Bethanechol
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Also known as SID90341349SID26756574SID124879661BETHANECHOL CHLORIDE
Summary
Bethanechol (CHEMBL1482) is an approved small-molecule muscarinic agonist (ATC N07AB02) targeting CHRM1, CHRM2, and CHRM3; indicated across 3 conditions including eosinophilic esophagitis and exocrine pancreatic carcinoma.
At a glance
- Status: Approved (max clinical phase 4)
- Modality: Small molecule
- ATC class: N07AB02
- Targets: 5 (CHRM1, CHRM2, CHRM3…)
- Indications: 3 conditions
- Clinical trials: 7
- Chemistry: 161.22 Da · C7H17N2O2+
Identifiers
Drug identity and classification
| Field | Value |
|---|---|
| ChEMBL ID | CHEMBL1482 |
| Name | Bethanechol |
| Type | Small molecule |
| Max phase | 4 |
| FDA approved | yes |
| PubChem CID | 2370 |
| ChEBI | CHEBI:3084 |
| ATC | N07AB02 |
| Molecular formula | C7H17N2O2+ |
| Molecular weight | 161.22 |
| InChIKey | NZUPCNDJBJXXRF-UHFFFAOYSA-O |
SMILES: CC(C[N+](C)(C)C)OC(=O)N
IUPAC name: 2-carbamoyloxypropyl(trimethyl)azanium
ChEBI definition: The carbamic acid ester of 2-methylcholine. A slowly hydrolysed muscarinic agonist with no nicotinic effects, it is used as its chloride salt to increase smooth muscle tone, as in the gastrointestinal tract following abdominal surgery, treatment of gastro-oesophageal reflux disease, and as an alternative to catheterisation in the treatment of non-obstructive urinary retention.
Pharmacological roles (ChEBI): muscarinic agonist.
Also known as: Bethanechol, SID90341349, SID26756574, bethanechol, SID124879661, BETHANECHOL, BETHANECHOL CHLORIDE
Parent form; salt/anhydrous children: CHEMBL1768
Patent coverage: 1,204 distinct patent families (4,165 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.
Targets
Targets
Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).
| Gene | Target | Action | pAffinity | Cancer dependency | UniProt |
|---|---|---|---|---|---|
| CHRM1 | M1 receptor | Full agonist | 4 | 0.2% | P11229 |
| CHRM2 | M2 receptor | Full agonist | 4 | 0% | P08172 |
| CHRM3 | M3 receptor | Full agonist | 4.2 | 0% | P20309 |
| CHRM4 | M4 receptor | Full agonist | 4 | 1.6% | P08173 |
| CHRM5 | M5 receptor | Agonist | 0% | P08912 |
Broader ChEMBL bioactivity targets: 3 (assay-derived). Sample: Muscarinic acetylcholine receptor, Muscarinic acetylcholine receptor M2, Muscarinic acetylcholine receptor M1.
Bioactivity
ChEMBL activities: 2 potent at pChembl ≥ 5 of 3 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):
| Target | pChembl | Type | Value | Unit | Activity ID |
|---|---|---|---|---|---|
| CHRM2 | 7.01 | Ki | 97 | nM | CHEMBL_ACT_13500531 |
| CHRM2 | 5.41 | AC50 | 3900 | nM | CHEMBL_ACT_25215118 |
Target pathways
Aggregated over 5 target gene(s): CHRM1, CHRM2, CHRM3, CHRM4, CHRM5.
Top Reactome pathways
17 total, by targets touching each:
| Pathway | Targets | Genes |
|---|---|---|
| Signal Transduction | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| Signaling by GPCR | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| Class A/1 (Rhodopsin-like receptors) | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| Amine ligand-binding receptors | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| GPCR downstream signalling | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| Muscarinic acetylcholine receptors | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| GPCR ligand binding | 5 | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| G alpha (q) signalling events | 3 | CHRM1, CHRM3, CHRM5 |
| G alpha (i) signalling events | 2 | CHRM2, CHRM4 |
| Metabolism | 1 | CHRM3 |
| Integration of energy metabolism | 1 | CHRM3 |
| Membrane Trafficking | 1 | CHRM2 |
| Acetylcholine regulates insulin secretion | 1 | CHRM3 |
| Regulation of insulin secretion | 1 | CHRM3 |
| Vesicle-mediated transport | 1 | CHRM2 |
| Cargo recognition for clathrin-mediated endocytosis | 1 | CHRM2 |
| Clathrin-mediated endocytosis | 1 | CHRM2 |
Dominant GO biological processes
| GO term | Targets |
|---|---|
| signal transduction | 5 |
| G protein-coupled receptor signaling pathway | 5 |
| G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messenger | 5 |
| adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathway | 5 |
| G protein-coupled acetylcholine receptor signaling pathway | 5 |
| chemical synaptic transmission | 5 |
| phospholipase C-activating G protein-coupled acetylcholine receptor signaling pathway | 3 |
| nervous system development | 3 |
| acetylcholine receptor signaling pathway | 3 |
| regulation of locomotion | 2 |
| saliva secretion | 2 |
| regulation of smooth muscle contraction | 2 |
| phospholipase C-activating G protein-coupled receptor signaling pathway | 1 |
| neuromuscular synaptic transmission | 1 |
| positive regulation of monoatomic ion transport | 1 |
Indications & clinical
Indications
3 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).
| Indication | Trial phase | MONDO | EFO |
|---|---|---|---|
| eosinophilic esophagitis | 2 | MONDO:0005361 | EFO:0004232 |
| exocrine pancreatic carcinoma | 2 | MONDO:0005192 | EFO:0002618 |
| type 2 diabetes mellitus | 1 | MONDO:0005148 | MONDO:0005148 |
Clinical trials
Total trials: 7.
Phase distribution
| Phase | Trials |
|---|---|
| PHASE2 | 2 |
| PHASE1 | 2 |
| PHASE4 | 1 |
| EARLY_PHASE1 | 1 |
| Not specified | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT02910596 | PHASE4 | COMPLETED | Effectiveness of Bethanechol Chloride and Early Bladder Training for Prevention of Bladder Dysfunction After Radical Hysterectomy in Cervical Cancer Stage IB - IIA |
| NCT05241249 | PHASE2 | RECRUITING | Stimulation With Bethanechol in Combination With Gemcitabine and Nab-paclitaxel in Pancreatic Adenocarcinoma |
| NCT02058537 | PHASE2 | TERMINATED | Bethanechol for Eosinophilic Esophagitis |
| NCT01031043 | PHASE1 | COMPLETED | Topical Bethanechol for Improvement of Esophageal Dysmotility |
| NCT01434901 | PHASE1 | COMPLETED | The Effects of Bethanechol on Glucose Homeostasis |
| NCT03572283 | EARLY_PHASE1 | COMPLETED | Bethanechol Prior to Pancreatic Surgery |
| NCT05299008 | Not specified | UNKNOWN | The Effect of Bethanechol on Tracheobronchomalacia |
Clinical evidence (CIViC)
No CIViC predictive evidence (expected for non-precision-medicine drugs).
Pharmacology
Pharmacogenomics
No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.
Related molecules
Related molecules
Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.
576 molecules share ≥1 primary target. Top 60 by shared-target count:
| Molecule | Source | Status | Shared targets |
|---|---|---|---|
| ACLIDINIUM BROMIDE | ChEMBL + PubChem | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CLOZAPINE | ChEMBL + PubChem | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| GENTIAN VIOLET | ChEMBL + PubChem | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| Mavorixafor | ChEMBL + PubChem | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| OLANZAPINE | ChEMBL + PubChem | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| ACETYLCHOLINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| AMIODARONE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| AMITRIPTYLINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| AMOXAPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| ASTEMIZOLE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| ATROPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| BENZTROPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CARBACHOL | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CARBAMOYLCHOLINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CHLOROQUINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CHLORPROMAZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CINNARIZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CLEMASTINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CLIDINIUM | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CLOMIPRAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CYCLIZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| CYPROHEPTADINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DARIFENACIN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DESLORATADINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DEXCHLORPHENIRAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DICYCLOMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DIMENHYDRINATE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DIPHENHYDRAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DIPHENIDOL | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| DOXEPIN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| EBASTINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| GLYCOPYRRONIUM BROMIDE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| HALOPERIDOL | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| HOMATROPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| HYDROXYCHLOROQUINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| IMIPRAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| IPRATROPIUM | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| KETOTIFEN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| LOXAPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| MAPROTILINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| MEPAZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| METHSCOPOLAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| METHSCOPOLAMINE BROMIDE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| MIANSERIN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| NORTRIPTYLINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| ORPHENADRINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| OXYBUTYNIN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PAROXETINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PERHEXILINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PILOCARPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PIRENZEPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PROCHLORPERAZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PROMAZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| PROMETHAZINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| QUETIAPINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| QUINACRINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| RISPERIDONE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| SCOPOLAMINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| SERTRALINE | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
| SOLIFENACIN | ChEMBL | Phase 4 (approved) | CHRM1, CHRM2, CHRM3, CHRM4, CHRM5 |
Related Atlas pages
- Genes: CHRM1, CHRM2, CHRM3, CHRM4, CHRM5
- Drugs: Aclidinium Bromide, Clozapine, Mavorixafor, Olanzapine, Acetylcholine, Amiodarone, Amitriptyline, Amoxapine, Astemizole, Atropine, Benztropine, Carbachol, Chloroquine, Chlorpromazine, Cinnarizine, Clemastine, Clidinium, Clomipramine, Cyclizine, Cyproheptadine, Darifenacin, Desloratadine, Dexchlorpheniramine, Dicyclomine, Dimenhydrinate, Diphenhydramine, Diphenidol, Doxepin, Ebastine, Glycopyrronium Bromide, Haloperidol, Homatropine, Hydroxychloroquine, Imipramine, Ipratropium, Ketotifen, Loxapine, Maprotiline, Mepazine, Methscopolamine, Mianserin, Nortriptyline, Orphenadrine, Oxybutynin, Paroxetine, Perhexiline, Pilocarpine, Pirenzepine, Prochlorperazine, Promazine, Promethazine, Quetiapine, Quinacrine, Risperidone, Scopolamine, Sertraline, Solifenacin