1.URECHOLINE HISTORY
(How was Urecholine discovered?)

Urecholine is a product of Odyssey Pharmaceuticals.

Odyssey Pharmaceuticals, Inc.® was established in February 2000 as a wholly owned subsidiary of Sidmak Laboratories, a leading U.S. - based pharmaceutical manufacturer.

In July of 2002, Sidmak Laboratories was acquired by PLIVA D.D., Zagreb , Croatia , the largest pharmaceutical company in Central and Eastern Europe.

Odyssey Pharmaceuticals, Inc. is now a wholly owned subsidiary of PLIVA, Inc. The name change from Sidmak Laboratories, Inc. to PLIVA, Inc. took place in March of 2003. There has been no name change to Odyssey Pharmaceuticals, Inc. 

Note: World-drugs.net sells generic version of Urecholine

2.URECHOLINE FACTS

Urecholine mimics the action of acetylcholine, which is a chemical found naturally in the body. Acetylcholine stimulates receptors, called muscarinic receptors, which leads to a range of different effects.

Muscarinic receptors are found all over the body, including the muscle which surrounds the bladder and the muscles of the gastro-intestinal tract.

Stimulation of the bladder muscle receptors enables the bladder to empty while stimulation of the oesophageal (gullet) muscles prevents the reflux of stomach contents. 

3.ABOUT URECHOLINE MEDICATION

What is Urinary Retention?

When you cannot empty your bladder completely, or at all, despite an urge to urinate, you have urinary retention. To understand how urinary retention occurs, you need to understand the basics of how urine is stored in and released from the body.

• The bladder is a balloon-like organ in your lower belly (pelvis) that stores urine.
• Urine is composed of waste and water filtered from the blood by the kidneys.
• It travels down thin tubes called ureters to the bladder.
• When about 1 cup (200-300 ml) of urine has collected in the bladder, a signal is sent via nerves in the spinal cord to the brain; the brain then returns a signal that starts contractions in the bladder wall. At the same time, the internal sphincter muscle relaxes.

 

• These 2 reactions combined allow urine to flow out of the bladder and down a narrow tube called the urethra.
• From there, it is released from the body by urination.
• To a certain point, you can control when you urinate. We are all familiar with the experience of having to urinate at an inconvenient time. When you "hold it in," you are squeezing a muscle called the external sphincter to keep urine in the urethra.

Retention can be an acute (new, short-term) or chronic (ongoing, long-term) condition. It always requires medical attention, sometimes hospitalization, for treatment, symptom relief, and detection of the underlying cause. Failure to treat the condition can lead to infections or damage to the urinary tract and kidneys.

Urinary retention is not an unusual condition. It is more common in men than in women.

Causes of Urinary Retention

The 2 essential causes of urinary retention are (1) blockage of the urethra and (2) disruption of the delicate and complex system of nerves that connects the urinary tract with the brain.

1.) Acute conditions

Blockage (obstruction): The most common cause of blockage of the urethra in men is enlargement of the prostate. In males, the prostate gland partially surrounds the urethra. If the prostate becomes enlarged, which is common in older men, it presses on the urethra and can block it. The most common cause of prostate enlargement is benign prostatic hypertrophy (often called BPH). Other causes of prostate enlargement include cancer and infection. Causes that can occur in both sexes include scar tissue, injury (as in a car wreck or bad fall), blood clots, infection, tumors, and stones (rare).

Nerve problems: Disruption of the nerves between the bladder and the brain can cause you to lose control of your bladder function. The problem may lie in the nerves that send messages back and forth or in the nerves that control the muscles used in urination, or both. Some forms of this are called neurogenic bladder. Occasionally, urinary retention is the first sign of spinal cord compression, a medical emergency that must be treated right away to prevent permanent, serious disability. The most common causes of this disruption include spinal cord injury, spinal cord tumor, herniated disk in your back, or an infection or blood clot that places pressure on your spinal cord.

Infection : An infection in your pelvic area, such as herpes, can interfere with nerves in the area. Inflammation and swelling caused by infections can also compress the urethra. Infections around the spinal cord can cause retention by placing pressure on the cord.

Surgery : Urinary retention is a relatively common problem after surgery. It is a direct result of the anesthetic or the type of operation.

2.) Medications

Certain medications can cause urinary retention, especially in men with prostate enlargement. Many of these medications are found in over-the-counter cold and allergy preparations.

• Drugs that act to tighten the urinary channel and block the flow of urine include ephedrine, pseudoephedrine and phenylpropanolamine.
• Antihistamines such as diphenhydramine and chlorpheniramine, as well as some older antidepressants, can relax the bladder too much and cause urination problems.
• Caution: The ingredient phenylpropanolamine has been associated with stroke. The FDA is taking over-the-counter medications containing phenylpropanolamine off the market and asking their manufacturers to change them.

3.) Urinary retention in children

• A child can have problems from birth that cause an inability to urinate properly. These problems usually become apparent within the first 6 months of life.
• A child may suddenly become unwilling to urinate. This is generally due to a temporary condition causing them pain with urination. Pain can be caused by a vaginal yeast infection in girls or an irritation from soap or shampoo used in bathing. Almost always, the child will eventually urinate without further help.

4.) Chronic conditions

Chronic urinary retention usually develops slowly because the bladder does not empty completely. It may take a very long time to be diagnosed because you may not have any symptoms.

• A weak bladder muscle, chronic obstruction, and nerve diseases or injury all can contribute to chronic urinary retention.
• Chronic retention can lead to urinary incontinence (the unwanted leakage of urine from the bladder), urinary tract infection, and kidney failure.

Symptoms of Urinary Retention

With urinary retention, you are unable to empty your bladder even though you feel a strong urge to urinate. Some people have the following symptoms:

• Most people with acute urinary retention also feel pain in the lower abdomen (pelvis). Chronic urinary retention is usually painless.
• A small amount of urine may leak out of the bladder but generally not enough to relieve symptoms.
• With chronic urinary retention or sensory problems, you may show no symptoms.
• Back pain, fever, and painful urination may indicate a urinary tract infection.

Medical Evaluation of Urinary Retention

Medical evaluation for urinary retention includes a medical and physical examination (including a prostate examination in men) to find the cause of the problem.

A catheter will be placed in your urethra. This is a thin, flexible tube. It goes up into your bladder and drains the urine into a bag.

• This is done both for diagnosis and as a treatment of the immediate problem. Draining urine almost always relieves the symptoms, at least for a while.
• A urine sample will be taken to check for signs of infection, bladder irritation, stones, or other problems.

Other lab tests may be done, depending on your health care provider's conclusions from your medical interview and exam.

• Blood may be drawn to check for signs of infection, to check your electrolyte balance, and possibly to rule out certain conditions.
• The blood also may be checked for prostate-specific antigen (PSA). This is the same test used to screen men for prostate cancer.
• A sample of the secretions from your penis (men) or vagina (women) may be checked for signs of infection as well.

If your health care provider suspects that you have an acute nerve problem causing urinary retention, a CT scan or MRI of your spine will be done.

People with chronic urinary retention or suspected bladder muscle weakness may be referred to a speTadalafilt in disorders of the urinary tract (urologist).

• The urologist may perform advanced urodynamic testing to see what is causing the problem.
• If indicated, an ultrasound will be done to examine the upper urinary tract (the kidneys and ureters).
• The urologist also may recommend cystoscopy. A cystoscope is a thin, flexible tube with a tiny camera on the end. It is inserted through your urethra to examine your bladder, urethra, and prostate for abnormalities that can cause urinary retention.

Treatment of Urinary Retention

Urine retention may occur either because the bladder wall muscle cannot contract or because the sphincter muscle cannot relax.

Catheter. A catheter is a thin tube that can be slid through the urethra into the bladder to let urine flow out into a collection bag. If you are able to place the catheter yourself, you can learn to carry out the procedure at regular intervals, a practice called clean intermittent catheterization (CIC). Some patients cannot place their own catheters because nerve damage affects their hand coordination as well as their voiding function. These patients need to have a caregiver place the catheter for them at regular intervals. If this is not feasible, the patients may need to have an indwelling catheter that can be changed less often. Indwelling catheters have several risks, including infection, bladder stones, and bladder tumors. However, if the bladder cannot be emptied any other way, then the catheter is the only way to stop the buildup of urine in the bladder that can damage the kidneys.

Urethral stent. Stents are small tube-like devices inserted into the urethra and allowed to expand, like a spring, widening the opening for urine to flow out. Stents can help prevent urine backup when the bladder wall and sphincter contract at the same time because of improper nerve signals. However, stents can cause problems if they move or lead to infection.

Surgery. Men may consider a surgery that removes the external sphincter (sphincterotomy) or a piece of it (sphincter resection) to prevent urinary retention. The surgeon will pass a thin instrument through the urethra to deliver electrical or laser energy that burns away sphincter tissue. Possible complications include bleeding that requires a transfusion and rarely problems with erections. This procedure causes loss of urine control and requires the patient to collect urine by wearing an external catheter that fits over the penis like a condom. No external collection device is available for women.

Urinary diversion. If other treatments fail and urine regularly backs up and damages the kidneys, the doctor may recommend a urinary diversion, a procedure that may require an outside collection bag attached to a stoma, a surgically created opening where urine passes out of the body. Another form of urinary diversion replaces the bladder with a continent urinary reservoir, an internal pouch made from sections of the bowel or other tissue. This method allows the person to store urine inside the body until a catheter is used to empty it through a stoma.

4.URECHOLINE EFFECTIVENESS
(When is Urecholine best taken?)

Effects on the GI and urinary tracts sometimes appear within 30 minutes after oral administration of Urecholine dose, but more often 60-90 minutes are required to reach maximum effectiveness. Following oral administration of Urecholine dose, the usual duration of action of Urecholine is one hour, although large Urecholine doses (300-400 mg) have been reported to produce effects for up to six hours.

The metabolic fate and mode of excretion of Urecholine have not been elucidated. 

5.URECHOLINE EFFECTS ON SPECIAL POPULATION
(How do different people react to Urecholine?)

Pregnancy

Animal reproduction studies have not been conducted with Urecholine. It is also not known whether Urecholine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Urecholine should be given to a pregnant woman only if clearly needed.

Nursing Mothers

It is not known whether Urecholine is secreted in human milk. Because many drugs are secreted in human milk and because of the potential for serious adverse reactions from Urecholine in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

6.URECHOLINE EFFECTS ON MEDICAL CONDITION
(How does Urecholine affect your existing condition/ailment?)

Urecholine should not be used if you suffer from blockage of the gut (intestinal obstruction), obstruction of the urinary tract (urethra), people who have recently had a heart attack or intestinal anastomosis.

Urecholine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using Urecholine and inform your doctor or pharmacist immediately. 

7.OTHER/ALTERNATE USES OF URECHOLINE
(What else does Urecholine treat?)

Urecholine may also be prescribed for the treatment of GERD (Gastroesophageal Reflux Disease).

8.ADVERSE/SIDE EFFECTS of URECHOLINE
(What are the side effects of Urecholine?)

Adverse reactions are rare following oral administration of Urecholine, but are more common following subcutaneous injection. Adverse reactions are more likely to occur when dosage is increased. The following adverse reactions have been observed:

Body as a Whole: malaise;

Digestive: abdominal cramps or discomfort, colicky pain, nausea and belching, diarrhea, borborygmi, salivation;

Renal : urinary urgency;

Nervous System : headache; seizures

Cardiovascular : a fall in blood pressure with reflex tachycardia, vasomotor response;

Skin : flushing producing a feeling of warmth, sensation of heat about the face, sweating;

Respiratory : bronchial constriction, asthmatic attacks;

Special Senses : lacrimation, miosis.