Tolterodine Overview and Guidelines

Brand and Generic Names

• Brand name: Detrol
• Generic name: Tolterodine

Indications

• Primarily used for managing overactive bladder.
• Symptoms treated include urinary frequency, urgency, and urge incontinence.

Dosing Guidelines

• Recommended starting dose for adults: 4 mg daily.
• Dosage can be adjusted based on effectiveness and tolerability.
• Patients with hepatic impairment or those taking CYP3A4 inhibitors should use 1 mg twice daily or 2 mg once daily.

Available Dosage Forms

• Tablets available in strengths of 1 mg and 2 mg.
• Extended-release capsules (LA) available in strengths of 2 mg and 4 mg.

Medication Classification

• Classified as a urinary bladder modifier.

Mechanism of Action

• Acts as a competitive muscarinic receptor antagonist.
• Results in:
  • Increased residual urine, indicating incomplete bladder emptying.
  • Reduced detrusor pressure.

Drug Interactions

• CYP3A4 inhibitors (like ketoconazole and erythromycin) can elevate tolterodine plasma levels in poor metabolizers.

Side Effects

• Common side effects include:
  • Dry mouth
  • Headache
  • Dizziness
  • Constipation
  • Dyspepsia
  • Somnolence
  • Blurred vision

Contraindications

• Contraindicated in:
  • Urinary or gastric retention
  • Uncontrolled narrow-angle glaucoma
  • Hypersensitivity to any components
  • Patients with significant bladder outflow obstruction or pyloric stenosis.
• Caution advised in patients with impaired hepatic or renal function.
• Discontinuation during nursing is recommended due to pregnancy risk category C.

Patient Counseling Tips

• Warn patients about the potential for dizziness or drowsiness; advise caution with machinery.
• Recommend avoiding alcohol during treatment.
• Inform patients about the possibility of dry mouth and blurred vision.
• Advise storing the medication in a cool, dry place away from children.
• Instruct to contact a physician for severe or persistent side effects.
• Advise that if a dose is missed, it should be skipped rather than doubled.

This quiz covers essential information about Tolterodine, including its brand name, indications for use, dosing guidelines, and available dosage forms. The quiz also examines the mechanism of action and potential drug interactions, making it crucial for understanding this urinary bladder modifier.