Sanctura, Sanctura XR
Classifications: anticholinergic; antimuscarinic; antispasmodic; Therapeutic:anticholinergic; antispasmodic; urinary smooth muscle relaxant
Prototype: Ipratropium bromide
Pregnancy Category: C
20 mg tablets; 60 mg extended release capsule
Antagonizes the effect of acetylcholine on muscarinic receptors in smooth muscle. Its parasympatholytic action reduces the
tonus of the smooth muscle of the bladder.
Trospium decreases urinary frequency, urgency, and urge incontinence in patients with overactive bladders.
Treatment of overactive (neurogenic) bladder with symptoms of urgency, frequency, and urge urinary incontinence.
Hypersensitivity to trospium; patients with or at risk for urinary retention; uncontrolled narrow-angle glaucoma; gastric
tension, GI obstruction, ileus, pyloric stenosis, toxic megacolon, severe ulcerative colitis; pregnancy (category C). Safety
and effectiveness in children have not been established.
Significant bladder obstruction, closed-angle glaucoma; BPH; ulcerative colitis, GERD, intestinal atony; myasthenia gravis,
autonomic neuropathy; moderate or severe hepatic dysfunction; severe renal insufficiency, renal failure; glaucoma; older
Route & Dosage
Adult: PO 20 mg twice daily OR 60 mg (extended release) daily
Geriatric (≥75 y): PO 20 mg once daily at bedtime if anticholinergic adverse effects are intolerable
Clcr <30 mL/min: 20 mg once daily at bedtime
- Give at least 1 h before meals or on an empty stomach.
- Store at 20°25° C (66°77° F).
Adverse Effects (≥1%) Body as a Whole: Fatigue
Headache. GI: Dry mouth, constipation,
abdominal pain, dyspepsia, flatulence. Special Senses:
Dry eyes. Urogenital:
Increased anticholinergic adverse effects with anticholinergic agents
<10% absorbed orally. Peak:
56 h. Elimination:
Primarily in feces (unabsorbed dose), renal
tubular secretion of absorbed dose. Half-Life:
Assessment & Drug Effects
- Monitor bowel and bladder function. Report urinary hesitancy or significant constipation.
- Withhold drug and notify physician if urinary retention develops.
- Monitor for and report worsening of GI symptoms in those with GERD.
- Frequent monitoring of IOP is required in those with controlled narrow-angle glaucoma.
Patient & Family Education
- Report promptly any of the following: signs of an allergic reaction, (e.g., itching or hives), blurred vision or difficulty
focusing, confusion, dizziness, difficulty passing urine.
- Moderate intake of tea, coffee, caffeinated sodas, and alcohol to minimize side effects of this drug.
- Avoid situations in which overheating is likely, as drug may impair sweating, which is a normal cooling mechanism.
- Do not engage in hazardous activities until response to the drug is known.