Details About Generic Salt ::  Tolterod

Main Medicine Class:: Urinary tract product, Muscarinic antagonist   

(tole-THE-roe-deen)
Detrol
Tablets: 1 mg, Tablets: 2 mg, Detrol LA, Capsule, extended-release: 2 mg, Capsule, extended-release: 4 mg
Class: Urinary tract product, Muscarinic antagonist

 

Drugs Class ::

 Action Antagonizes muscarinic receptor, which mediates urinary bladder contraction and salivation.

Indications for Drugs ::

 Indications Treatment of overactive bladder with symptoms of urinary frequency, urgency, or urge incontinence.

Drug Dose ::

 Route/Dosage

Immediate-Release:

ADULTS: PO 1 to 2 mg daily.

Extended-Release PO 2 to 4 mg daily.

Contraindication ::

 Contraindications Urinary retention; gastric retention; uncontrolled narrow-angle glaucoma.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Controlled Narrow-Angle Glaucoma: Use with caution. Hepatic Insufficiency: Use with caution. Renal Insufficiency: Use with caution. Urinary/Gastric Retention: Use with caution.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Hypertension. CNS: Headache; somnolence; paresthesia, nervousness (immediate-release); dizziness, anxiety (extended-release). DERMATOLOGIC: Pruritus; dry skin. EENT: Abnormal vision (accommodation abnormalities); xerophthalmia; sinusitis (extended-release). GI: Dry mouth; constipation; abdominal pain; dyspepsia; flatulence, vomiting, nausea (immediate-release).

Dysuria (extended-release). METABOLIC: Weight gain. RESPIRATORY: Bronchitis; coughing. OTHER: Chest pain; infection; fungal infection; falling (immediate-release); fatigue (extended-release).

Drug Mode of Action ::  

 Action Antagonizes muscarinic receptor, which mediates urinary bladder contraction and salivation.

Drug Interactions ::

 Interactions

Fluoxetine: Plasma levels of tolterodine may be decreased while the area under the curve of the active 5-hydroxymethly metabolite may be increased; requires no dosage adjustment.

Clarithromycin, Erythromycin, Itraconazole, Ketoconazole, Miconazole (and other cytochrome P450 3A4 inhibitors): May increase tolterodine plasma levels, which may increase activity and side effects.

Drug Assesment ::

 Assessment/Interventions

  • Obtain a complete history of prescription and otc drug use and history of hypersensitivities.
  • Assess for possible drug interactions and potential adverse reactions.
OVERDOSAGE: SIGNS & SYMPTOMS
  Dry mouth, thirst, cardiac slowing followed by acceleration, palpitations, hypertension, hypotension, inhibition of sweating, flushing, hot skin, photophobia, dilated pupils, blurred vision, speech disturbances, CNS stimulation, delirium, restlessness, drowsiness, stupor, headache, decreased intestinal peristalsis, abdominal distension, ataxia, hallucinations, seizures, coma

Drug Storage/Management ::

 Administration/Storage

  • Store at room temperature in tightly closed container.
  • Do not administer to nursing mothers and pregnant women unless the potential benefit for the mother justifies the potential risk for the fetus.
  • Do not administer > l mg dose bid to patients receiving cytochrome P450 3A4 inhibitors (ie, macrolide antibiotic and antifungal agents) or to patients with reduced hepatic function.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to take the medication as prescribed at the same time each day.
  • Advise patient that antimuscarinic agents such as tolterodine may produce side effects including blurred vision and to notify primary health care giver if side effects occur or if there are any other concerns.
  • Caution female patients to notify the health care provider immediately should they become or plan to become pregnant.

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Disclaimer ::

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