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Pronunciation
(proe PAN the leen)
Generic Available (U.S.)
Yes
Index Terms
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Adjunctive treatment of peptic ulcer
Use: Dental
Induce dry field (xerostomia) in oral cavity
Use: Unlabeled
Decreased salivation and drooling
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/use caution
Breast-Feeding Considerations
No data reported; however, atropine may be taken while breast-feeding.
Contraindications
Severe ulcerative colitis, toxic megacolon, obstructive disease of the GI or urinary tract; glaucoma; myasthenia gravis; unstable cardiovascular adjustment in acute hemorrhage; intestinal atony of elderly or debilitated patients
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.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with coronary artery disease, tachyarrhythmias, heart failure, or hypertension; evaluate tachycardia prior to administration.
• Endocrine disease: Use with caution in patients with endocrine diseases.
• Gastrointestinal infections: Use with caution in patients with GI infections.
• Hepatic impairment: Use with caution in patients with hepatic impairment.
• Hiatal hernia: Use with caution in patients with hiatal hernia with reflux esophagitis.
• Hyperthyroidism: Use with caution in patients with hyperthyroidism.
• Neuropathy: Use with caution in patients with autonomic neuropathy.
• Renal impairment: Use with caution in patients with renal impairment.
Special populations:
• Elderly: Avoid long-term use in this age group due to anticholinergic adverse effects and uncertain effectiveness (Beers Criteria)
Adverse Reactions
Frequency not defined.
Cardiovascular: Palpitation, tachycardia
Central nervous system: Confusion, dizziness, drowsiness, headache, insomnia, nervousness
Endocrine & metabolic: Suppression of lactation
Gastrointestinal: Bloated feeling, constipation, loss of taste, nausea, vomiting, xerostomia
Genitourinary: Impotence, urinary hesitancy, urinary retention
Neuromuscular & skeletal: Weakness
Ocular: Blurred vision, cycloplegia, mydriasis, ocular tension increased
Miscellaneous: Allergic reactions, anaphylaxis, diaphoresis decreased
Metabolism/Transport Effects
None known.
Drug Interactions
AbobotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of AbobotulinumtoxinA. Risk C: Monitor therapy
Acetylcholinesterase Inhibitors (Central): Anticholinergics may diminish the therapeutic effect of Acetylcholinesterase Inhibitors (Central). Acetylcholinesterase Inhibitors (Central) may diminish the therapeutic effect of Anticholinergics. If the anticholinergic action is a side effect of the agent, the result may be beneficial. Risk C: Monitor therapy
Anticholinergics: May enhance the adverse/toxic effect of other Anticholinergics. Exceptions: Levocabastine (Nasal); Paliperidone. Risk C: Monitor therapy
Cannabinoids: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoids. Risk C: Monitor therapy
MAO Inhibitors: May enhance the orthostatic hypotensive effect of Orthostatic Hypotension Producing Agents. Risk C: Monitor therapy
OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. Risk C: Monitor therapy
Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Risk D: Consider therapy modification
Pramlintide: May enhance the anticholinergic effect of Anticholinergics. These effects are specific to the GI tract. Risk D: Consider therapy modification
RimabotulinumtoxinB: Anticholinergic Agents may enhance the anticholinergic effect of RimabotulinumtoxinB. Risk C: Monitor therapy
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Risk D: Consider therapy modification
Storage
Store at 20°C to 25°C (68°F to 77°F).
Mechanism of Action
Competitively blocks the action of acetylcholine at postganglionic parasympathetic receptor sites
Pharmacodynamics/Kinetics
Onset of action: 30-45 minutes
Duration: 4-6 hours
Half-life elimination, serum: Average: 1.6 hours
Dosage
Oral:
Antisecretory (unlabeled use):
Children: 1-2 mg/kg/day in 3-4 divided doses
Adults: 15 mg 3 times/day before meals or food and 30 mg at bedtime
Elderly: 7.5 mg 3 times/day before meals and at bedtime
Antispasmodic:
Children: 2-3 mg/kg/day in divided doses every 4-6 hours and at bedtime
Adults: 15 mg 3 times/day before meals or food and 30 mg at bedtime
Dental Usual Dosing
Antisecretory: Oral:
Children: 1-2 mg/kg/day in 3-4 divided doses
Adults: 15 mg 3 times/day before meals or food and 30 mg at bedtime
Elderly: 7.5 mg 3 times/day before meals and at bedtime
Administration: Oral
Administer 30 minutes before meals and at bedtime.
Dietary Considerations
Should be taken 30 minutes before meals so that the drug's peak effect occurs at the proper time. The tablet (15 mg) contains lactose 23.2 mg.
Geriatric Considerations
The primary use of propantheline in the geriatric population was for treatment of urinary incontinence due to detrusor instability. It is rarely used presently since newer agents, with fewer side effects, have been introduced. Even though it does not cross the blood-brain barrier, CNS effects have been reported. Orthostatic hypotension may also occur.
This medication is considered to be potentially inappropriate in this patient population (Beers Criteria severity: High).
Dental Health: Effects on Dental Treatment
Key adverse event(s) related to dental treatment: Significant xerostomia (therapeutic effect; normal salivary flow resumes upon discontinuation), dry throat, nasal dryness, and dysphagia.
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause drowsiness, confusion, amnesia, nervousness, or insomnia
Mental Health: Effects on Psychiatric Treatment
Concurrent use with psychotropics may produce additive sedation or anticholinergic side effects (dry mouth)
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, oral, as bromide: 15 mg
Pricing: U.S. (www.drugstore.com)
Tablets (Propantheline Bromide)
15 mg (30): $22.65
International Brand Names
Lexi-Comp.com
Last full review/revision January 2012
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