Tolterodine

Tolterodine is a prescription medication used to treat the symptoms of an overactive bladder in adults. Tolterodine belongs to a group of drugs called antimuscarinic medications, which help the bladder muscles to relax.

This medication comes in an immediate-release tablet form and is usually taken twice a day with or without food.

It also comes in a long-acting capsule form and is usually taken once a day with water. Swallow long-acting capsules whole.

Common side effects of tolterodine include dry mouth, dizziness, and headache. 

Tolterodine is a prescription medicine for adults used to treat the following symptoms due to a condition called overactive bladder:

• urge urinary incontinence: a strong need to urinate with leaking or wetting accidents
• urgency: a strong need to urinate right away
• frequency: urinating often

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Tolterodine may be found in some form under the following brand names:

• Detrol

The most common side effects with tolterodine are:

• dry mouth
• dizziness
• headache
• stomach pain
• constipation

This is not a complete list of side effects of tolterodine. Talk to your doctor about any side effect that is bothersome or does not go away.

Tell your doctor about all the medicines you take or are planning to take includine prescription and non-prescription medicines, vitamins, and herbal supplements. If you take tolterodine with other medicines, the effects of either could be increased, decreased, or altered. Especially tell your doctor if you take:

• clarithromycin
• cyclosporin
• erythromycin
• itraconazole
• ketoconazole
• miconazole
• vinblastine

This is not a complete list of tolterodine drug interactions. Ask your doctor or pharmacist for more information.

Do not take tolterodine if you

• are not able to empty your bladder (urinary retention)
• have delayed or slow emptying of your stomach (gastric retention)
• have an eye problem called "uncontrolled narrow-angle glaucoma"
• are allergic to tolterodine or to any of its ingredients
• are allergic to Toviaz, which contains fesoterodine

Medicines like tolterodine can cause blurred vision or drowsiness. Use caution while driving or doing other dangerous activities until you know how tolterodine affects you.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of tolterodine there are no specific foods that you must exclude from your diet when receiving tolterodine.

Before starting tolterodine, tell your doctor about all of your medical and other conditions that may affect the use of tolterodine, including

• stomach or intestinal problems or problems with constipation
• problems emptying your bladder or if you have a weak urine stream
• treatment for an eye problem called narrow-angle glaucoma
• liver problems
• kidney problems
• a condition called myasthenia gravis
• if you or any family members have a rare heart condition called QT prolongation (long QT syndrome)
• if you are pregnant or trying to become pregnant. It is not known if tolterodine could harm your unborn baby.
• if you are breastfeeding. It is not known if tolterodine passes into your breast milk or if it can harm your baby. Talk to your doctor about the best way to feed your baby if you take tolterodine.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Other medicines can affect how your body handles tolterodine.

Your doctor may use a lower dose of tolterodine if you are taking:

• Certain medicines for fungus or yeast infections
• Certain medicines for bacterial infections
• Sandimmune (cyclosporine) or Velban (vinblastine)

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or if you are planning to breastfeed. It is not known if tolterodine is excreted in human breast milk or if it will harm your nursing baby.

Take tolterodine exactly as your doctor tells you to take it. Your doctor will tell you how many tolterodine tablets to take and when to take them.

• Do not change your dose unless told to do so by your doctor.
• You can take tolterodine with or without food.
• Take tolterodine at the same times each day.
• If you miss a dose of tolterodine, just take your next regular dose at your next regular time. Do not try to make up for your missed dose.
• If you take too much tolterodine, call your doctor, or go to the hospital emergency room right away.
• Swallow tolterodine long-acting capsules whole with a glass of water. Tell your doctor if you cannot swallow a capsule.

Medicines like tolterodine can cause blurred vision or drowsiness. Use caution while driving or doing other dangerous activities until you know how tolterodine affects you.

Take tolterodine exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Tolterodine immediate release tablets

The initial recommended dose of tolterodine is 2 mg twice daily. The dose may be lowered to 1 mg twice daily based on how you respond to and tolerate tolterodine.

Dosage Adjustment in Specific Populations

For patients with reduced liver or kidney function or who are currently taking certain drugs that can affect how tolterodine works in the body, the recommended dose of tolterodine is 1 mg twice daily.

Tolterodine long-acting capsules

The recommended dose of tolterodine long-acting capsules is 4 mg once daily with water and swallowed whole. The dose may be lowered to 2 mg daily based on how you respond and tolerate your medication; however, limited efficacy data are available for 2 mg.

Dosage Adjustment in Specific Populations

For patients with reduced liver or kidney function or who are currently taking certain drugs that can affect how tolterodine long-acting capsules works in the body, the recommended dose of tolterodine long-acting capsules is 2 mg once daily.

Tolterodine long-acting capsules is not recommended for use in patients with severe liver impairment or in patients with a certain degree of kidney impairment.

If you take too much tolterodine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If tolterodine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store tolterodine immediate release tablets at 25°C (77°F).
• Store tolterodine long-acting capsules at room temperature, 68° - 77°F (20° - 25°C).
• Keep it in a dry place.
• Keep tolterodine and all medicines out of the reach of children.