Pregnancy Risk Category C
How supplied
Tablets: 1 mg, 2 mg
Action
A competitive muscarinic receptor antagonist. Both urinary bladder contraction and salivation are mediated via cholinergic muscarinic receptors.
Indications & dosage
Overactive bladder in patients with symptoms of urinary frequency, urgency, or urge incontinence--
Adults: 2 mg P.O. b.i.d. Dose may be lowered to 1 mg P.O. b.i.d. based on patient response and tolerance.
Adjust-a-dose: For adults with significantly reduced hepatic function or in those who are currently taking drug that inhibits cytochrome P-450 3A4 isoenzyme system, 1 mg P.O. b.i.d.
Adverse reactions
CNS: dry mouth, fatigue, paresthesia, vertigo, dizziness, headache, nervousness, somnolence.
CV: hypertension, chest pain.
EENT: abnormal vision, xerophthalmia, pharyngitis, rhinitis, sinusitis.
GI: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea, vomiting.
GU: dysuria, micturition frequency, urine retention, urinary tract infection.
Metabolic: weight gain.
Musculoskeletal: arthralgia, back pain.
Respiratory: bronchitis, coughing, upper respiratory tract infection.
Skin: pruritus, rash, erythema, dry skin.
Other: flulike syndrome, falls, fungal infection, infection.
Interactions
Drug-drug. Antifungal drugs (itraconazole, ketoconazole, miconazole), cytochrome P-450 3A4 inhibitors (such as macrolide antibiotics [clarithromycin, erythromycin]): effects haven't been studied. However, tolterodine doses above 1 mg b.i.d. shouldn't be given concurrently.
Fluoxetine: increased tolterodine levels. Avoid concomitant use.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug or its components and in those with uncontrolled narrow-angle glaucoma or urine or gastric retention.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING