Tolterodine

Tolterodine is prescribed for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.

• Tolterodine is available under the following different brand names: Detrol, and Detrol LA.

Tablet, immediate release

• 1 mg
• 2 mg

Capsule, extended-release

• 2 mg
• 4 mg

Dosage Considerations – Should be Given as Follows:

Overactive Bladder, Urge Incontinence)

• Immediate release: 2 mg orally every 12 hours
• Extended-release: 2-4 mg orally once daily

Renal impairment

• CrCl 10-30 mL/minute: Not to exceed 1 mg orally every 12 hours (immediate-release) or 2 mg orally once daily (extended-release)
• CrCl less than 10 mL/minute: Not recommended

Hepatic impairment

• Mild to moderate (Child-Pugh class A or B): Not to exceed 1 mg orally every 12 hours (immediate-release) or 2 mg orally once daily (extended-release)
• Severe (Child-Pugh class C): Not recommended

Strong CYP3A4 inhibitors

• Not to exceed 1 mg orally every 12 hours (immediate-release) or 2 mg orally once daily (extended-release)

Not recommended for pediatric use

Common side effects of tolterodine include:

• Dry mouth
• Blurred vision
• Constipation
• Dizziness
• Drowsiness
• Indigestion
• Headache
• Dry eyes
• Diarrhea
• Stomach pain or upset
• Joint pain

Serious side effects of tolterodine include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Tolterodine has no known severe interactions with other drugs.
• Serious interactions of tolterodine include:
  • carbamazepine
  • cimetidine
  • clarithromycin
  • erythromycin base
  • erythromycin ethylsuccinate
  • erythromycin lactobionate
  • erythromycin stearate
  • fluoxetine
  • idelalisib
  • itraconazole
  • ivacaftor
  • ketoconazole
  • mefloquine
  • nefazodone
  • paroxetine
  • pramlintide
  • rifabutin
  • rifampin
  • St. John's wort
• Tolterodine has moderate interactions with at least 196 different drugs.
• Tolterodine has mild interactions with at least 30 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains tolterodine. Do not take Detrol or Detrol LA if you are allergic to tolterodine or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Urinary or gastric retention
• Uncontrolled narrow-angle glaucoma
• Hypersensitivity to drug or ingredients or to fesoterodine fumarate, which is metabolized to 5-hydroxymethyl tolterodine

Effects of Drug Abuse

• None

Short-Term Effects

• Anticholinergic central nervous system effects (e.g., dizziness, somnolence) reported; patients should not drive or operate heavy machinery until they adjust to therapy
• See "What Are Side Effects Associated with Using Tolterodine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Tolterodine?"

Cautions

• Controlled narrow-angle glaucoma, bladder outflow obstruction, gastrointestinal obstruction, hepatic or renal impairment
• Anaphylaxis and angioedema necessitating hospitalization and emergency treatment reported with first or subsequent doses
• Anticholinergic central nervous system effects (e.g., dizziness, somnolence) reported; patients should not drive or operate heavy machinery until they adjust to therapy
• Use with caution in patients with myasthenia gravis, which is characterized by decreased cholinergic activity at the neuromuscular junction
• When coadministered with strong CYP3A4 inhibitors, tolterodine should be given at a reduced dosage

Pregnancy and Lactation

• Use tolterodine with caution during pregnancy if benefits outweigh risks
• Animal studies show risk and human studies are not available or neither animal nor human studies were done
• It is unknown whether tolterodine is distributed in breast milk
• Do not nurse while using tolterodine