Tolterodine

Brand Name(s): Detrol®, Detrol® LA; also available generically

WHY is this medicine prescribed?

Tolterodine is used treat overactive bladder (a condition in which the bladder muscles contract uncontrollably and cause frequent urination, urgent need to urinate, and inability to control urination). Tolterodine is in a class of medications called antimuscarinics. It works by relaxing the bladder muscles preventing bladder contraction.

HOW should this medicine be used?

Tolterodine comes as a tablet and an extended-release (long-acting) capsule to take by mouth. The tablet is usually taken twice a day. The extended-release capsule is usually taken once a day with liquids. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tolterodine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release capsules whole; do not split, chew, or crush them.

Are there OTHER USES for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking tolterodine,

• tell your doctor and pharmacist if you are allergic to tolterodine, fesoterodine fumarate (Toviaz), any other medications, or any of the ingredients in tolterodine tablets or extended-release capsules. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Nexterone, Pacerone); antihistamines; atazanavir (Reyataz, in Evotaz); clarithromycin; cyclosporine (Gengraf, Neoral, Sandimmune); donepezil (Aricept, in Namzaric); erythromycin (E.E.S., Ery-Tab, others); galantamine (Razadyne); itraconazole (Onmel, Sporanox. Tolsura); medications for irritable bowel disease, motion sickness, or Parkinson's disease; ketoconazole; procainamide; quinidine (in Nuedexta); ritonavir (Norvir, in Kaletra, Technivie, Viekira); rivastigmine (Exelon); saquinavir (Invirase); sotalol (Betapace, Sorine, Sotylize); and vinblastine . Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had glaucoma (increased pressure in the eye that may cause vision loss), urinary retention (inability to empty your bladder completely or at all), or gastric retention (slow emptying of your stomach).Your doctor may tell you not to take tolterodine.
• tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death), or if you have or have ever had bladder problems, stomach or bowel problems including problems with constipation, myasthenia gravis (a disorder of the nervous system that causes muscle weakness), or kidney or liver disease..
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking tolterodine, call your doctor.
• you should know that tolterodine may make you dizzy or drowsy, or cause blurred vision or other vision problems. Do not drive a car or operate machinery until you know how this medication affects you.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Tolterodine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dry mouth
• heartburn
• headache
• constipation
• diarrhea
• dry eyes
• dry skin
• joint pain
• abdominal pain
• excessive tiredness
• difficulty emptying the bladder
• painful urination
• weight gain
• anxiety

• swelling of the face, throat, tongue, lips, and eyes
• difficulty swallowing or breathing

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• confusion
• dry mouth

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

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