Drug Index

Tolterodine

 
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Mechanism :

Tolterodine is a competitive muscarinic receptor antagonist. Both urinary bladder contraction and salivation are mediated via cholinergic muscarinic receptors.


Indication :

• Urinary Urgency

• Urinary incontinence

• Urinary frequency


Contraindications :

Contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma, and in patients who have demonstrated hypersensitivity to the drug or its ingredients. Caution in liver and renal impairment.


Dosing :

<35 kg: 2 mg/day PO once daily.

>35 kg: 4 mg/day PO once daily.

Usually effective within 4 weeks.


Adverse Effect :

Frequently seen adverse reactions include constipation, dyspepsia, nausea, abdominal discomfort. Dry mouth, blurred vision, drowsiness, paraesthesia, dry skin, facial flushing, headache and dizziness may also occur.


Interaction :

Ketoconazole: An inhibitor of the drug metabolizing enzyme CYP3A4, significantly increased plasma concentrations of tolterodine when coadministered to subjects who were poor metabolizers.
Macrolide antibiotics: Avoid use with macrolide antibiotics.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
30-50Dose as in normal renal function. Use with caution
10-301 mg twice daily. Use with caution
<101 mg twice daily. Use with caution

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnlikely to be dialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as in GFR=10–30 mL/min

Hepatic Dose :

For immediate release tablet: Use cautiously. The dose is halved
For extended release formulation:
Mild to moderate hepatic impairment: dose is halved.
Severe hepatic impairment: Do not use the drug.
04/07/2020 01:11:30 Tolterodine
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