tolterodine

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Related to Detrol: Detrol la

tolterodine

 [tol-ter´ah-dēn]
an antispasmodic agent used in treatment of bladder hyperactivity.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

tolterodine

Detrol, Detrol LA, Detrusitol (UK), Detrusitol XL (UK)

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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

tolterodine

Detrol® Urology An agent used to manage overactive bladder Contraindications Urinary retention, gastric retention, narrow-angle glaucoma
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
Tolterodine Tartrate ER Capsules are reportedly the generic version of Pfizer's Detrol LA, and are indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency and frequency.
* Anticholinergic drugs, such as oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura) or solifenacin (Vesicare)
(217) For example, I would try to convince the physician by stating: "Detrol LA may reduce the number of trips your patient has to make to the bathroom, but a common side effect is dry mouth and the product is contraindicated in patients with urinary retention" or "this insurance company is covering Lipitor at third-tier now so your patients will have to pay forty-five to fifty dollars a month, instead of the fifteen to twenty dollars that they were paying.
The most commonly used antimuscarinic agent was tolterodine extended release (Detrol LA) with 4,716 prescriptions.
There are seven anticholinergics that are used as antispasmodics for the treatment of overactive bladder: darifenacin (Enablex) [C], fesoterodine (Toviaz) [C], flavoxate (Urispas) [B], oxybutynin (Ditropan) [B], solifenacin (Vesicare) [C], tolterodine (Detrol) [C], and trospium (Sanctura) [C].
Anticholinergics, such as Ditropan (oxybutynin) and Detrol (tolterodine), tend to cause dry mouth.
The medicine may have about $500 million in peak annual sales and will compete with Pfizer's Detrol and Detrol LA, which work similarly and had combined sales of $1.2 billion last year, analysts have said.
The company then paid some of these doctors to write articles about this new disease and how the company's drug Detrol worked to remedy it.
Samantha Jones is director of government relations for the Detrol: Regional Chamber.
You may have thought that taking multiple trips to the bathroom was something that you just had to "deal with" as you got older, until you saw the commercial for the overactive bladder drug Detrol with the catchy theme song, "Gotta go, gotta go, gotta go right now." Treatment with Detrol isn't appropriate for everyone, but the ad lets people know that increased urinary frequency is a treatable condition.
Or a little over - for the AA give the total bill for running a 1500cc car, on 4-star detrol. at 73p a gallon, over 10,000 miles in the year, as pounds 1,183.
Other commonly used and helpful nonspecific treatments include urinary analgesics to reduce bladder pain such as phenazopyridine hydrochloride (Pyridium), anticholinergic/antispasmodic therapies (Ditropan, Detrol, Levbid) to decrease frequency and urgency, and on occasion muscle relaxants such as Valium and Flexeril to reduce pelvic floor muscle spasticity.

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