Mepenzolate
Medically reviewed by Drugs.com. Last updated on May 28, 2024.
Pronunciation
(me PEN zoe late)
Index Terms
- Mepenzolate Bromide
Pharmacologic Category
- Anticholinergic Agent
- Antispasmodic Agent, Gastrointestinal
Pharmacology
Mepenzolate is a postganglionic parasympathetic inhibitor. It decreases gastric acid and pepsin secretion and suppresses spontaneous contractions of the colon.
Absorption
Oral: Low
Excretion
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
Contraindications
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
Dosing: Adult
Peptic ulcer disease: Oral: 25-50 mg 4 times/day
Dosing: Geriatric
Avoid use (Beers Criteria [AGS 2019]).
Administration
Administration with meals and at bedtime is preferred.
Dietary Considerations
May be taken with meals.
Storage
Store below 30°C (86°F). Keep tightly sealed. Protect from heat.
Drug Interactions
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Monitor therapy
Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Avoid combination
Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Monitor therapy
Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Monitor therapy
Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. 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
CloZAPine: Anticholinergic Agents may enhance the constipating effect of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Consider therapy modification
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. Monitor therapy
Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Avoid combination
Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. 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. Monitor therapy
Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. 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
Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Avoid combination
Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Avoid combination
Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Monitor therapy
Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Avoid combination
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of 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
Adverse Reactions
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
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
Hypersensitivity: Anaphylaxis
Neuromuscular & skeletal: Weakness
Ophthalmic: Blurred vision, cycloplegia, increased intraocular pressure, mydriasis
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Warnings/Precautions
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.
Disease-related concerns:
• 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.
Special populations:
• 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 B Pregnancy Considerations
Adverse events were not observed in animal reproduction studies.
Patient Education
What is this drug used for?
• It is used to treat GI (gastrointestinal) ulcers.
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
• Lightheadedness
• Fatigue
• Blurred vision
• Headache
• Change in taste
• Nausea
• Vomiting
• Constipation
• Dry mouth
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
• Severe dizziness
• Passing out
• Severe loss of strength and energy
• Change in balance
• Fast heartbeat
• Abnormal heartbeat
• Confusion
• Mood changes
• Sensing things that seem real but are not
• Trouble with memory
• Trouble sleeping
• Trouble speaking
• Vision changes
• Diarrhea
• Sexual dysfunction
• Unable to pass urine
• Lack of sweat
• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.
Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.
More about mepenzolate
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