Tolterodine

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Generic Name: Tolterodine Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Tolterodine used for?

Tolterodine is used to treat an overactive bladder. By relaxing the muscles in the bladder, tolterodine improves your ability to control your urination. It helps to reduce leaking of urine, feelings of needing to urinate right away, and frequent trips to the bathroom. This medication belongs to the class of drugs known as antispasmodics.

How should I take Tolterodine?

Take this medication by mouth with or without food as directed by your doctor, usually once a day. Swallow the medication whole with a full glass of liquid. Do not crush or chew the medication. Doing so can destroy the long action of the drug and may increase side effects.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. The dosage is based on your medical condition (especially kidney and liver disease), response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Ask your doctor or pharmacist for more details.

Do not increase your dose or take this medication more often than directed. Your condition will not improve any faster and your risk of serious side effects may be increased.

Tell your doctor if your condition persists or worsens.

How do I store Tolterodine?

Tolterodine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Tolterodine in the bathroom or the freezer. There may be different brands of Tolterodine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Tolterodine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Tolterodine?

Before taking tolterodine, tell your doctor or pharmacist if you are allergic to it; or to fesoterodine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: problems emptying your bladder (urinary retention, bladder outflow obstruction), severe blockage of stomach/intestines (gastric retention), glaucoma, stomach/intestinal disease (such as ulcerative colitis, slowed movement of stomach/intestines), severe constipation, kidney disease, liver disease, a certain muscle disease (myasthenia gravis).

Tolterodine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using tolterodine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using tolterodine safely.

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above), drowsiness, confusion, constipation, or trouble urinating. Drowsiness and confusion can increase the risk of falling.

This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Tolterodine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Tolterodine. Tolterodine is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Tolterodine?

Dry mouth, dry eyes, headache, constipation, stomach upset/pain, dizziness, drowsiness, tiredness, or blurred vision may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a laxative (such as a stimulant-type with stool softener).

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: vision changes, severe stomach/abdominal pain, trouble urinating, signs of kidney infection (such as burning/painful urination, lower back pain, fever).

Get medical help right away if you have any very serious side effects, including: fast/slow/irregular heartbeat, severe dizziness, fainting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Tolterodine?

Some products that may interact with this drug include: anticholinergic drugs (such as atropine, scopolamine), other antispasmodic drugs (such as dicyclomine, propantheline), certain anti-Parkinson’s drugs (such as benztropine, trihexyphenidyl), belladonna alkaloids, potassium tablets/capsules, pramlintide.

Many drugs besides tolterodine may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as erythromycin), among others.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Tolterodine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Tolterodine?

Tolterodine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

What health conditions may interact with Tolterodine?

Tolterodine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Tolterodine.

What is the dose of Tolterodine for an adult?

Usual Adult Dose for Urinary Incontinence

Immediate release tablets:

-Initial dose: 2 mg orally 2 times a day

-Maintenance dose: 1 to 2 mg orally 2 times a day, depending on patient response and tolerability

Extended release capsules:

-Initial dose: 4 mg orally once a day

-Maintenance dose: 2 to 4 mg orally once a day, depending on patient response and tolerability

Comments:

-This drug can be taken with or without food.

-The extended release formulation should be swallowed whole.

Use: For the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and frequency

Usual Adult Dose for Urinary Frequency

Immediate release tablets:

-Initial dose: 2 mg orally 2 times a day

-Maintenance dose: 1 to 2 mg orally 2 times a day, depending on patient response and tolerability

Extended release capsules:

-Initial dose: 4 mg orally once a day

-Maintenance dose: 2 to 4 mg orally once a day, depending on patient response and tolerability

Comments:

-This drug can be taken with or without food.

-The extended release formulation should be swallowed whole.

Use: For the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and frequency

Renal Dose Adjustments

-Severe renal impairment (CrCl 10 to 30 mL/min):

Tablets: 1 mg orally 2 times a day

Extended release capsules: 2 mg orally once a day

-End stage renal disease (CrCl less than 10 mL/min):

Use is not recommended

Liver Dose Adjustments

-Mild to moderate hepatic impairment (Child-Pugh Class A or B):

Immediate release formulation: 1 mg orally 2 times a day

Extended release formulation: 2 mg orally 2 times a day

-Severe hepatic impairment (Child-Pugh Class C):

Not recommended

Dose Adjustments

Concomitant use of potent CYP450 3A4 inhibitors:

Immediate release formulation: 1 mg orally 2 times a day

Extended release formulation: 2 mg orally once a day

Other Comments

Administration advice:

-This drug can be taken with or without food.

General:

-Treatment effect should be reevaluated after 2 to 6 months.

What is the dose of Tolterodine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Tolterodine available?

Tolterodine is available in the following dosage forms and strengths:

  • Oral tablet,
  • Oral capsule, extended release.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Tolterodine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: November 8, 2018 | Last Modified: November 8, 2018

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