Tolterodine Tartrate

A to Z Drug Facts

Tolterodine Tartrate

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(tole-THE-roe-deen)

Detrol

Tablets: 1 mg, Tablets: 2 mg, Detrol LA, Capsule, extended-release: 2 mg, Capsule, extended-release: 4 mg

Class: Urinary tract product, Muscarinic antagonist

Action Antagonizes muscarinic receptor, which mediates urinary bladder contraction and salivation.

Indications Treatment of overactive bladder with symptoms of urinary frequency, urgency, or urge incontinence.

Contraindications Urinary retention; gastric retention; uncontrolled narrow-angle glaucoma.

Route/Dosage

Immediate-Release:

ADULTS: PO 1 to 2 mg daily.

Extended-Release PO 2 to 4 mg daily.

Interactions

Fluoxetine: Plasma levels of tolterodine may be decreased while the area under the curve of the active 5-hydroxymethly metabolite may be increased; requires no dosage adjustment.

Clarithromycin, Erythromycin, Itraconazole, Ketoconazole, Miconazole (and other cytochrome P450 3A4 inhibitors): May increase tolterodine plasma levels, which may increase activity and side effects.

Lab Test Interferences None well documented.

Adverse Reactions

CARDIOVASCULAR: Hypertension. CNS: Headache; somnolence; paresthesia, nervousness (immediate-release); dizziness, anxiety (extended-release). DERMATOLOGIC: Pruritus; dry skin. EENT: Abnormal vision (accommodation abnormalities); xerophthalmia; sinusitis (extended-release). GI: Dry mouth; constipation; abdominal pain; dyspepsia; flatulence, vomiting, nausea (immediate-release).

Dysuria (extended-release). METABOLIC: Weight gain. RESPIRATORY: Bronchitis; coughing. OTHER: Chest pain; infection; fungal infection; falling (immediate-release); fatigue (extended-release).

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Controlled Narrow-Angle Glaucoma: Use with caution. Hepatic Insufficiency: Use with caution. Renal Insufficiency: Use with caution. Urinary/Gastric Retention: Use with caution.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Store at room temperature in tightly closed container.
Do not administer to nursing mothers and pregnant women unless the potential benefit for the mother justifies the potential risk for the fetus.
Do not administer > l mg dose bid to patients receiving cytochrome P450 3A4 inhibitors (ie, macrolide antibiotic and antifungal agents) or to patients with reduced hepatic function.

Assessment/Interventions

Obtain a complete history of prescription and otc drug use and history of hypersensitivities.
Assess for possible drug interactions and potential adverse reactions.

OVERDOSAGE: SIGNS & SYMPTOMS
	Dry mouth, thirst, cardiac slowing followed by acceleration, palpitations, hypertension, hypotension, inhibition of sweating, flushing, hot skin, photophobia, dilated pupils, blurred vision, speech disturbances, CNS stimulation, delirium, restlessness, drowsiness, stupor, headache, decreased intestinal peristalsis, abdominal distension, ataxia, hallucinations, seizures, coma

Patient/Family Education

Instruct patient to take the medication as prescribed at the same time each day.
Advise patient that antimuscarinic agents such as tolterodine may produce side effects including blurred vision and to notify primary health care giver if side effects occur or if there are any other concerns.
Caution female patients to notify the health care provider immediately should they become or plan to become pregnant.

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