Generic drug: fesoterodine fumarate
Brand name: Toviaz
What is Toviaz (fesoterodine fumarate), and how does it work?
Toviaz (fesoterodine fumarate) is a prescription medicine used in adults to treat symptoms of a condition called overactive bladder, including:
- Urge urinary incontinence — leaking or wetting accidents due to a strong need to urinate,
- Urinary urgency — having a strong need to urinate right away,
- Urinary frequency — having to urinate too often.
Toviaz has not been studied in children.
What are the side effects of Toviaz?
Toviaz may cause allergic reactions that may be serious. Symptoms of a serious allergic reaction may include swelling of the face, lips, throat or tongue. If you experience these symptoms, you should stop taking Toviaz and get emergency medical help right away.
The most common side effects of Toviaz are:
Toviaz may cause other less common side effects, including:
- Dry eyes
- Trouble emptying the bladder
Tell your doctor if you have any side effects that bother you or that do not go away.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
These are not all of the possible side effects of Toviaz. For a complete list, ask your doctor.
What is the dosage for Toviaz?
The recommended starting dose of Toviaz is 4 mg once daily. Based upon individual response and tolerability, the dose may be increased to 8 mg once daily.
The daily dose of Toviaz should not exceed 4 mg in the following populations:
- Patients with severe renal impairment (CLCR <30 mL/min).
- Patients taking potent CYP3A4 inhibitors, such as ketoconazole, itraconazole, and clarithromycin.
Toviaz is not recommended for use in patients with severe hepatic impairment (Child-Pugh C).
Toviaz should be taken with liquid and swallowed whole. Toviaz can be administered with or without food, and should not be chewed, divided, or crushed.
What drugs interact with Toviaz?
- Coadministration of Toviaz with other antimuscarinic agents that produce dry mouth, constipation, urinary retention, and other anticholinergic pharmacological effects may increase the frequency and/or severity of such effects.
- Anticholinergic agents may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility.
- Doses of Toviaz greater than 4 mg are not recommended in patients taking potent CYP3A4 inhibitors, such as ketoconazole, itraconazole, and clarithromycin. Coadministration of the potent CYP3A4 inhibitor ketoconazole with fesoterodine led to approximately a doubling of the maximum concentration (Cmax) and area under the concentration versus time curve (AUC) of 5-hydroxymethyl tolterodine (5-HMT), the active metabolite of fesoterodine.
- Compared with CYP2D6 extensive metabolizers not taking ketoconazole, further increases in the exposure to 5-HMT were observed in subjects who were CYP2D6 poor metabolizers taking ketoconazole.
- There is no clinically relevant effect of moderate CYP3A4 inhibitors on the pharmacokinetics of fesoterodine.
- Following blockade of CYP3A4 by coadministration of the moderate CYP3A4 inhibitor fluconazole 200 mg twice a day for 2 days, the average (90% confidence interval) increase in Cmax and AUC of the active metabolite of fesoterodine was approximately 19% (11% -28%) and 27% (18% -36%) respectively. No dosing adjustments are recommended in the presence of moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole, diltiazem, verapamil and grapefruit juice).
- The effect of weak CYP3A4 inhibitors (e.g. cimetidine) was not examined; it is not expected to be in excess of the effect of moderate inhibitors.
- No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. Following induction of CYP3A4 by coadministration of rifampin 600 mg once a day, Cmax and AUC of the active metabolite of fesoterodine decreased by approximately 70% and 75%, respectively, after oral administration of Toviaz 8 mg. The terminal half-life of the active metabolite was not changed.
- The interaction with CYP2D6 inhibitors was not tested clinically. In poor metabolizers for CYP2D6, representing a maximum CYP2D6 inhibition, Cmax and AUC of the active metabolite are increased 1.7-and 2fold, respectively.
- No dosing adjustments are recommended in the presence of CYP2D6 inhibitors.
Drugs Metabolized By Cytochrome P450
- In vitro data indicate that at therapeutic concentrations, the active metabolite of fesoterodine does not have the potential to inhibit or induce Cytochrome P450 enzyme systems.
- In the presence of fesoterodine, there are no clinically significant changes in the plasma concentrations of combined oral contraceptives containing ethinyl estradiol and levonorgestrel.
- A clinical study has shown that fesoterodine 8 mg once daily has no significant effect on the pharmacokinetics or the anticoagulant activity (PT/INR) of warfarin 25 mg. Standard therapeutic monitoring for warfarin should be continued.
Drug-Laboratory Test Interactions
- Interactions between Toviaz and laboratory tests have not been studied.
Is Toviaz safe to use while pregnant or breastfeeding?
- There are no data with the use of Toviaz in pregnant women to inform a drug associated risk for birth defects or miscarriage.
- There is no information on the presence of fesoterodine in human milk, the effects on the breastfed child, or the effects on milk production.
- The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Toviaz and any potential adverse effects on the breastfed child from Toviaz or from the underlying maternal condition.
Latest MedicineNet News
Daily Health News
Toviaz (fesoterodine fumarate) is a prescription medicine used in adults to treat symptoms of an overactive bladder, including urge urinary incontinence, urinary urgency, and urinary frequency. Serious side effects of Toviaz include allergic reactions.
Multimedia: Slideshows, Images & Quizzes
Urinary Tract Infection (UTI) Symptoms, Diagnosis, Medication
Bladder infections can be painful and often require medical treatment. Get the latest information on urinary tract infections...
Bladder Cancer Symptoms, Stages, Treatments
Bladder cancer occurs when cancerous cells, often from the lining of the bladder, begin to multiply. Find more information about...
Urinary Incontinence in Women: Types, Causes, and Treatments for Bladder Control
Urinary incontinence in women is a common problem. Overactive bladder (OAB), stress incontinence, and urge incontinence can be...
Bladder Infections: UTI Causes, Symptoms, Treatments
Urinary Tract Infections (UTI's) can happen to anyone. Learn about symptoms, causes and home remedy treatments for bladder and...
Why Do I Pee So Often? Incontinence & Overactive Bladder
You went to the bathroom to pee just a few minutes ago. Now you need to go again. What's going on? Here are some possible reasons.
Urinary Incontinence in Men: Types, Solutions, Home Remedies, & Treatments
Male urinary incontinence has a variety of causes and treatments. Learn about bladder incontinence surgeries, medications for...
Urinary Incontinence: Foods and Drinks That Cause Overactive Bladder
What causes overactive bladder (OAB)? A natural remedy is to avoid caffeine, alcohol, and these foods. Learn the foods and...
Urinary Incontinence Quiz: Test Your Medical IQ
What is urinary incontinence and why do people develop it? Learn all you need to know with this quiz.
Urinary Tract Infection Quiz
How would you know if you had urinary tract infection (UTI)? Take the Urinary Tract Infection in Adult Quiz to learn the causes,...
Picture of Bladder
The urinary bladder is a muscular sac in the pelvis, just above and behind the pubic bone. See a picture of the Bladder and learn...
Related Disease Conditions
Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency, and frequency. Treatment involves a course of antibiotics.
Bladder Infection (Cystitis)
Bladder infection is an infection of the bladder, usually caused by bacteria or, rarely, by Candida. Certain people, including females, the elderly, men with enlarged prostates, and those with chronic medical conditions are at increased risk for bladder infection. Bladder infections are treated with antibiotics, but cranberry products and adequate hydration may help prevent bladder infections.
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.
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 Infection in Adults
Second Source article from Government
Second Source article from Government
Is a Urinary Tract Infection (UTI) Contagious?
Bacteria such as E. coli or Pseudomonas can cause a urinary tract infection (UTI). The incubation period for a UTI ranges from three to eight days.
Urinary Incontinence in Children
Second Source article from Government
Can Urinary Incontinence Be Reversed?
Urinary incontinence can happen to anyone and the severity varies depending on the age, cause, and type of urinary incontinence. Most cases of urinary incontinence can be cured or controlled with appropriate treatment.
What Foods Are Bad for Urinary Retention?
Urinary retention is a condition in which you cannot empty your bladder completely. While no direct connection exists between diet and urinary retention, certain foods may aggravate urinary retention including acidic and spicy foods, artificial sweetener and caffeinated foods.
How Can You Tell If Your Bladder Has Dropped?
The urinary bladder is a hollow organ in the pelvis that stores urine. During urination, urine leaves the bladder and exits the body through the urethra. The vagina supports the front of the bladder in women. This wall can weaken with age or get damaged during vaginal childbirth.
What Are 4 Types of Urinary Incontinence?
What is urinary continence? Learn the four different types, what causes them, and how to treat them.
Interstitial Cystitis (IC) and Painful Bladder Syndrome (PBS)
Interstitial cystitis (IC)/painful bladder syndrome (PBS) is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
Treatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
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 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.
Yeast Infection vs. Urinary Tract Infection (UTI)
Candida albicans typically causes vaginal yeast infections. Bacterial infections typically cause urinary tract infections (UTIs). Thick white cottage-cheese like vaginal discharge characterizes vaginal yeast infections. Painful, frequent urination characterize urinary tract infections. Antifungal medications treat yeast infections while prescription antibiotics treat UTIs.
How Long Will You Live if You Have Bladder Cancer?
The survival rate depends on the stage of cancer at diagnosis and other health issues. Overall, 70 to 90 percent of people with localized bladder cancer will live for at least five years or more. The physician calculates this with the help of survival rates. Survival rates indicate the percentage of people who live with a certain type of cancer for a specific time.
What Neurological Disorders Cause Loss of Bladder Control?
Loss of bladder control is urinary incontinence. Severity ranges from occasionally leaking urine while straining, coughing or sneezing to having a frequent sudden urge to urinate. The causes of neurologic urinary incontinence include multiple sclerosis, Parkinson's disease, stroke, brain tumor, spinal injury and heavy metal poisoning.
What Are the 5 Warning Signs of Bladder Cancer?
The term cancer means an uncontrolled growth of cells in the body. When cancer begins in the urinary bladder, it is called bladder cancer. The urinary bladder, often simply called the bladder, is a balloon-like organ present in the lower abdomen near the pelvis.
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.
A cystocele is also known as a fallen or prolapsed bladder. Heavy lifting and straining may cause a cystocele, which causes urine leakage and incomplete emptying of the bladder. Mild cystoceles may require no treatment, while large cystoceles may require surgery.
Sex, Urinary, and Bladder Problems of Diabetes
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
Can Bladder Cancer Be Detected With a Urine Test?
Bladder cancer is often detected when a person develops signs and symptoms. It is a highly treatable type of cancer when detected early. Although screening tests for bladder cancer are not conducted routinely, the following tests may be used to diagnose and learn more about bladder cancer:
What Is the Best Treatment for Urinary Incontinence?
Urinary incontinence is the leaking of urine from the bladder that you can’t control. There are different kinds of urinary incontinence, and not all types are permanent. Treatment for urinary incontinence may include catheters, urine drainage bags, absorbent products, toilet substitutes and skin care products.
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.
How Do You Know if You Have a Urinary Tract Infection?
Urinary tract infections can occur in both women and men. Learn the signs of urinary tract infection, what causes it, how doctors diagnose it, and what you can do to treat it.
What Causes Bladder Cancer in Females?
Bladder cancer is cancer that begins in the cells of the urinary bladder. The urinary bladder is a hollow muscular organ in the lower abdomen that is responsible for the storage of urine filtered by the kidneys. Bladder cancer is a common urologic cancer that has the highest recurrence rate of any malignancy. Bladder cancer is more common in men compared to women.
What Are The Warning Signs Of Bladder Cancer?
Bladder cancer is a tumor (uncontrolled growth of cells) that starts in your urinary bladder. The urinary bladder is a balloon-like organ present in the lower abdomen near the pelvis. Its function is to store urine coming from the kidneys through the ureters (pipe-like passageways for urine) until it is expelled from the body through the tube-like passage called the urethra.
How Do You Get Rid of a Urinary Tract Infection (UTI)?
Learn what medical treatments can help treat your urinary tract infection symptoms and help you manage this condition.
What Are the 6 Types of Urinary Incontinence?
Urinary incontinence is loss of bladder control. The severity ranges from occasionally leaking urine while straining, coughing, or sneezing or having a frequent urge to urinate that occurs suddenly. Some people may only experience occasional and minor leaks of urine, whereas others may lose small-to-moderate amounts of urine frequently.
What Is the Main Cause of Bladder Cancer?
Bladder cancer refers to the uncontrolled cell growth that begins in the bladder. This happens when an abnormal change (a mutation) in the deoxyribonucleic acid (DNA) causes the DNA to malfunction.
What Causes a Urinary Tract Infection in a Child?
What is a urinary tract infection, and how does it affect children? Learn the signs of urinary tract infection in kids, what causes it, and what you can do to treat it.
What Are the Different Stages of Bladder Cancer?
Bladder cancer is staged according to the TNM classification. TNM stands for T (tumor): It refers to the size of the original tumor. N (node): It describes whether cancer is present in the lymph nodes. M (metastasis): It refers to cancer spread to other parts of the body.
Urinary Tract Infection or Urinary Infection
The urinary system of your body includes two kidneys, two tubes (ureters), a urine sac (bladder) and an opening to expel the urine from the body (urethra). An infection of this system due to germs is called a urinary tract infection (UTI). UTI may be treated with antibiotics, especially if a kidney infection is involved.
Is Bladder Cancer Common in Females?
Bladder cancer is cancer that begins in the cells of the urinary bladder. The urinary bladder is a hollow muscular organ in the lower abdomen that is responsible for the storage of urine filtered by the kidneys. The disease is caused when deoxyribonucleic acid (DNA) in the cells of the bladder mutate or change.
Treatment & Diagnosis
- Urinary Tract Infection FAQs
- Urinary Incontinence FAQs
- What Is a Lesion in the Bladder?
- Are All Tumors in the Bladder Cancerous?
- What Is the Difference Between a Bladder Infection vs. UTI?
- Urinary Tract Infection (UTI) Symptoms
- Bladder Cancer Causes, Symptoms, and Signs
- Urinary Tract Infection (UTI) Treatment
- Urinary Incontinence: More Common Than You Think
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.