Thelin

• Peptic Ulcer Disease: Adjunctive treatment to reduce gastric acid secretion and relieve symptoms.
• Irritable Bowel Syndrome (IBS): Management of abdominal cramps and intestinal spasms.
• Urinary Tract Disorders: Treatment of bladder spasms, urinary incontinence, and neurogenic bladder.
• Hyperhidrosis: Off-label use for controlling excessive sweating (primary hyperhidrosis).
• Other Conditions: Relief of smooth muscle spasms in biliary colic and other spastic conditions involving the gastrointestinal or genitourinary tracts.

• Route: Oral.
• Adults: Generally, 15 to 30 mg taken three to four times daily before meals and at bedtime.
• Elderly: Start with lower doses due to increased susceptibility to anticholinergic effects.
• Pediatrics: Safety and efficacy not well established; use only under specialist supervision if necessary.
• Renal/Hepatic Impairment: Use cautiously; dose adjustment may be required.
• Duration: Treatment duration depends on clinical response; monitor for side effects.

Propantheline bromide is a quaternary ammonium anticholinergic agent that selectively blocks muscarinic acetylcholine receptors on smooth muscle and secretory glands. By antagonizing parasympathetic nerve impulses, it reduces smooth muscle spasms and glandular secretions in the gastrointestinal and urinary tracts. This results in decreased gastric acid secretion and muscle relaxation, alleviating symptoms caused by hyperactive parasympathetic activity.

• Absorption: Well absorbed orally but undergoes variable first-pass metabolism.
• Distribution: Does not significantly cross the blood-brain barrier due to its quaternary ammonium structure.
• Metabolism: Partially metabolized by the liver.
• Elimination: Mainly excreted unchanged in urine.
• Half-life: Approximately 2 to 4 hours.

• Pregnancy: FDA Category C. Animal studies have shown adverse fetal effects; use only if benefits outweigh risks.
• Lactation: Excretion into breast milk is unknown; caution advised during breastfeeding.

• Anticholinergic agent
• Muscarinic receptor antagonist

• Known hypersensitivity to propantheline bromide or other anticholinergics.
• Myasthenia gravis.
• Obstructive gastrointestinal conditions (e.g., pyloric stenosis, paralytic ileus).
• Urinary retention or obstruction.
• Narrow-angle glaucoma.
• Severe ulcerative colitis or toxic megacolon.

• Use cautiously in elderly patients due to increased risk of cognitive impairment and anticholinergic toxicity.
• Caution in patients with benign prostatic hyperplasia, glaucoma, cardiac disease, or gastrointestinal obstruction.
• May cause heat intolerance due to decreased sweating; patients should avoid overheating.
• Monitor for signs of urinary retention and glaucoma exacerbation.

• Common: Dry mouth, blurred vision, constipation, urinary retention, tachycardia.
• Serious (rare): Confusion, hallucinations, severe urinary retention, glaucoma exacerbation, heat stroke due to impaired sweating.
• Onset: Side effects typically develop shortly after dosing and may be dose-dependent.

• Increased anticholinergic side effects when combined with other anticholinergics (e.g., antihistamines, tricyclic antidepressants).
• May reduce effectiveness of cholinesterase inhibitors used in myasthenia gravis.
• Caution when used with drugs affecting heart rate or QT interval.
• No major interactions involving CYP450 enzymes reported.

• Current recommendations highlight cautious use in elderly patients to minimize anticholinergic burden.
• Emphasis on patient education regarding heat intolerance and hydration.
• No significant recent changes in approved indications or dosing.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed and out of reach of children.