoming overheated by exercise or high environmental temperatures.
- Instruct patient to report the following symptoms to health care provider: drowsiness, dizziness, urinary hesitancy and retention, blurred vision, diarrhea or constipation, skin rash, flushing, or eye pain.
- Tell patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
- Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
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More Propantheline Bromide resources:
Pro-Banthine - Includes detailed dosage instructions.
Propantheline Bromide Drug Interactions
