VOL: 102, ISSUE: 23, PAGE NO: 27Generic and proprietary names
Generic and proprietary names
- Tolterodine is an antimuscarinic drug.
- It reduces involuntary detrusor contractions that cause urgency and urge incontinence.
- Reducing contractions increases bladder capacity and delays the desire to empty the bladder.
- Obstetrics, gynaecology, and urinary-tract disorders.
- Drugs for urinary frequency, enuresis and incontinence.
- Urinary frequency.
- Urgency and incontinence.
- Myasthenia gravis.
- Significant bladder outflow obstruction or urinary retention.
- Severe ulcerative colitis.
- Toxic megacolon.
- Gastrointestinal obstruction.
- Intestinal atony.
- Pregnancy or breastfeeding.
- Older patients, especially if frail.
- Autonomic neuropathy.
- Hiatus hernia with reflux oesophagitis.
- Hepatic or renal impairment.
- Coronary artery disease.
- Congestive heart failure.
- Arrhythmias and tachycardia.
- Prostatic hypertrophy.
- Fatigue or drowsiness.
- Chest pain.
- Dry eyes.
- Peripheral oedema.
- Dry mouth.
- Gastrointestinal disturbance.
- Blurred vision.
- Difficulty in micturition.
- Skin reactions.
- Central nervous system problems.
- Increased side-effects from anticholinergic medication if taken with tolterodine.
- Tolterodine may reduce the effects of domperidone and metoclopramide.
- Some antifungal and antibacterial medication may increase blood tolterodine levels.
- Modified release capsules.
- Children and older people are at higher risk of side-effects.
- Antimuscarinic drugs may reduce sweating, leading to heat sensations and fainting in hot environments or in patients who have fever.
- Incontinence in adults arising from detrusor instability is managed by combining drug therapy with conservative methods for managing urge incontinence, such as pelvic floor exercises and bladder training.
- Stress incontinence is generally managed by non-drug methods.
- Tolterodine can trigger glaucoma. Therefore, periodic eye testing should be performed.
- The need for continuing therapy should be reviewed after 3-6 months.
- Patients should be warned of the possible side-effects of drowsiness or disorientation and advised not to drive or undertake hazardous work if affected.
- Avoid alcohol with this medication as it increases the sedative side-effects.
Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines