Tolterodine
Urinary Bladder Diseases, Urinary Incontinence
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Cholinergic Muscarinic Antagonist
Controlled Drug Substance
No
Tolterodine
Summary
Tolterodine is used to treat overactive bladder. This condition causes frequent urination, urgency, and incontinence.
Tolterodine works by relaxing the bladder muscles. It is a competitive antagonist of acetylcholine at muscarinic receptors in the bladder. This helps to control urination frequency and urgency.
For adults, the usual dose of Tolterodine is 2 mg twice daily. If you have liver or severe renal impairment, the dose is reduced to 1 mg twice daily. Tolterodine can be taken with or without food.
Common side effects of Tolterodine include dry mouth, headache, constipation, and abdominal pain. Serious adverse effects include swelling of the face, throat, tongue, lips, and eyes and difficulty swallowing or breathing.
Tolterodine is contraindicated in patients with urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, and known hypersensitivity to the drug. It should be used with caution in patients with certain conditions like bladder outflow obstruction, gastrointestinal obstructive disorders, narrow-angle glaucoma, myasthenia gravis, and those with a history of QT prolongation.
Indications and Purpose
How does Tolterodine work?
Tolterodine acts as a competitive antagonist of acetylcholine at muscarinic receptors, primarily in the bladder. By blocking these receptors, it relaxes the bladder muscles, reducing involuntary contractions and helping to control urination frequency and urgency.
Is Tolterodine effective?
Tolterodine has been shown to effectively reduce the number of urinary incontinence episodes and decrease urinary frequency in patients with overactive bladder. Clinical trials have demonstrated statistically significant improvements in these symptoms compared to placebo, confirming its efficacy in treating overactive bladder.
What is Tolterodine?
Tolterodine is used to treat overactive bladder, which causes frequent urination, urgency, and incontinence. It belongs to a class of medications called antimuscarinics and works by relaxing the bladder muscles to prevent involuntary contractions. This helps reduce the symptoms of urgency and frequency.
Directions for Use
For how long do I take Tolterodine?
The typical duration of use for Tolterodine is not explicitly stated, but the effect of treatment should be re-evaluated after 2-3 months. This allows the doctor to assess the effectiveness and adjust the treatment plan as necessary.
How do I take Tolterodine?
Tolterodine can be taken with or without food. The tablet is usually taken twice a day, while the extended-release capsule is taken once a day with liquids. Swallow the extended-release capsules whole without splitting, chewing, or crushing them. Follow your doctor's instructions and prescription label carefully.
How long does it take for Tolterodine to start working?
The effects of Tolterodine can be expected within 4 weeks of starting treatment. It is important to continue taking the medication as prescribed and consult your doctor if you do not notice improvements in your symptoms.
How should I store Tolterodine?
Tolterodine should be stored at room temperature, between 20°–25°C (68°–77°F), and protected from light. It should be kept in its original container, tightly closed, and out of reach of children. Avoid storing it in the bathroom to prevent exposure to moisture.
What is the usual dose of Tolterodine?
For adults, the usual dose of Tolterodine is 2 mg twice daily. For those with liver or severe renal impairment, the dose is reduced to 1 mg twice daily. Tolterodine is not recommended for children as its efficacy has not been demonstrated in this population.
Warnings and Precautions
Can I take Tolterodine with other prescription drugs?
Tolterodine interacts with potent CYP3A4 inhibitors like ketoconazole, clarithromycin, and ritonavir, which can increase its plasma concentration. It should be used cautiously with other anticholinergic agents, as this may increase side effects. No significant interactions have been observed with warfarin, oral contraceptives, or diuretics.
Can Tolterodine be taken safely while breastfeeding?
There is no information on the presence of Tolterodine in human milk or its effects on the breastfed infant. Due to the lack of data, it is recommended to avoid using Tolterodine while breastfeeding. Consult your doctor for personalized advice if you are breastfeeding.
Can Tolterodine be taken safely while pregnant?
There are no adequate data from the use of Tolterodine in pregnant women, and animal studies have shown reproductive toxicity. The potential risk for humans is unknown, so Tolterodine is not recommended during pregnancy. Consult your doctor for personalized advice if you are pregnant or planning to become pregnant.
Is it safe to exercise while taking Tolterodine?
Tolterodine may cause dizziness or drowsiness, which could affect your ability to exercise safely. If you experience these side effects, it is advisable to avoid strenuous activities until you know how the medication affects you. Consult your doctor for personalized advice.
Is Tolterodine safe for the elderly?
No overall differences in safety were observed between older and younger patients treated with Tolterodine. However, elderly patients may have higher serum concentrations of the drug. It is important for elderly patients to be monitored for side effects, and dosage adjustments may be necessary based on individual response and tolerability.
Who should avoid taking Tolterodine?
Tolterodine is contraindicated in patients with urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, and known hypersensitivity to the drug. It should be used with caution in patients with bladder outflow obstruction, gastrointestinal obstructive disorders, narrow-angle glaucoma, myasthenia gravis, and those with a history of QT prolongation. Patients should be monitored for side effects, especially dizziness and drowsiness.
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