Urigen

Indications

Tolterodine tartrate is used to treat overactive bladder, with symptoms such as:

• A sudden, strong need to pass urine (urgency).
• Passing urine more often than usual (frequency).
• Leaking urine before reaching the toilet (urge incontinence).

How It Works

Tolterodine is an antimuscarinic medicine, which means it blocks the nerve signals that make the bladder muscle squeeze. This relaxes the bladder so it can hold more urine and reduces sudden urges.

Dosage and Administration

• Adults, standard tablets: usually 2 mg twice a day.
• Extended-release capsules: usually 4 mg once a day; swallow whole.
• People with liver or kidney problems, or taking certain interacting medicines: usually 1 mg twice a day (or 2 mg once a day of the extended-release form), as prescribed.
• Can be taken with or without food. The full effect may take a few weeks; the doctor will review whether it is helping.
• Not recommended for children.

Interactions

• Ketoconazole, Itraconazole, Clarithromycin, Ritonavir and similar medicines can raise its level; a lower dose is needed.
• Other medicines with anticholinergic effects (some antihistamines, antidepressants such as Amitriptyline, and medicines for Parkinson's disease) can add to dry mouth, constipation and confusion.
• It may weaken the effect of medicines that speed up stomach emptying, such as Metoclopramide and Domperidone.
• Care with medicines that can affect heart rhythm.

Contraindications

• Allergy to tolterodine or Fesoterodine.
• Inability to empty the bladder (urinary retention) or delayed stomach emptying.
• Uncontrolled narrow-angle glaucoma.
• Myasthenia gravis (a muscle weakness disease).
• Severe ulcerative colitis or toxic megacolon.

Side Effects

Common: dry mouth, constipation, headache, dizziness, drowsiness, blurred vision, dry eyes, indigestion and tiredness.

Get urgent medical help if you have:

• Inability to pass urine.
• Swelling of the face, lips, tongue or throat, or difficulty breathing.
• Eye pain with blurred vision or seeing halos (possible glaucoma attack).
• Fast or irregular heartbeat or fainting.
• Confusion, hallucinations or severe drowsiness, especially in older people.

Pregnancy and Lactation

Not recommended during pregnancy, as safety is not established. It is not known if it passes into breast milk; avoid while breastfeeding unless the doctor advises otherwise.

Precautions and Warnings

• It can cause dizziness, drowsiness or blurred vision; do not drive or use machines if affected.
• It reduces sweating, so avoid overheating in hot weather or during exercise.
• Use with care in older people and in people with liver or kidney disease, an enlarged prostate, bowel blockage, reflux, or heart rhythm problems.
• The doctor may check for other causes of urinary symptoms, such as infection, first.

Overdose

Overdose can cause severe dry mouth, flushing, fast heartbeat, enlarged pupils, inability to pass urine, agitation, confusion and hallucinations. Get emergency medical help straight away and take the pack with you.

Therapeutic Class

Urinary antispasmodic; antimuscarinic medicine.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.