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Tolterodine (Oral route)

Pronunciation:

tol-TER-oh-deen TAR-trate

Brand Names:

  • Detrol
  • Detrol LA

Dosage Forms:

  • Capsule, Extended Release
  • Tablet

Classifications:

Therapeutic—

Urinary Antispasmodic

Pharmacologic—

Tolterodine

Uses of This Medicine:

Tolterodine is used to treat symptoms of an overactive bladder, such as incontinence (loss of bladder control) or a frequent need to urinate.

Tolterodine belongs to the group of medicines called antispasmodics. It helps decrease muscle spasms of the bladder and the frequent urge to urinate caused by these spasms.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated that tolterodine is useful in children.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of tolterodine in the elderly. However, elderly patients are more likely to have age-related kidney or liver problems, which may require an adjustment in the dose for patients receiving tolterodine.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Piperaquine
  • Potassium

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acrivastine
  • Aripiprazole
  • Bupropion
  • Buserelin
  • Clarithromycin
  • Crizotinib
  • Dabrafenib
  • Delamanid
  • Deslorelin
  • Domperidone
  • Escitalopram
  • Fluoxetine
  • Gonadorelin
  • Goserelin
  • Histrelin
  • Ivabradine
  • Ketoconazole
  • Leuprolide
  • Metronidazole
  • Morphine
  • Morphine Sulfate Liposome
  • Nafarelin
  • Ondansetron
  • Oxymorphone
  • Pazopanib
  • Quetiapine
  • Sevoflurane
  • Triptorelin
  • Umeclidinium
  • Vandetanib
  • Vemurafenib
  • Vinflunine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Cyclosporine
  • Donepezil
  • Erythromycin
  • Galantamine
  • Itraconazole
  • Miconazole
  • Propafenone
  • Quinidine
  • Rivastigmine
  • Vinblastine
  • Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart rhythm problems (e.g., QT prolongation), or history of or
  • Intestinal or stomach problems (e.g., blockage, intestinal atony, pyloric stenosis) or
  • Myasthenia gravis (severe muscle weakness) or
  • Narrow-angle glaucoma, controlled or
  • Urinary problems (e.g., blockage)—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease (including cirrhosis)—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Liver disease, severe—Use is not recommended for patients taking tolterodine extended-release capsules.
  • Narrow-angle glaucoma, uncontrolled or
  • Stomach problems (e.g., gastric retention) or
  • Urinary retention (hard to pass urine)—Should not be used in patients with these conditions.

Proper Use of This Medicine:

Take this medicine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. Also, do not change your dose without checking first with your doctor.

This medicine comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

You may take this medicine with or without food.

Swallow the extended-release capsule whole with water. Do not crush, open, or chew it.

Take this medicine at the same time each day.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For bladder problems:
    • For oral dosage form (tablets):
      • Adults—At first, 2 milligrams (mg) two times a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (extended-release capsules):
      • Adults—4 milligrams (mg) once a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Tolterodine may cause serious types of allergic reactions, including anaphylaxis and angioedema. Anaphylaxis and angioedema can be life-threatening and require immediate medical attention. Stop using this medicine and call your doctor right away if you have a rash; itching; hoarseness; lightheadedness, dizziness, or fainting; trouble breathing; trouble swallowing; or any swelling of your hands, face, mouth, or throat after using this medicine.

This medicine may cause some people to become dizzy, drowsy, or have blurred vision. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy, not alert, or not able to see well.

This medicine may cause dryness in the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Abnormal vision, including difficulty with adjusting to distances
bloody or cloudy urine
difficult, burning, or painful urination
frequent urge to urinate
Less common
Chest pain
chills
cough
diarrhea
fever
general feeling of discomfort or illness
headache
joint pain
loss of appetite
muscle aches and pains
nausea
pain or tenderness around the eyes and cheekbones
shivering
shortness of breath or troubled breathing
sore throat
stuffy or runny nose
sweating
tightness of the chest or wheezing
trouble with sleeping
vomiting
Incidence not known
Being forgetful
bloating or swelling of the face, arms, hands, ankles, lower legs, or feet
confusion about identity, place, and time
difficulty with swallowing
dizziness
fast, pounding, or irregular heartbeat or pulse
hives
itching
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
mood or mental changes
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
seeing, hearing, or feeling things that are not there
skin rash
tingling of the hands or feet
unusual tiredness or weakness
unusual weight gain or loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Abdominal or stomach pain
constipation
drowsiness
dry eyes
dry mouth
upset stomach
Less common
Acid or sour stomach
belching
blurred vision
difficulty with moving
dizziness or lightheadedness
dry skin
fear or nervousness
feeling of constant movement of self or surroundings
heartburn
indigestion
sensation of spinning
sleepiness or unusual drowsiness
stomach discomfort
weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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