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- What is tolterodine, and how does it work (mechanism of action)?
- What are the side effects of tolterodine?
- What is the dosage for tolterodine?
- Which drugs or supplements interact with tolterodine?
- Is tolterodine safe to take if I'm pregnant or breastfeeding?
- What else should I know about tolterodine?
What is tolterodine, and how does it work (mechanism of action)?
Tolterodine belongs to a class of drugs called cholinergic (acetylcholine) receptor blockers. It is used to treat disorders of the urinary bladder that affect urination. The urinary bladder is a muscular "bag." Urine coming from the kidneys fills the bladder and causes it to stretch like a balloon. As it stretches, pressure in the bladder increases and, when the bladder reaches a certain level of stretch, a desire to urinate is felt. Nerves in the muscular wall of the bladder release acetylcholine, a chemical that attaches to receptors on the muscle cells and causes the cells to contract (tighten). This contributes further to the increase in pressure within the bladder and the desire to urinate. At the appropriate time (for example, when a toilet is available), there is conscious relaxation of the muscle at the outlet of the bladder, and the high bladder pressure forces urine out of the bladder. Normally, urination is under conscious control; however, in some individuals normal control as well as normal sensation are lost. The desire to urinate may be felt when there is little urine in the bladder, and urination may occur without warning or control. By blocking the effect of acetylcholine on the muscle cells, tolterodine slows the build-up of pressure in the bladder, reduces the sensation to urinate, and prevents uncontrolled urination. The FDA approved tolterodine in 1998. An extended release form of tolterodine, (Detrol LA) was approved by the FDA in 2001.
What brand names are available for tolterodine?
Detrol, Detrol LA
Is tolterodine available as a generic drug?
Do I need a prescription for tolterodine?
What are the side effects of tolterodine?
The most common side effects of tolterodine are:
Tolterodine also may cause blurred vision. Caution is recommended for patients with narrow-angle glaucoma, obstruction to the flow of urine, or poor emptying of the stomach since tolterodine may worsen these medical conditions.
What is the dosage for tolterodine?
Tolterodine usually is taken twice daily. The starting dose is 1 or 2 mg twice daily. The starting dose when using long-acting tolterodine is 2 or 4 mg daily. The dose may need to be reduced for patients who have impaired liver or kidney function.
Which drugs or supplements interact with tolterodine?
Tolterodine is broken down by liver enzymes before elimination from the body. Drugs that block these liver enzymes may slow the elimination of tolterodine, raise tolterodine blood levels, and lead to side effects. The list of drugs that may interfere with the elimination of tolterodine includes erythromycin, clarithromycin (Biaxin), ketoconazole (Nizoral), itraconazole (Sporanox), cyclosporine, vinblastine, and miconazole (Monistat, Micatin). The dose of tolterodine should be reduced to 1 mg twice daily if taken with any of these drugs.
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Is tolterodine safe to take if I'm pregnant or breastfeeding?
At doses much greater than those used in humans, tolterodine causes fetal abnormalities in animals, but there are no studies with tolterodine in pregnant women. Therefore, tolterodine should only be given to pregnant women if the benefits are felt to outweigh the potential risks.
Tolterodine is secreted into breast milk in animals; however, it is not known if tolterodine is secreted into the breast milk of women. Therefore, nursing mothers should either not breast feed or discontinue tolterodine.
What else should I know about tolterodine?
What preparations of tolterodine are available?
Tablets: 1 and 2mg. Long acting capsules: 2 and 4 mg.
How should I keep tolterodine stored?
Tablets and capsules should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
Tolterodine (Detrol, Detrol LA) is a medication prescribed for the treatment of overactive bladder and urinary incontinence. Side effects, drug interactions, warnings and precautions, and pregnancy safety should be reviewed prior to taking any medication.
Related Disease Conditions
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Overactive Bladder (OAB)
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Urinary Incontinence in Children
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
Urinary Incontinence in Women
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, transient incontinence, and mixed incontinence.
Urinary Tract Infections in Children
Urinary tract infections (UTIs) are very common in children. Symptoms and signs include fever and abdominal pain. Associated symptoms and signs include flank pain, vomiting, and blood in the urine. Treatment for a UTI involves antibiotic therapy.
Nerve Disease and Bladder Control
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
People who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
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