tolterodine


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tolterodine

 [tol-ter´ah-dēn]
an antispasmodic agent used in treatment of bladder hyperactivity.

tolterodine

Pharmacologic class: Anticholinergic

Therapeutic class: Urinary tract antispasmodic

Pregnancy risk category C

Action

Competitively antagonizes muscarinic receptors, inhibiting bladder contractions and reducing urinary frequency

Availability

Capsules (extended-release): 2 mg, 4 mg

Tablets: 1 mg, 2 mg

Indications and dosages

Overactive bladder

Adults: 2 mg (immediate-release) P.O. b.i.d.; may decrease to 1 mg P.O. b.i.d. depending on response and tolerance. Or 4 mg (extended-release) P.O. daily; may decrease to 2 mg P.O. daily, depending on response.

Dosage adjustment

• Hepatic impairment or disease
• Renal impairment
• Concurrent use of potent CYP3A4 inhibitors

Contraindications

• Hypersensitivity to drug, its components, or to fesoterodine fumarate extended-release tablets
• Urinary or gastric retention
• Uncontrolled angle-closure glaucoma

Precautions

Use cautiously in:
• GI obstruction, significant bladder outflow obstruction, controlled angle-closure glaucoma, significant hepatic impairment, renal impairment
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give with food to increase bioavailability.

Adverse reactions

CNS: headache, dizziness, vertigo, drowsiness, paresthesia, fatigue

CV: chest pain

EENT: vision abnormalities, xerophthalmia, pharyngitis

GI: diarrhea, constipation, abdominal pain, dyspepsia, dry mouth

GU: dysuria, urinary retention or frequency, urinary tract infection

Musculoskeletal: joint pain

Skin: dry skin

Other: weight gain, flulike symptoms, infection, anaphylaxis, angioedema

Interactions

Drug-drug. Clarithromycin, erythromycin, itraconazole, ketoconazole, miconazole: inhibited metabolism and increased effects of tolterodine

Drug-food. Any food: increased drug bioavailability

Patient monitoring

Monitor patient for anaphylaxis and angioedema with first or subsequent doses. If difficulty breathing, upper airway obstruction, or fall in blood pressure occurs, discontinue drug and promptly provide appropriate treatment.

Monitor patient for signs and symptoms of anticholinergic CNS effects, particularly after beginning treatment or increasing dosage. Consider dosage reduction or drug discontinuation if symptoms occur.
• Monitor bladder function.
• Assess blood pressure and stay alert for chest pain.
• Monitor neurologic status. Report paresthesia or visual impairment.

Patient teaching

• Tell patient to take with food.
• If patient takes extended-release form, instruct him not to chew or crush it.

Instruct patient how to recognize and immediately report signs and symptoms of anaphylaxis or angioedema.
• Caution patient not to drive or operate heavy machinery until drug's effects are known.
• Advise patient to use sugarless gum or hard candy to relieve dry mouth.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and foods mentioned above.

tolterodine

/tol·ter·o·dine/ (tol-ter´ah-dēn) an antispasmodic used in the treatment of bladder hyperactivity.

tolterodine

a muscarinic receptor antagonist.
indications It is used to treat overactive bladder (frequency and urgency). It controls bladder incontinence by controlling contractions.
contraindications Factors that prohibit its use include known hypersensitivity, uncontrolled narrow-angle glaucoma, urinary retention, and gastric retention.
adverse effects Adverse effects include paresthesia, fatigue, headache, chest pain, hypertension, vision abnormalities, xerophthalmia, abdominal pain, constipation, dry mouth, dyspepsia, dysuria, urinary retention, urinary frequency, urinary tract infection, rash, pruritus, bronchitis, cough, pharyngitis, and upper respiratory infection. Common side effects include anxiety, dizziness, nausea, vomiting, and anorexia.

tolterodine

Detrol® Urology An agent used to manage overactive bladder Contraindications Urinary retention, gastric retention, narrow-angle glaucoma
References in periodicals archive ?
Prescriptions were tracked for the following target drugs: mirabegron, fesoterodine, oxybutynin ER, oxybutynin IR, solifenacin, and tolterodine ER.
Failure Oxybutynin (Ditropan) 5 mg, 2-3 times per day to store Tolterodine 4 mg, daily (Detrusitol SR) Trospium (Uricon) 20 mg, twice daily Darifenacin(Enablex) 7.
tolterodine; dry mouth and constipation were more likely with oxybutynin than with tolterodine.
Recommended doses are as follows (before going to bed at night): 2 mg tolterodine or 5 mg oxybutirine or 0,4 mg/kg propiverine.
Tolterodine, trospium klorid, propiverin hidroklorid ve darifenasin calismalarina ait veriler, her ne kadar sonuclar ayri olarak degerlendirilmemis olsa da yasli insanlari da icermektedir.
1996) Bladder and bowel Oxybutynin and tolterodine (Ortho-McNeil dysfunction Pharmaceutical, Inc.
Patients may benefit from anticholinergic/ antimuscarinic drugs such as desmopressin nasal spray or tablets, tolterodine (Detro [R]), oxybutynin (Ditropan [R]), or imipramine (Tofranil [R]).
If a patient has a hyper-reflexic bladder, a urinary tract antispasmodic such as oxybutynin or tolterodine may be used to relax the bladder wall and allow for adequate bladder filling before the patient performs intermittent self-catheterisation.
The more recent drugs, oxybutynin and tolterodine, have appeared to be equally efficacious in treating the symptoms of OAB in clinical trials; however, tolterodine has proven to be better tolerated with fewer adverse effects.
Pharmacotherapy (anticholinergic medication) includes any form of oxybutynin, tolterodine, trospium chloride, solfenacin, or darifenacin.
Anticholinergic (antimuscarinic) agents, including tolterodine and oxybutynin, are indicated for the treatment of bladder overactivity and are sometimes prescribed off-label for SUI.