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Sanctura XR(trade name),
Pregnancy Category: C
ClassificationTherapeutic: urinary tract antispasmodics
Overactive bladder with symptoms of urge urinary incontinence, urgency and urinary frequency.
Antagonizes the effect of acetylcholine at muscarinic receptors in the bladder; this parasympatholytic action reduces bladder smooth muscle tone.
Increased bladder capacity and decreased symptoms of overactive bladder.
Absorption: Less than 10% absorbed following oral administration; food significantly ↓ absorption.
Distribution: Mostly distributed to plasma.
Metabolism and Excretion: Of the 10% absorbed, 40% is metabolized. Unabsorbed drug is mainly excreted in feces. Of absorbed drug, 60% is eliminated in urine as unchanged drug via active tubular secretion.
Half-life: 20 hr.
Time/action profile (anticholinergic effects)
|PO||unknown||5–6 hr||24 hr|
Contraindicated in: Hypersensitivity;Gastric or urinary retention, uncontrolled angle-closure glaucoma or risk for these conditions.
Use Cautiously in: Bladder outflow obstruction;Gastrointestinal obstructive disorders (ulcerative colitis, intestinal atony, myasthenia gravis);Controlled angle-closure glaucoma (use only if necessary and with careful monitoring);CCr <30 mL/min (dose ↓ recommended);Moderate to severe hepatic impairment; Obstetric / Lactation: Use only if benefit justifies risks to fetus/newborn; Pediatric: Safety not established; Geriatric: May have↑ sensitivity to anticholinergic effects; ↓ dose may be required.
Adverse Reactions/Side Effects
Central nervous system
- headache (most frequent)
Ear, Eye, Nose, Throat
- blurred vision
- constipation (most frequent)
- dry mouth (most frequent)
- urinary retention
- urinary tract infection
- angioedema (life-threatening)
- heat stroke
Drug-Drug interactionMay interact with other drugs that compete for tubular secretion.Metformin may ↓ levels.↑ risk of anticholinergic effects with other drugs having anticholinergic properties.
Oral (Adults) 20 mg twice daily or 60 mg once daily (XR dose form).
Oral (Adults ≥75 yr) Based on tolerability, dose may be ↓ to 20 mg once daily.
Renal ImpairmentOral (Adults) CCr <30 mL/min—20 mg once daily at bedtime.
Availability (generic available)
Tablets: 20 mg
Extended release tablets: 60 mg
- Monitor voiding pattern and intake and output ratios.
Potential Nursing DiagnosesImpaired urinary elimination (Indications)
- Oral: Administer 1 hr prior to meals or on an empty stomach.
- Instruct patient to take as directed. If a dose is skipped, take next dose 1 hr prior to next meal.
- May cause drowsiness, dizziness, and blurred vision. Caution patient to avoid driving and other activities requiring alertness until response to medication is known. Advise patient to avoid alcohol; may increase drowsiness.
- Advise patient to notify health care professional immediately of signs and symptoms of angioedema (edema of the tongue or laryngopharynx, difficulty breathing) occur.
- Caution patient that heat prostration (fever and heat stroke due to decreased sweating) may occur when trospium is taken in a hot environment.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
- Advise female patient to notify health care professional if pregnancy is planned or suspected, or if breast feeding.
- Increased bladder capacity and decreased symptoms of overactive bladder.