INTRODUCTION

MACPEE contains Bethanechol which belongs to the group of medicines called Cholinergic agents. It is used to treat urinary retention (inability to empty the bladder) following an operation or after giving birth or other health problems (such as brain, spinal or nerve problems) and also used in the treatment of reflux esophagitis (inflammation of the esophagus due to back flow of stomach contents into the esophagus).

MACPEE is not recommended for use in patients with gut or heart problems, asthma, fits, parkinsonism or if you had recent surgery on your stomach. MACPEE should be used with caution in patients taking certain medicines for heart problems, as a critical fall in blood pressure may occur.

MACPEE should be used with caution in pregnant and breastfeeding women only if clearly advised by the doctor. It is not recommended for use in elderly patients (above 70 years of age).

The most common side effects of taking MACPEE are diarrhea, skin flushing, increased salivation and sweating, decreased body temperature (hypothermia), etc. Consult your doctor if any of the side effect worsens.

USES OF MACPEE

Treats:

• urinary retention
• reflux esophagitis

HOW MACPEE WORKS

MACPEE works by making the contraction of urinary bladder muscles adequately strong to initiate urination and empty the bladder. It also stimulates motility and increases tone of the stomach and often restores impaired rhythmic peristalsis (wave-like muscle contractions that move food through the digestive tract).  

DIRECTIONS FOR USE

Take MACPEE as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight, and disease condition.

SIDE EFFECTS OF MACPEE

HOW TO MANAGE SIDE EFFECTS

Nausea or vomiting:

Take MACPEE on an empty stomach (one hour before meals or two hours after meals). Stick to simple meals. Avoid eating oily, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.

Diarrhoea:

Drink lot of fluids, like water or fruit juice to keep yourself hydrated. Avoid taking high fat or spicy foods. Consult your doctor if the symptom does not improve.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking MACPEE inform your doctor if you are taking any of the following medicines:

• medicines used to treat abnormal heart rhythms (Ex. quinidine, procainamide)
• other medicines used to treat urinary retention (Ex. distigmine and carbachol)
• medicines used to reduce high blood pressure in emergency situations (Ex. trimethaphan, hexamethonium)

Overdosage:

If you or anyone else accidentally take too much of MACPEE, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of MACPEE are abdominal discomfort, salivation, hot feeling, sweating, nausea, and vomiting.

SYNOPSIS

MORE INFORMATION

• Keep MACPEE out of reach of children
• Store at room temperature

FAQs ABOUT MACPEE

How does MACPEE act?

MACPEE works by making the contraction of urinary bladder muscles adequately strong to initiate urination and empty the bladder. It also stimulates motility and increases tone of the stomach and often restores impaired rhythmic peristalsis (wave-like muscle contractions that move food through the digestive tract).  

What is MACPEE used for?

It is used to treat urinary retention (inability to empty the bladder) following an operation or after giving birth or other health problems (such as brain, spinal or nerve problems) and also used in the treatment of reflux esophagitis (inflammation of the esophagus due to back flow of stomach contents into the esophagus).   

What are the common side effects of MACPEE?

The common side effects of taking MACPEE are diarrhea, skin flushing, increased salivation and sweating, decreased body temperature (hypothermia), urinary urgency, and bradycardia (slow pulse rate below 60 beats per minute) and drop in blood pressure. Consult your doctor immediately if any of the side effect worsens.

What to do If I forget to take a dose of MACPEE?

You should take MACPEE immediately when you remember. If it is time for your next dose skip the missed dose and follow your regular dose schedule. Do not double the dose of MACPEE to match up your missed dose.

Does MACPEE cause diarrhea?

MACPEE may cause diarrhea in some individuals. To manage this effect, drink lot of fluids, like water or fruit juice to keep yourself hydrated. Avoid eating high fat or spicy foods. Avoid taking any medicine on your own to treat diarrhea. Consult your doctor if the symptom does not improve.

REFERENCES

1. Joan Heller Brown, Katharina Brandl, and Jurgen Wess. Muscarinic Receptor Agonists and Antagonists. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 13th Edition. New York McGraw Hill Medical 2018. Page –152.

2. Inderbir S. Padda; Armen Derian. Bethanechol. NIH National Library of Medicine, National center for biotechnology information. StatPearls [Internet]. May 2022. [Accessed on 9th June 2022] https://www.ncbi.nlm.nih.gov/books/NBK560587/

3. Columbia University. Bethanechol Prior to Pancreatic Surgery. NIH U.S. National Library of Medicine. ClinicalTrials.gov. [Revised in February 2022] [Accessed on 9th June 2022] https://clinicaltrials.gov/ct2/show/NCT03572283

4. Shivani Gaitonde, Rena D. Malik, Alana L. Christie, Philippe E. Zimmern. Bethanechol: Is it still being prescribed for bladder dysfunction in women. The International Journal of Clinical Practice. August 2018. [Accessed on 9th June 2022] https://onlinelibrary.wiley.com/doi/abs/10.1111/ijcp.13248

5. BDR Pharmaceuticals International Pvt. Ltd. Urivoid Tablets (Bethanechol chloride). Ciplamed [Revised in September 2020] [Accessed on 9th June 2022] https://www.ciplamed.com/content/urivoid-tablets-0

6. Taj Pharmaceuticals Ltd. Tefecholine (Bethanechol chloride Tablets 25 mg USP). [Revised in August 2015] [Accessed on 9th June 2022] https://tajpharmaindia.com/wp-content/uploads/2015/09/PIL-TEFECHOLINE-BETHANECHOL-CHLORIDE-TAB.pdf

USEFUL DIAGNOSTIC TESTS

• Urodynamic testing