Tolterodine
Urinary Incontinence Products · Anticholinergic
Indications
Unstable bladder with symptoms of urgency, frequency or urge incontinence.
Dosage
Adults: 2 mg twice daily, decreased if not tolerated to 1 mg twice daily. SR cap: 4 mg once daily. Children: Not recommended.
Adverse Effects
Dry mouth, GI upset, headache, xerophthalmia, dry skin, somnolence, nervousness, paraesthesia, dry eye, visual disturbances, dizziness, fatigue, chest pain, palpitations, vertigo, dysuria, urinary retention, sinusitis, bronchitis, peripheral oedema, wt gain.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Urinary retention, uncontrolled narrow angle glaucoma, Myasthaenia gravis, severe ulcerative colitis, toxic megacolon. Precautions: Bladder outlet or GI obstruction, renal or hepatic impairment, autonomic neuropathy, hiatus hernia, decreased GI motility, risk factors for QT prolongation.
Interactions
Potent CYP3A4 inhibitors such as azole antifungals or macrolides. Anticholinergics, muscarinic agonists, metoclopramide, cisapride, protease inhibitors. Drugs that prolong QT interval.
Advice to Patient
Take with or without meals. Do not chew or crush, swallow whole. Preferably taken with meals. Contact prescriber if there is change in gait, muscle spasms, numbness of extremities, unrelieved constipation, diarrhoea or vomiting, upper respiratory infection or flu, difficulty or pain in urination, chest pain, palpitations.
Pharmacokinetics
Absorption: Immediate release tab: Rapid; =77%. Metabolism: Extensively hepatic. Bioavailability: Immediate release tab: Increased 53% with food. Half-life elimination: Immediate release tab: Extensive metabolizers: Approx. 2 hrs; Poor metabolizers: Approx. 10 hrs. Extended release cap: Extensive metabolizers: Approx. 7 hrs; Poor metabolizers: Approx. 18 hrs. Time to peak: Immediate release tab: 1-2 hrs. Extended release cap: 2-6 hrs. Excretion: Urine (77%). Faeces (17%).
Unlicensed Use
Children: Urinary frequency, urgency, incontinence: 2-18 yr, 1 mg once daily, increased according to response; max. 2 mg twice daily. Nocturnal enuresis associated with overactive bladder: 5-18 yr, 1 mg once daily at bedtime, increased according to response, max 2 mg twice daily.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.