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tolterodine tartrate
Detrol

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

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