tolterodine

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Related to Detrol la: Overactive bladder

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.
Tolterodine tartrate ER capsules are the generic version of Pfizer Inc.'s Detrol LA and are indicated for the treatment of overactive bladder.
M2 EQUITYBITES-January 6, 2014-Teva Pharmaceutical Industries Ltd reports availiblity of authorised generic Detrol LA in the US
M2 PHARMA-January 6, 2014-Teva Pharmaceutical Industries Ltd reports availiblity of authorised generic Detrol LA in the US
A study in the November 15 Journal of the American Medical Association finds that a combination of two drugs--tolterodine (Detrol LA), which is used to treat urinary problems, and tamsulosin (Flomax), which is used to treat BPH symptoms--shows real benefit for treating men with overactive bladder.
In addition to Sanctura and oxybutynin--available as Ditropan and in generic formulations and as extended release oxybutynin (Ditropan XL)--the other anticholinergics approved for OAB are regular and long-acting tolterodine (Detrol and Detrol LA) and the oxybutynin transdermal patch (Oxytrol).
A study compared the two most commonly used drugs for overactive bladder, extended-release oxybutynin (Ditropan XL) and extended-release tolterodine (Detrol LA), in 790 women with urinary incontinence.
Drug Dosage Cost/Day oxybutynin 5-15 mg/day, $3.05 * (Ditropan XL) once daily (10 mg/day) tolterodine 2-4 mg/day $2.95 * (Detrol LA) once daily (4 mg/day) oxybutynin 3.9 mg/day $2.34 ** transdermal system (Oxytrol) oxybutynin 5 mg, three to $1.38 * four times (15 mg/day) daily imipramine 10-150 $1.74 * mg/day, three (75 mg/day) times daily Drug Comment[dagger] oxybutynin Extended-release formulation.
One limitation of this meta-analysis is that it did not include long-acting oxybutynin (Ditropan XL) or tolterodine (Detrol LA), which may be better tolerated.
Tolterodine Detrol, Detrol LA, IR: 2 mg twice daily.