PROPANTHELINE 15 MG SUGAR COATED TABLET

Indications

• Irritable bowel syndrome
• Urinary incontinence
• Excessive gastrointestinal motility
• Muscle spasms in the gastrointestinal tract

Dosage

Children: Refer to BNF for Children for specific dosing information.

Adults: Refer to BNF for specific dosing information.

Mechanism of action

Propantheline operates through a dual mechanism: it exerts a specific anticholinergic effect by blocking acetylcholine receptors at postganglionic cholinergic sites and also has a direct effect on smooth muscle (musculotropic). This leads to increased bladder capacity by reducing motor impulses to the detrusor muscle and alleviates muscle spasms in the gastrointestinal tract.

Pharmacodynamics

As an anticholinergic agent, propantheline decreases the effects of acetylcholine, which is responsible for muscle stimulation. It relaxes smooth muscle, inhibits gastrointestinal motility, decreases gastric acid secretion, and controls excessive secretions in the pharyngeal, tracheal, and bronchial areas. These effects make it useful in treating irritable bowel syndrome and reducing urinary urgency.

Pharmacokinetics

The pharmacokinetic profile of propantheline includes absorption from the gastrointestinal tract, distribution throughout the body, and metabolism primarily in the liver. The elimination half-life and specific metabolic pathways are not detailed in the provided information.

Contra-indications

• Myasthenia gravis
• Narrow-angle glaucoma
• Prostatic hypertrophy
• Severe ulcerative colitis
• Tachycardia
• Intestinal obstruction

Adverse effects

• Dry mouth
• Blurred vision
• Constipation
• Urinary retention
• Dizziness
• Nausea
• Headache

Interactions

• clozapine+propantheline: Unknown (additive effect)
• antipsychotics, second generation+propantheline: Unknown (additive effect)

Precautions

• Use with caution in patients with renal impairment
• Use with caution in patients with liver impairment
• Caution in elderly patients due to increased sensitivity to anticholinergic effects

Pregnancy

Propantheline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether propantheline is excreted in human milk. Caution should be exercised when administering to breastfeeding women.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets: 15 mg

Indications

• Gastrointestinal smooth muscle spasm
• Hyperhidrosis
• Enuresis
• Symptomatic relief of gastrointestinal disorders characterized by smooth muscle spasm

Dosage

Children: Tablets not licensed for use in children under 6 years; refer to BNF for Children for specific dosing guidelines.

Adults: 15 mg three times a day, taken at least one hour before food; maximum daily dose is 120 mg.

Mechanism of action

Propantheline bromide exerts its effects by blocking the action of acetylcholine at muscarinic receptors in the smooth muscle of the gastrointestinal tract. This inhibition leads to decreased gastrointestinal motility and reduced secretions, effectively alleviating symptoms associated with smooth muscle spasm.

Pharmacodynamics

As an anticholinergic, propantheline bromide decreases gastrointestinal motility and secretions. Its action on the muscarinic receptors results in effects such as decreased gastric acid secretion, reduced peristalsis, and relaxation of smooth muscle. The onset of action typically occurs within 30 minutes to 1 hour after oral administration, with a duration of effect lasting up to 6 hours.

Pharmacokinetics

Propantheline bromide is absorbed following oral administration, although the bioavailability may be affected by first-pass metabolism. It reaches peak plasma concentrations within 1 to 2 hours. The drug is metabolized mainly in the liver, and its elimination half-life is approximately 2 to 3 hours. Excretion occurs primarily through urine, with both unchanged drug and metabolites present.

Contra-indications

• Tachycardia
• Severe myasthenia gravis
• Pyloric stenosis
• Glaucoma
• Prostatic hypertrophy
• Obstructive gastrointestinal disease

Adverse effects

• Dry mouth
• Constipation
• Blurred vision
• Dizziness
• Urinary retention
• Tachycardia
• Mydriasis
• Feeling hot
• Hypotension

Interactions

• Anticholinergic drugs
• Tricyclic antidepressants
• Antihistamines
• Antipsychotics
• Monoamine oxidase inhibitors

Precautions

• Caution in patients with cardiac disease
• Caution in patients with hepatic impairment
• Caution in patients with renal impairment
• Use with caution in the elderly

Pregnancy

Manufacturer advises avoidance unless essential, with no specific information available.

Breast-feeding

May suppress lactation; caution is advised.

Storage

Store below 25 degrees Celsius. Protect from light. Keep out of reach of children.

Formulations

• {'form': 'Tablets', 'strength': '15 mg'}
• {'form': 'Injection', 'strength': '15 mg/1 ml'}

Mechanism of action

Action is achieved via a dual mechanism: (1) a specific anticholinergic effect (antimuscarinic) at the acetylcholine-receptor sites and (2) a direct effect upon smooth muscle (musculotropic). ANTICHOLINERGIC DRUGS BLOCK THE ACTION OF ACETYLCHOLINE AT POSTGANGLIONIC CHOLINERGIC SITES, THEREBY INCREASING BLADDER CAPACITY BY REDUCING THE NUMBER OF MOTOR IMPULSES REACHING THE DETRUSOR MUSCLE. /ANTICHOLINERGIC DRUGS/

Pharmacodynamics

Propantheline is an anticholinergic drug, a medication that reduces the effect of acetylcholine, a chemical released from nerves that stimulates muscles, by blocking the receptors for acetylcholine on smooth muscle (a type of muscle). It also has a direct relaxing effect on smooth muscle. Propantheline is used to treat or prevent spasm in the muscles of the gastrointestinal tract in the irritable bowel syndrome. In addition, Propantheline inhibits gastrointestinal propulsive motility and decreases gastric acid secretion and controls excessive pharyngeal, tracheal and bronchial secretions.