Detrol, Detrol LA
Classifications: anticholinergic agent; muscarinic receptor antagonist; Therapeutic: anticholinergic agent; antimuscarinic agent; muscarinic receptor antagonist
Pregnancy Category: C
1 mg, 2 mg tablets; 2 mg, 4 mg sustained release
Selective muscarinic urinary bladder receptor antagonist. Reduces urinary incontinence, urgency, and frequency.
Controls urinary bladder incontinence by controlling contractions.
Overactive bladder (urinary frequency, urgency, urge incontinence).
Gastric retention; hypersensitivity to tolterodine; uncontrolled narrow-angle glaucoma; urinary retention; pregnancy (category
Cardiovascular disease; liver disease; controlled narrow-angle glaucoma; urinary retention; severe hepatic impairment; obstructive
GI disease; obstructive uropathy; paralytic ileus or intestinal atony; renal impairment; ulcerative colitis.
Route & Dosage
Adult: PO 2 mg b.i.d. or 4 mg sustained release q.d.
May decrease to 1 mg b.i.d. or 2 mg sustained release q.d. in those with significantly reduced liver function.
- Do not crush or chew sustained release tablets. These must be swallowed whole.
- Do not give doses >1 mg b.i.d. to those with significantly reduced liver function or concurrently receiving macrolide antibiotics,
azole antifungal agents, or other cytochrome P450 3A4 inhibitors.
- Store at 20°25° C (68°77° F) in a tightly closed container.
Adverse Effects (≥1%) Body as a Whole:
Back pain, fatigue
, flu-like syndrome
, falls, arthralgia
, weight gain. CNS:
Headache, paresthesias, vertigo, dizziness, nervousness, somnolence. CV:
Chest pain, hypertension. GI: Dry mouth,
, abdominal pain, diarrhea
, flatulence, nausea, vomiting. Urogenital:
Dysuria, micturition frequency, urinary retention, UTI. Respiratory: Bronchitis
, cough, pharyngitis, rhinitis, sinusitis
, URI. Skin:
Pruritus, rash, erythema
, dry skin. Special Senses:
Dry eyes, vision abnormalities.
Additive anticholinergic effects with amantadine, amoxapine, bupropion, clozapine, cyclobenzaprine, disopyramide, maprotiline, olanzapine, orphenadrine, sedating h1-blockers
, tricyclic antidepressants
. Increased effects with clarithromycin, cyclosporine, erythromycin, itraconazole,
or ketoconazole. Food: Grapefruit juice
may increase tolterodine
levels in some patients.
77% absorbed, significantly decreased with food. Peak:
12 h. Distribution:
96% protein bound. Metabolism:
In liver by cytochrome P450 2D6 enzymes to active metabolite
77% in urine, 17% in feces. Half-Life:
Assessment & Drug Effects
- Monitor intraocular pressure more frequently with glaucoma patients.
- Monitor vital signs carefully (HR and BP), especially in those with cardiovascular disease.
Patient & Family Education
- Notify physician promptly if you experience eye pain, rapid heartbeat, difficulty breathing, skin rash or hives, confusion,
- Report blurred vision, sensitivity to light, and dry mouth (all common adverse effects) to physician if bothersome.
- Avoid the use of alcohol or OTC antihistamines.