Propantheline Bromide is indicated in the treatment of

• Adjunctive therapy in peptic ulcer (gastric and duodenal)
• Relief of symptoms of gastritis (stomach discomfort, gastrointestinal bleeding, blood in vomit, blood in stool, persistent abdominal pain)
• Symptomatic treatment of diarrhoea-related irritable bowel syndrome (irritable colon, spastic colon, acute enterocolitis, functional GI disorders etc.)
• Urinary incontinence
• Control of salivation and enuresis
• Improves lactose intolerance
• Prevents excessive sweating (Hyperhidrosis)

Propantheline Bromide acts through a dual mechanism of action:

• Specific anticholinergic effect (antimuscarinic) at acetylcholine receptor sites
• Direct smooth muscle relaxant effect (musculotropic action)

It is a muscarinic receptor antagonist with antispasmodic properties. It reduces the action of acetylcholine, a neurotransmitter that stimulates smooth muscle contraction, by blocking its receptors on smooth muscle cells. It also produces a direct relaxing effect on smooth muscle. In addition, Propantheline decreases gastrointestinal motility and reduces gastric acid secretion. It controls excessive secretions from the pharynx, trachea, and bronchi. Other secretions such as pancreatic juice, sweat, and saliva are also reduced.

The usual initial adult dose of Propantheline Bromide is 75 mg daily. One tablet 30 min before each meal (15 mg three times daily). Two tablets at bedtime Dosage adjustment should be made according to the patient's individual response and tolerance. But the maximum daily dosage should not exceed 120 mg.

Pediatric use: Safety and effectiveness in pediatric patients have not been established.

Antacids or absorbent antidiarrhoeal agents may reduce the absorption of Propantheline Bromide, leading to decreased therapeutic effect. Therefore, these should be taken 2–3 hours apart from Propantheline Bromide. Anticholinergic drugs may delay the absorption of other concurrently administered medications. Significant drug interactions may also occur with digoxin, haloperidol, corticosteroids, ketoconazole, levodopa, opioid analgesics, phenothiazines, and urinary alkalinizers.

Propantheline Bromide is contraindicated in patients with

• Hypersensitivity to propantheline bromide or other anticholinergic agents
• Glaucoma
• Obstructive disease of the gastrointestinal tract (pyloroduodenal stenosis, paralytic ileus etc.)
• Obstructive uropathy (e.g. prostatic hypertrophy), intestinal atony in elderly patients
• Myasthenia gravis

The adverse effects of Propantheline Bromide are usually dose-related and reversible after discontinuation. Common effects include dry mouth, dry skin, and mydriasis. Other side effects may include urinary retention, nausea, vomiting, constipation, headache, nervousness, and mental confusion.

Propantheline Bromide is in Pregnancy Category C. Animal studies have not been conducted. It should be used in pregnancy only if clearly needed. It is not known whether it is excreted in breast milk; therefore, caution is required in nursing mothers. Anticholinergic drugs may suppress lactation.

Propantheline Bromide should be used with caution in elderly patients and in those with autonomic neuropathy, hepatic or renal disease, hyperthyroidism, coronary heart disease, congestive heart failure, cardiac tachyarrhythmias, and hypertension, as anticholinergics may worsen these conditions.

Symptoms of overdose progress from nausea and vomiting to CNS effects such as restlessness, excitement, and psychotic behavior. Cardiovascular effects include flushing, hypotension, circulatory failure. Severe cases may lead to respiratory failure and paralysis.

Anticholinergics (antimuscarinics) / Antispasmodics

Do not store above 30°C. Keep away from light and out of the reach of children.