Bethanechol is a cholinergic agent that stimulates the parasympathetic nervous system. It is most often used related to its effect on improvement of bladder emptying and improvement in esophageal gastric sphincter pressure for reflux control. It is also a salivary stimulant. Bethanechol mouth rinse has been evaluated in patients with cancer in the prevention and management of mucositis.
Jham, B.C., Chen, H., Carvalho, A.L., & Freire, A.R. (2009). A randomized phase III prospective trial of bethanechol to prevent mucositis, candidiasis, and taste loss in patients with head and neck cancer undergoing radiotherapy: A secondary analysis. Journal of Oral Science, 51, 565–572.
To determine the impact of bethanechol administration concomitant to radiotherapy on oral mucositis, candidiasis, and taste loss
Patients were randomly assigned to one of two treatment groups. Group 1 received 25 mg oral bethanechol, 3 times a day; group 2 received artificial saliva (OralBalance). Patients who experienced severe mucositis were subject to daily laser applications until remission of the lesions.
This was an outpatient radiation study conducted in Brazil.
Secondary analysis, stratified, open-label, random allocation to one of two groups.
No significant differences in frequency and severity of mucositis, candidiasis, or taste loss were found.
Bethanechol did not appear to reduce the incidence of mucositis, candidiasis, or taste loss when administered during RT.
Larger, randomized, double-blind, placebo-controlled studies are needed possibly to further test the hypothesis that bethanechol could minimize RT-induced mucositis incidence or severity.