trospium chloride


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trospium chloride

Regurin (UK), Sanctura, Sanctura XR

Pharmacologic class: Anticholinergic, antimuscarinic

Therapeutic class: Renal and genitourinary agent, antispasmodic

Pregnancy risk category C

Action

Antagonizes effects of acetylcholine on muscarinic receptors in cholinergically innervated organs, reducing bladder smooth muscle tone

Availability

Capsules (extended-release): 60 mg

Tablets: 20 mg

Indications and dosages

Overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency

Adults: 20 mg P.O. twice daily 1 hour before meals or on empty stomach, or 1 60-mg capsule daily in morning with water at least 1 hour before a meal

Dosage adjustment

• Severe renal impairment

• Patients age 75 and older

Contraindications

• Hypersensitivity to drug or its components

• Preexisting or risk of urinary or gastric retention or uncontrolled angle-closure glaucoma

Precautions

Use cautiously in:

• moderate renal impairment, moderate to severe hepatic impairment, decreased GI motility, controlled angle-closure glaucoma, clinically significant bladder outflow obstruction or GI obstructive disorders

• patients at risk for heat prostration

• elderly patients

• pregnant or breastfeeding patients

• children (safety and efficacy not established).

Administration

• Give at least 1 hour before meals or on empty stomach.

Adverse reactions

CNS: headache, fatigue, syncope, hallucinations, delirium, dizziness, drowsiness

CV: tachycardia, chest pain

EENT: dry eyes, blurred vision, dry throat

GI: vomiting, constipation (new-onset or aggravated), upper abdominal pain, dyspepsia, flatulence, abdominal distention, dry mouth

GU: urinary retention

Skin: dry skin

Other: altered taste, heat prostration, angioedema

Interactions

Drug-drug. Anticholinergics: additive anticholinergic effects

Digoxin, metformin, morphine, pancuronium, procainamide, tenofovir, vancomycin: increased blood levels of both drugs

Drug-behaviors. Alcohol use: increased risk of drowsiness

Patient monitoring

• Monitor renal and hepatic function tests.

• Monitor patient for decreased GI motility and urinary retention.

If patient has controlled angle-closure glaucoma, stay alert for severe eye pain accompanied by nausea, rainbows around lights, red eye, and blurred vision. Be prepared to treat immediately, as appropriate.

Be aware that angioedema associated with life-threatening upper airway swelling may occur. If involvement of the tongue, hypopharynx, or larynx occurs, promptly discontinue drug and provide appropriate treatment.

Patient teaching

• Instruct patient to take tablet 1 hour before meals on an empty stomach or to take capsule in morning with water at least 1 hour before a meal.

• Instruct patient not to consume alcohol within 2 hours of taking extended-release capsule.

• Advise patient to consult prescriber before taking over-the-counter products such as antihistamines because these may increase risk of side effects.

• Inform patient that drug increases risk of heat prostration; describe symptoms and advise him to seek prompt medical attention if these occur.

• Caution patient to avoid driving and other hazardous activities until drug effects are known.

• Advise patient to avoid alcohol use.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

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References in periodicals archive ?
Instead of trospium chloride, the microspheres are loaded with barium sulfate, which enables the analysis of the microstructure with a micro-computer tomography scanner ([micro]CT).
According to the company, the Trospium Chloride Extended-release Capsules is the generic equivalent to Allergan's Sanctura XR, which is indicated for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency and urinary frequency.
Efficacy of trospium chloride in patients with detrusor instability: a placebo-controlled, randomized, double blind, multicentre clinical trial.
Multicenter phase III trial studying trospium chloride in patients with overactive bladder.
Watson Pharmaceuticals Inc (NYSE: WPI), an integrated global specialty pharmaceutical company, announced on October 12 that its subsidiary, Watson Laboratories Inc Florida, has received approval for its Abbreviated New Drug Application for Trospium Chloride Extended-release Capsules, the generic equivalent to Allergan's Sanctura XR, from the United States Food and Drug Administration.
A thorough study of trospium chloride at therapeutic (20 mg BID) and supratherapeutic (up to 100 mg BID) doses revealed no change in QTc relative to placebo.
Tolterodine and trospium chloride display relatively equal affinity across receptor subtypes, suggesting that these agents are likely to bind to [M.
Sanctura[R] XR is a controlled release trospium chloride product indicated for the treatment of overactive bladder with symptoms of urge incontinence, urgency and urinary frequency.
The newer antimuscarinics for OAB - darifenacin, fesoterodine, solifenacin, tolterodine, and the quaternary ammonium compound, trospium chloride - do not appear to adversely affect cognition.
ALKS 27 is an inhaled formulation of trospium chloride using Alkermes' proprietary AIR([R]) pulmonary delivery system.
Trospium chloride is the active ingredient in SANCTURA([R]), Indevus' currently marketed product for overactive bladder.