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 ?
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.
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.
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.
Or a little over - for the AA give the total bill for running a 1500cc car, on 4-star detrol.
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.
While the investigators did not reveal conflict-of-interest information, one of the study's authors is an employee of Pfizer Worldwide Research, whose parent company distributes extended-release tolterodine under the brand name Detrol LA.
In addition to Sanctura, Ditropan, available in generic formulations, and Ditropan XL (extended release oxybutynin), the other anticholinergics approved for OAB are Detrol and Detrol LA (regular and long-acting tolterodine) and Oxytrol (oxybutynin transdermal patch).
Reynolds' physician recommended Detrol LA, a prescription medication that helps control involuntary contractions of the bladder muscle--the cause of the strong, sudden urges.
Source: Med Ad News; McKinsey analysis Total DTC spending, Includes $ million Pravachol 67 Fosamax 30 Prozac 23 BuSpar 22 Serevent 22 Propecia 104 Meridia 73 Lipitor 72 Nasonex 71 Detrol 54
Some common ones are Detrol, Cyctospaz, Ditropan, and Levsin.
Detrol (tolterodine tartrate tablets), approved in March 1998, calms overactive bladders by reducing bladder muscle contractions.
Three new brands pushed into the DTC top 10 as of last March: Detrol with $46 million in ads; Viagra with $45 million; and Zomig with $43 million.