(me PEN zoe late)
- Mepenzolate Bromide
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Tablet, Oral, as bromide:
Cantil: 25 mg [DSC]
Brand Names: U.S.
- Cantil [DSC]
- Anticholinergic Agent
- Antispasmodic Agent, Gastrointestinal
Mepenzolate is a postganglionic parasympathetic inhibitor. It decreases gastric acid and pepsin secretion and suppresses spontaneous contractions of the colon.
Urine (3% to 22%); feces
Use: Labeled Indications
Adjunctive treatment of peptic ulcer disease; has not been shown to be effective in contributing to the healing of peptic ulcer, preventing complications, or decreasing the rate of recurrence
Allergic or idiosyncratic reactions to mepenzolate or related compounds; glaucoma; obstructive uropathy (ie, bladder neck obstruction due to prostatic hyperplasia); obstructive gastrointestinal disease (ie, pyloroduodenal stenosis, achalasia); paralytic ileus; intestinal atony of the debilitated or elderly patient; unstable cardiovascular status in acute GI hemorrhage; toxic megacolon complicating ulcerative colitis; myasthenia gravis
Peptic ulcer disease: Oral: 25-50 mg 4 times/day
Refer to adult dosing. Use caution or avoid; anticholinergics generally not tolerated in older adults.
Dosing: Renal Impairment
No dosage adjustment provided in manufacturer’s labeling; use with caution.
Dosing: Hepatic Impairment
No dosage adjustment provided in manufacturer’s labeling; use with caution.
Administration with meals and at bedtime is preferred.
May be taken with meals.
Store below 30°C (86°F). Keep tightly sealed. Protect from heat.
AbobotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of AbobotulinumtoxinA. Monitor therapy
Acetylcholinesterase Inhibitors: Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Acetylcholinesterase Inhibitors may diminish the therapeutic effect of Anticholinergic Agents. Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Analgesics (Opioid): Anticholinergic Agents may enhance the adverse/toxic effect of Analgesics (Opioid). Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol. Monitor therapy
Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Monitor therapy
Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Avoid combination
Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Avoid combination
Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Monitor therapy
Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Avoid combination
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Monitor therapy
Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Avoid combination
Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Monitor therapy
Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Avoid combination
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Monitor therapy
Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Consider therapy modification
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
RimabotulinumtoxinB: Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Monitor therapy
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to secretin. Consider therapy modification
Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Monitor therapy
Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Avoid combination
Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Monitor therapy
Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Frequency not defined.
Cardiovascular: Palpitations, tachycardia
Central nervous system: Confusion, dizziness, drowsiness, headache, insomnia, nervousness
Dermatologic: Hypohidrosis, urticaria
Gastrointestinal: Ageusia, bloating, constipation, delayed gastric emptying, nausea, vomiting, xerostomia
Genitourinary: Decreased lactation, impotence, urinary hesitancy, urinary retention
Neuromuscular & skeletal: Weakness
Ophthalmic: Blurred vision, cycloplegia, increased intraocular pressure, mydriasis
Concerns related to adverse effects:
• CNS effects: May cause drowsiness and/or blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).
• Diarrhea: May be a sign of incomplete intestinal obstruction, treatment should be discontinued if this occurs.
• Heat prostration: May occur in the presence of increased environmental temperature; use caution in hot weather and/or exercise.
• Psychosis: Has been reported in patients with an extreme sensitivity to anticholinergic effects; usually resolves with discontinuation of treatment.
• Cardiovascular disease: Use with caution in patients with coronary artery disease, tachycardia, arrhythmias, heart failure, or hypertension; evaluate tachycardia prior to administration.
• Gastric ulcer treatment: Use of anticholinergics in gastric ulcer treatment may cause a delay in gastric emptying due to antral stasis.
• Hepatic impairment: Use with caution in patients with hepatic impairment.
• Hiatal hernia: Use with caution in patients with hiatal hernia with reflux esophagitis; may aggravate condition.
• Hyperthyroidism: Use with caution in patients with hyperthyroidism.
• Neuropathy: Use with caution in patients with autonomic neuropathy.
• Prostatic hyperplasia: Use with caution in patients with prostatic hyperplasia.
• Renal impairment: Use with caution in patients with renal impairment.
• Ulcerative colitis: Use with caution in patients with ulcerative colitis; may precipitate/aggravate toxic megacolon.
• Elderly: Use with caution in the elderly; increased risk for anticholinergic effects, confusion, and hallucinations.
Dosage form specific issues:
• Tartrazine: Some products may contain tartrazine.
Pregnancy Risk Factor
Adverse events were not observed in animal reproduction studies.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience lightheadedness, fatigue, blurred vision, headache, change in taste, nausea, vomiting, constipation, or dry mouth. Have patient report immediately to prescriber severe dizziness, passing out, severe loss of strength and energy, change in balance, tachycardia, arrhythmia, confusion, mood changes, hallucinations, memory impairment, insomnia, difficulty speaking, vision changes, diarrhea, sexual dysfunction, urinary retention, or lack of sweat (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.