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Pronunciation:

(me PEN zoe late)

U.S. Brand Names:

Cantil® [DSC]

Synonyms:

Mepenzolate Bromide

Generic Available:

Canadian Brand Names:

Cantil®

Use:

Adjunctive treatment of peptic ulcer disease

Pregnancy Risk Factor:

Pregnancy Implications:

Teratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.

Lactation:

Excretion in breast milk unknown/use caution

Contraindications:

Hypersensitivity to mepenzolate or any component of the formulation; angle-closure glaucoma; obstructive uropathy (ie, bladder neck obstruction due to prostatic hyperplasia); obstructive gastrointestinal disease (ie, pyloroduodenal stenosis, achalasia); paralytic ileus; intestinal atony of the debilitated or elderly patient; unstable cardiovascular status in acute hemorrhage; severe ulcerative colitis or toxic megacolon complicating ulcerative colitis; myasthenia gravis; allergic or idiosyncratic reactions of related compounds

Warnings/Precautions:

Use caution with high environmental temperature; may lead to fever or heat stroke due to decreased sweating. Use caution with diarrhea, may be symptom of incomplete intestinal obstruction. Use caution with autonomic neuropathy, ulcerative colitis, hiatal hernia associated with reflux esophagitis, coronary heart disease, congestive heart failure, tachycardia, hypertension, prostatic hypertrophy, hyperthyroidism, hepatic or renal dysfunction, or in the elderly. Tablets contain tartrazine which may cause allergic reactions in certain individuals. Safety and efficacy in pediatric patients have not been established.

Adverse Reactions:

Frequency not defined.

Cardiovascular: Palpitations, tachycardia

Central nervous system: Headache, nervousness, drowsiness, dizziness, CNS stimulation may be produced with large doses, confusion, insomnia

Dermatologic: Dry skin, urticaria

Gastrointestinal: Constipation, xerostomia, dysphagia, nausea, vomiting, delayed gastric emptying, loss of taste

Genitourinary: Impotence, urinary hesitation, urinary retention

Neuromuscular & skeletal: Weakness

Ophthalmic: Cycloplegia, blurred vision, ocular tension increased, pupil dilation

Miscellaneous: Diaphoresis decreased, hypersensitivity reactions, anaphylaxis, lactation suppressed

Overdosage/Toxicology:

Blurred vision, CNS stimulation, dysphagia, dilated pupils, dizziness, dry skin, headache, nausea, and vomiting may occur with overdose. A curare-like reaction (neuromuscular blockade leading to muscle weakness, paralysis) has also been reported.

Mechanism of Action:

Mepenzolate is a post-ganglionic parasympathetic inhibitor. It decreases gastric acid and pepsin secretion and suppresses spontaneous contractions of the colon.

Pharmacodynamics/Kinetics:

Absorption: Oral: Low

Excretion: Urine (3% to 33%); feces

Dosage:

Adults: Oral: 25-50 mg 4 times/day with meals and at bedtime

Administration:

May be administered with meals.

Dietary Considerations:

May be taken with meals.

Dental Health: Effects on Dental Treatment:

Key adverse event(s) related to dental treatment: Xerostomia (normal salivary flow resumes upon discontinuation) and dry throat.

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

May rarely cause confusion, amnesia, drowsiness, nervousness, or insomnia

Mental Health: Effects on Psychiatric Treatment:

Concurrent use with psychotropics may produce additive drowsiness or anticholinergic side effects (dry mouth)

Dosage Forms:

[DSC] = Discontinued product

Tablet, as bromide: 25 mg [contains tartrazine] [DSC]

International Brand Names:

Cantil® (CA, ID, SE); Eftoron® (JP); Trancolon P® (JP)

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